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5. SURVIVAL AND RECURRENCE OF ENDOCARDITIS FOLLOWING MECHANICAL VS. BIOLOGICAL MITRAL VALVE REPLACEMENT FOR ENDOCARDITIS IN PATIENTS AGED 40 TO 70 YEARS: DATA FROM THE INFECT-REGISTRY

Author

Salsano, A., Di Mauro, M., Labate, L., Della Corte, A., De Bonis, M., Rinaldi, M., Actis Dato, G., Nicolini, F., De Vincentiis, C., Cappabianca, G., Cugola, D., Pacini, D., Vendramin, I., Pilozzi Casado, A., Mikus, E., Onorati, F., Scrofani, R., Musumeci, F., Colli, A., Nicolardi, S., Vizzardi, E., Pantaleo, A., Villa, E., Pollari, F., Barili, F., Parolari, A., Lorusso, R., and Santini, F.

Published
2024
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6. Beating Versus Arrested Heart Isolated Tricuspid Valve Surgery: Long-term Outcomes

Author

Russo, M, Di Mauro, M, Saitto, G, Lio, A, Berretta, P, Taramasso, M, Scrofani, R, Della Corte, A, Sponga, S, Greco, E, Saccocci, M, Calafiore, A, Bianchi, G, Leviner, D, Biondi, A, Della Ratta, E, Livi, U, Sharoni, E, Werner, P, De Vincentiis, C, Di Eusanio, M, Kocher, A, Antona, C, Miraldi, F, Troise, G, Solinas, M, Maisano, F, Laufer, G, Musumeci, F, Andreas, M, Russo M., Di Mauro M., Saitto G., Lio A., Berretta P., Taramasso M., Scrofani R., Della Corte A., Sponga S., Greco E., Saccocci M., Calafiore A., Bianchi G., Leviner D. B., Biondi A., Della Ratta E., Livi U., Sharoni E., Werner P., De Vincentiis C., Di Eusanio M., Kocher A., Antona C., Miraldi F., Troise G., Solinas M., Maisano F., Laufer G., Musumeci F., Andreas M., Russo, M, Di Mauro, M, Saitto, G, Lio, A, Berretta, P, Taramasso, M, Scrofani, R, Della Corte, A, Sponga, S, Greco, E, Saccocci, M, Calafiore, A, Bianchi, G, Leviner, D, Biondi, A, Della Ratta, E, Livi, U, Sharoni, E, Werner, P, De Vincentiis, C, Di Eusanio, M, Kocher, A, Antona, C, Miraldi, F, Troise, G, Solinas, M, Maisano, F, Laufer, G, Musumeci, F, Andreas, M, Russo M., Di Mauro M., Saitto G., Lio A., Berretta P., Taramasso M., Scrofani R., Della Corte A., Sponga S., Greco E., Saccocci M., Calafiore A., Bianchi G., Leviner D. B., Biondi A., Della Ratta E., Livi U., Sharoni E., Werner P., De Vincentiis C., Di Eusanio M., Kocher A., Antona C., Miraldi F., Troise G., Solinas M., Maisano F., Laufer G., Musumeci F., and Andreas M.

Abstract

Background: Isolated tricuspid valve (TV) surgery is a rare procedure generally considered at high risk for perioperative mortality and poor long-term outcomes. Surgical treatment can be performed with either an arrested heart (AH) or beating heart (BH) technique. The aim of this study was to compare the outcomes of isolated tricuspid surgery with 2 different approaches. Methods: The Surgical-Tricuspid Study is a multicenter international retrospective study enrolling adult patients who underwent isolated TV procedures (n = 406; age 56 ± 16 years; 56% female) at 13 international sites. The AH and BH strategies were performed in 253 and 153 patients, respectively. Propensity score-matched analysis was used to compare groups. Results: After matching, 129 pairs were obtained and analyzed. The 30-day mortality rate was 6.2% versus 5.0% in the AH and BH groups, respectively (P = .9). The rates of acute renal failure requiring replacement therapy (10% versus 3%; P = .02) and stroke (1.6% versus 0%; P = .08) were numerically higher in the AH group. The 6-year survival rate was 67% ± 6% versus 78% ± 5% in the AH and BH groups, respectively (P = .18), whereas freedom from cardiac death was 75% ± 5% versus 84% ± 4% (P = .21). The 6-year composite cardiac end point of cardiac death and reoperation rate was 60% ± 9% versus 86% ± 5% (P = .024) comparing AH-TV replacement and BH-TV repair groups. Conclusions: Isolated TV surgery performed with a BH strategy is a safe option and resulted in a trend of increased long-term survival and freedom from reoperation compared with the standard AH technique. Patients undergoing BH valve repair had the best long-term outcome.

Published
2022

7. OC69 SURGERY FOR BENTALL ENDOCARDITIS: SHORT AND LONG-TERM OUTCOME FROM A MULTI-CENTRE REGISTRY

Author

Sponga, S., Di Mauro, M., Pacini, D., Murara, G., Di Bartolomeo, R., Cappabianca, G., Beghi, C., Weltert, L., De Paulis, R., De Vincentiis, C., Biondi, A., Santini, F., Salsano, A., Salvador, L., Picichè, M., Mariscalco, G., Maselli, D., Rinaldi, M., Mancuso, S., Scrofani, R., Cagnoni, G., Antona, C., Dato, G.M.A., Centofani, P., De Bonis, M., Pozzoli, A., Cugola, D., Galletti, L., Villa, E., Dossena, Y., Troise, G., Barili, F., Paparella, D., Margari, V., Lorusso, R., Parolari, A., and Livi, U.

Published
2018
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8. OC71 SURGICAL TREATMENT FOR ISOLATED TRICUSPID VALVE INFECTIVE ENDOCARDITIS. 25-YEAR RESULTS

Author

Di Mauro, M., Dato, G. Actis, Barili, F., Corte, A. Della, Ratta, E. Della, Cugola, D., Galletti, L., Centofanti, P., Santini, F., Salsano, A., Rinaldi, M., Mancuso, S., Cappabianca, G., Beghi, C., De Vincentiis, C., Biondi, A., Livi, U., Sponga, S., Pacini, D., Murara, G., Di Bortalomeo, R., Scrofani, R., Cagnoni, G., Antona, C., Nicolini, F., Benassi, F., De Bonis, M., Pozzoli, A., Casali, G., Scrascia, G., Bortolotti, U., Falcetta, G., Musumeci, F., Gherli, R., Vizzardi, E., Salvador, L., Piccichè, M., Paparella, D., Margari, V., Troise, G., Villa, E., Dossena, Y., Lucarelli, C., Onorati, F., Faggian, G., Mariscalco, G., Maselli, D., Foschi, M., Parolari, A., and Lorusso, R.

Published
2018
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10. Progressive right ventricular dysfunction and exercise impairment in patients with heart failure and diabetes mellitus: insights from the T.O.S.CA. Registry

Author

Salzano, A, D'Assante, R, Iacoviello, M, Triggiani, V, Rengo, G, Cacciatore, F, Maiello, C, Limongelli, G, Masarone, D, Sciacqua, A, Perrone Filardi, P, Mancini, A, Volterrani, M, Vriz, O, Castello, R, Passantino, A, Campo, M, Modesti, Pa, De Giorgi, A, Arcopinto, M, Gargiulo, P, Perticone, M, Colao, A, Milano, S, Garavaglia, A, Napoli, R, Suzuki, T, Bossone, E, Marra, Am, Cittadini, A, Saccà, L, Monti, Mg, Matarazzo, M, Stagnaro, Fm, Piccioli, L, Lombardi, A, Panicara, V, Flora, M, Golia, L, Faga, V, Ruocco, A, Della Polla, D, Franco, R, Schiavo, A, Gigante, A, Spina, E, Sicuranza, M, Monaco, F, Apicella, M, Miele, C, Campanino, Ag, Mazza, L, Abete, R, Farro, A, Luciano, F, Polizzi, R, Ferrillo, G, De Luca, M, Crisci, G, Giardino, F, Barbato, M, Ranieri, B, Ferrara, F, Russo, V, Malinconico, M, Citro, R, Guastalamacchia, E, Leone, M, Giagulli, Va, Amarelli, C, Mattucci, I, Calabrò, P, Calabrò, R, D'Andrea, A, Maddaloni, V, Pacileo, G, Scarafile, R, Belfiore, A, Cimellaro, A, Casaretti, L, Paolillo, S, Favuzzi, Amr, Di Segni, C, Bruno, C, Vergani, E, Massaro, R, Grimaldi, F, Frigo, A, Sorrentino, Mr, Malandrino, D, Manfredini, R, Fabbian, F, Puzzo, A, Ragusa, L, Caliendo, L, Carbone, L, Frigiola, A, Generali, T, Giacomazzi, F, De Vincentiis, C, Ballotta, A, Garofalo, P, Malizia, G, Misiano, G, Israr, Mz, Bernieh, D, Cassambai, S, Yazaki, Y, Heaney, Lm, Eagle, Ka, Ventura, Ho, Bruzzese, D, Salzano, Andrea, D'Assante, Roberta, Iacoviello, Massimo, Triggiani, Vincenzo, Rengo, Giuseppe, Cacciatore, Francesco, Maiello, Ciro, Limongelli, Giuseppe, Masarone, Daniele, Sciacqua, Angela, Filardi, Pasquale Perrone, Mancini, Antonio, Volterrani, Maurizio, Vriz, Olga, Castello, Roberto, Passantino, Andrea, Campo, Michela, Modesti, Pietro A, De Giorgi, Alfredo, Arcopinto, Michele, Gargiulo, Paola, Perticone, Maria, Colao, Annamaria, Milano, Salvatore, Garavaglia, Agnese, Napoli, Raffaele, Suzuki, Toru, Bossone, Eduardo, Marra, Alberto M, Cittadini, Antonio, and Misiano, Gabriella

Subjects
Registrie, Heart Failure, Endocrinology, Diabetes and Metabolism, Ventricular Dysfunction, Right, Diabetes, Insulins, Socio-culturale, Stroke Volume, Insulin resistance, Diabete, Cardiopulmonary exercise test, Chronic heart failure, Diabetes, Insulin resistance, Right ventricle, TOSCA Registry, Chronic heart failure, Diabetes Mellitus, Type 2, TOSCA Registry, Exercise Test, Ventricular Function, Right, Humans, Insulin, Right ventricle, Registries, Cardiology and Cardiovascular Medicine, Cardiopulmonary exercise test, TOSCA, Human, LS4_7
Abstract

Background Findings from the T.O.S.CA. Registry recently reported that patients with concomitant chronic heart failure (CHF) and impairment of insulin axis (either insulin resistance—IR or diabetes mellitus—T2D) display increased morbidity and mortality. However, little information is available on the relative impact of IR and T2D on cardiac structure and function, cardiopulmonary performance, and their longitudinal changes in CHF. Methods Patients enrolled in the T.O.S.CA. Registry performed echocardiography and cardiopulmonary exercise test at baseline and at a patient-average follow-up of 36 months. Patients were divided into three groups based on the degree of insulin impairment: euglycemic without IR (EU), euglycemic with IR (IR), and T2D. Results Compared with EU and IR, T2D was associated with increased filling pressures (E/e′ratio: 15.9 ± 8.9, 12.0 ± 6.5, and 14.5 ± 8.1 respectively, p 2) in TD2 vs EU and IR patients was recorded (respectively, 15.8 ± 3.8 ml/Kg/min, 18.4 ± 4.3 ml/Kg/min and 16.5 ± 4.3 ml/Kg/min, p 2 in the T2D group (+ 13% increase in RV dimension, − 21% decline in TAPSE/PAPS ratio and − 20% decrease in peak VO2). Conclusion The higher risk of death and CV hospitalizations exhibited by HF-T2D patients in the T.O.S.CA. Registry is associated with progressive RV ventricular dysfunction and exercise impairment when compared to euglycemic CHF patients, supporting the pivotal importance of hyperglycaemia and right chambers in HF prognosis. Trial registration ClinicalTrials.gov identifier: NCT023358017

Published
2022
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11. Multiple hormonal and metabolic deficiency syndrome predicts outcome in heart failure: the T.O.S.CA. Registry

Author

Cittadini A., Salzano A., Iacoviello M., Triggiani V., Rengo G., Cacciatore F., Maiello C., Limongelli G., Masarone D., Perticone F., Cimellaro A., Filardi P. P., Paolillo S., Mancini A., Volterrani M., Vriz O., Castello R., Passantino A., Campo M., Modesti P. A., de Giorgi A., Monte I. P., Puzzo A., Ballotta A., D'Assante R., Arcopinto M., Gargiulo P., Sciacqua A., Bruzzese D., Colao A., Napoli R., Suzuki T., Eagle K. A., Ventura H. O., Marra A. M., Bossone E., Sacca L., Monti M. G., Matarazzo M., Stagnaro F. M., Piccioli L., Lombardi A., Panicara V., Flora M., Golia L., Faga V., Ruocco A., della Polla D., Franco R., Schiavo A., Gigante A., Spina E., Sicuranza M., Monaco F., Apicella M., Miele C., Campanino A. G., Mazza L., Abete R., Farro A., Luciano F., Polizzi R., Ferrillo G., de Luca M., Crisci G., Giardino F., Barbato M., Ranieri B., Ferrara F., Russo V., Malinconico M., Citro R., Guastalamacchia E., Leone M., Giagulli V. A., Amarelli C., Mattucci I., Calabro P., Calabro R., D'Andrea A., Maddaloni V., Pacileo G., Scarafile R., Belfiore A., Casaretti L., Favuzzi A. M. R., Di Segni C., Bruno C., Vergani E., Massaro R., Grimaldi F., Frigo A., Campo M. R., Sorrentino M. R., Malandrino D., Manfredini R., Fabbian F., Ragusa L., Caliendo L., Carbone L., Frigiola A., Generali T., Giacomazzi F., de Vincentiis C., Garofalo P., Malizia G., Milano S., Misiano G., Israr M. Z., Bernieh D., Cassambai S., Yazaki Y., Heaney L. M., Cittadini, Antonio, Salzano, Andrea, Iacoviello, Massimo, Triggiani, Vincenzo, Rengo, Giuseppe, Cacciatore, Francesco, Maiello, Ciro, Limongelli, Giuseppe, Masarone, Daniele, Perticone, Francesco, Cimellaro, Antonio, Perrone Filardi, Pasquale, Paolillo, Stefania, Mancini, Antonio, Volterrani, Maurizio, Vriz, Olga, Castello, Roberto, Passantino, Andrea, Campo, Michela, Modesti, Pietro A, De Giorgi, Alfredo, Monte, Ines P, Puzzo, Alfonso, Ballotta, Andrea, D'Assante, Roberta, Arcopinto, Michele, Gargiulo, Paola, Sciacqua, Angela, Bruzzese, Dario, Colao, Annamaria, Napoli, Raffaele, Suzuki, Toru, Eagle, Kim A, Ventura, Hector O, Marra, Alberto M, Bossone, Eduardo, Cittadini, A., Salzano, A., Iacoviello, M., Triggiani, V., Rengo, G., Cacciatore, F., Maiello, C., Limongelli, G., Masarone, D., Perticone, F., Cimellaro, A., Filardi, P. P., Paolillo, S., Mancini, A., Volterrani, M., Vriz, O., Castello, R., Passantino, A., Campo, M., Modesti, P. A., de Giorgi, A., Monte, I. P., Puzzo, A., Ballotta, A., D'Assante, R., Arcopinto, M., Gargiulo, P., Sciacqua, A., Bruzzese, D., Colao, A., Napoli, R., Suzuki, T., Eagle, K. A., Ventura, H. O., Marra, A. M., Bossone, E., Sacca, L., Monti, M. G., Matarazzo, M., Stagnaro, F. M., Piccioli, L., Lombardi, A., Panicara, V., Flora, M., Golia, L., Faga, V., Ruocco, A., della Polla, D., Franco, R., Schiavo, A., Gigante, A., Spina, E., Sicuranza, M., Monaco, F., Apicella, M., Miele, C., Campanino, A. G., Mazza, L., Abete, R., Farro, A., Luciano, F., Polizzi, R., Ferrillo, G., de Luca, M., Crisci, G., Giardino, F., Barbato, M., Ranieri, B., Ferrara, F., Russo, V., Malinconico, M., Citro, R., Guastalamacchia, E., Leone, M., Giagulli, V. A., Amarelli, C., Mattucci, I., Calabro, P., Calabro, R., D'Andrea, A., Maddaloni, V., Pacileo, G., Scarafile, R., Belfiore, A., Casaretti, L., Favuzzi, A. M. R., Di Segni, C., Bruno, C., Vergani, E., Massaro, R., Grimaldi, F., Frigo, A., Campo, M. R., Sorrentino, M. R., Malandrino, D., Manfredini, R., Fabbian, F., Ragusa, L., Caliendo, L., Carbone, L., Frigiola, A., Generali, T., Giacomazzi, F., de Vincentiis, C., Garofalo, P., Malizia, G., Milano, S., Misiano, G., Israr, M. Z., Bernieh, D., Cassambai, S., Yazaki, Y., and Heaney, L. M.

Subjects
medicine.medical_specialty, Multiple hormonal and metabolic deficiency syndrome, Epidemiology, Prognosi, Anabolic deficiency, Socio-culturale, Heart failure, 030204 cardiovascular system & hematology, Ventricular Function, Left, 03 medical and health sciences, 0302 clinical medicine, Insulin resistance, Diabetes mellitus, Internal medicine, Multiple hormonal, medicine, Clinical endpoint, Humans, 030212 general & internal medicine, Prospective Studies, Registries, TOSCA, LS4_7, Ejection fraction, business.industry, Hazard ratio, Metabolic deficiency syndrome, Heart failure • Anabolic deficiency • Multiple hormonal and metabolic deficiency syndrome • Hormones • Prognosis • TOSCA, Stroke Volume, medicine.disease, Prognosis, Hormone, Confidence interval, Heart failure, Anabolic deficiency, Multiple hormonal and metabolic deficiency syndrome, Hormones, Prognosis, TOSCA, Hormones, Hospitalization, Observational study, Cardiology and Cardiovascular Medicine, business
Abstract

Aims Recent evidence supports the occurrence of multiple hormonal and metabolic deficiency syndrome (MHDS) in chronic heart failure (CHF). However, no large observational study has unequivocally demonstrated its impact on CHF progression and outcome. The T.O.S.CA. (Trattamento Ormonale nello Scompenso CArdiaco; Hormone Treatment in Heart Failure) Registry has been specifically designed to test the hypothesis that MHDS affects morbidity and mortality in CHF patients. Methods and Results The T.O.S.CA. Registry is a prospective, multicentre, observational study involving 19 Italian centres. Thyroid hormones, insulin-like growth factor-1, total testosterone, dehydropianoandrosterone sulfate, insulin resistance, and the presence of diabetes were evaluated. A MHDS was defined as the presence of ≥2 hormone deficiencies (HDs). Primary endpoint was a composite of all-cause mortality and cardiovascular hospitalizations. Four hundred and eighty heart failure patients with ejection fraction ≤45% were enrolled. MHDS or diabetes was diagnosed in 372 patients (77.5%). A total of 271 events (97 deaths and 174 cardiovascular hospitalizations) were recorded, 41% in NO-MHDS and 62% in MHDS (P Conclusion MHDS is common in CHF and independently associated with increased all-cause mortality and cardiovascular hospitalization, representing a promising therapeutic target. Trial registration ClinicalTrials.gov identifier: NCT023358017

Published
2021

13. Surgical treatment of isolated tricuspid valve infective endocarditis: 25-year results from a multicenter registry

Author

Di Mauro, M, Foschi, M, Dato, G, Centofanti, P, Barili, F, Corte, A, Ratta, E, Cugola, D, Galletti, L, Santini, F, Salsano, A, Rinaldi, M, Mancuso, S, Cappabianca, G, Beghi, C, De Vincentiis, C, Biondi, A, Livi, U, Sponga, S, Pacini, D, Murana, G, Scrofani, R, Antona, C, Cagnoni, G, Nicolini, F, Benassi, F, De Bonis, M, Pozzoli, A, Casali, G, Scrascia, G, Falcetta, G, Bortolotti, U, Musumeci, F, Gherli, R, Vizzardi, E, Salvador, L, Piciche, M, Paparella, D, Margari, V, Troise, G, Villa, E, Dossena, Y, Lucarelli, C, Onorati, F, Faggian, G, Mariscalco, G, Maselli, D, Parolari, A, Lorusso, R, Di Mauro M., Foschi M., Dato G. M. A., Centofanti P., Barili F., Corte A. D., Ratta E. D., Cugola D., Galletti L., Santini F., Salsano A., Rinaldi M., Mancuso S., Cappabianca G., Beghi C., De Vincentiis C., Biondi A., Livi U., Sponga S., Pacini D., Murana G., Scrofani R., Antona C., Cagnoni G., Nicolini F., Benassi F., De Bonis M., Pozzoli A., Casali G., Scrascia G., Falcetta G., Bortolotti U., Musumeci F., Gherli R., Vizzardi E., Salvador L., Piciche M., Paparella D., Margari V., Troise G., Villa E., Dossena Y., Lucarelli C., Onorati F., Faggian G., Mariscalco G., Maselli D., Parolari A., Lorusso R., Di Mauro, M, Foschi, M, Dato, G, Centofanti, P, Barili, F, Corte, A, Ratta, E, Cugola, D, Galletti, L, Santini, F, Salsano, A, Rinaldi, M, Mancuso, S, Cappabianca, G, Beghi, C, De Vincentiis, C, Biondi, A, Livi, U, Sponga, S, Pacini, D, Murana, G, Scrofani, R, Antona, C, Cagnoni, G, Nicolini, F, Benassi, F, De Bonis, M, Pozzoli, A, Casali, G, Scrascia, G, Falcetta, G, Bortolotti, U, Musumeci, F, Gherli, R, Vizzardi, E, Salvador, L, Piciche, M, Paparella, D, Margari, V, Troise, G, Villa, E, Dossena, Y, Lucarelli, C, Onorati, F, Faggian, G, Mariscalco, G, Maselli, D, Parolari, A, Lorusso, R, Di Mauro M., Foschi M., Dato G. M. A., Centofanti P., Barili F., Corte A. D., Ratta E. D., Cugola D., Galletti L., Santini F., Salsano A., Rinaldi M., Mancuso S., Cappabianca G., Beghi C., De Vincentiis C., Biondi A., Livi U., Sponga S., Pacini D., Murana G., Scrofani R., Antona C., Cagnoni G., Nicolini F., Benassi F., De Bonis M., Pozzoli A., Casali G., Scrascia G., Falcetta G., Bortolotti U., Musumeci F., Gherli R., Vizzardi E., Salvador L., Piciche M., Paparella D., Margari V., Troise G., Villa E., Dossena Y., Lucarelli C., Onorati F., Faggian G., Mariscalco G., Maselli D., Parolari A., and Lorusso R.

Abstract

Background: To assess early and late mortality in patients with isolated acute tricuspid valve infective endocarditis (TVIE) using data from a multicenter registry. Methods: From 1983 to 2018, isolated acute TVIE was surgically treated in 157 (3.8%) patients [mean age 47 ± 16 years (range 15–86 years), 25% females]. Of these, 142 (90%) had native tricuspid regurgitation, 7 (5%) native tricuspid valve (TV) steno-regurgitation, and 8 (5%) prosthetic TVIE. Intravenous drug use (IVDU) was recorded in 38% of patients, infection involved cardiac implantable electronic device leads in 21%, and vascular catheters for dialysis in 1%; in the remaining cases, the cause was unknown. The primary endpoint was in-hospital outcome, long-term freedom from recurrence and overall survival. Results: Overall, 77 (49%) patients underwent TV repair, 72 (46%) TV replacement, and 8 (5%) prosthetic TV replacement. Early mortality was 11% (n = 17). Expected early mortality according to EndoSCORE was 12%, with age (odds ratio 1.06) and redo (odds ratio 6.64) as risk factors. Late deaths occurred in 31 patients and TVIE recurrences in 4. Survival rates at 10, 20, and 25 years were 66%, 60%, and 44%, respectively. Risk factors were age [hazard ratio (HR) 1.06], mycotic TVIE (HR 4.2), IVDU (HR 4.90), infected prosthesis replacement (HR 4.4), and presence of cardiac implantable electronic device leads (HR 3.0). No significant difference was found in valve repair vs. replacement and in IVDUs vs. non-IVDUs. Conclusions: Patients with isolated acute TVIE undergoing surgical treatment show acceptable early and late outcomes. TVIE recurrence was low, and repair of the affected valve does not seem to confer any advantage either at early or long term up to 25 years.

Published
2019

14. Corrigendum to “A predictive model for early mortality after surgical treatment of heart valve or prosthesis infective endocarditis. The EndoSCORE”. [Int. J. Cardiol. 241 (Aug 15 2017) 97–102](S0167527317309877)(10.1016/j.ijcard.2017.03.148)

Author

Di Mauro M., Di Mauro, M, Dato, G, Barili, F, Gelsomino, S, Sante, P, Corte, A, Carrozza, A, Ratta, E, Cugola, D, Galletti, L, Devotini, R, Casabona, R, Santini, F, Salsano, A, Scrofani, R, Antona, C, Botta, L, Russo, C, Mancuso, S, Rinaldi, M, De Vincentiis, C, Biondi, A, Beghi, C, Cappabianca, G, Tarzia, V, Gerosa, G, De Bonis, M, Pozzoli, A, Nicolini, F, Benassi, F, Rosato, F, Grasso, E, Livi, U, Sponga, S, Pacini, D, Di Bartolomeo, R, Demartino, A, Bortolotti, U, Onorati, F, Faggian, G, Lorusso, R, Vizzardi, E, Di Giammarco, G, Marinelli, D, Villa, E, Troise, G, Piciche, M, Musumeci, F, Paparella, D, Margari, V, Tritto, F, Damiani, G, Scrascia, G, Zaccaria, S, Renzulli, A, Serraino, G, Mariscalco, G, Maselli, D, Foschi, M, Parolari, A, Nappi, G, Di Mauro M., Dato G. M. A., Barili F., Gelsomino S., Sante P., Corte A. D., Carrozza A., Ratta E. D., Cugola D., Galletti L., Devotini R., Casabona R., Santini F., Salsano A., Scrofani R., Antona C., Botta L., Russo C., Mancuso S., Rinaldi M., De Vincentiis C., Biondi A., Beghi C., Cappabianca G., Tarzia V., Gerosa G., De Bonis M., Pozzoli A., Nicolini F., Benassi F., Rosato F., Grasso E., Livi U., Sponga S., Pacini D., Di Bartolomeo R., DeMartino A., Bortolotti U., Onorati F., Faggian G., Lorusso R., Vizzardi E., Di Giammarco G., Marinelli D., Villa E., Troise G., Piciche M., Musumeci F., Paparella D., Margari V., Tritto F., Damiani G., Scrascia G., Zaccaria S., Renzulli A., Serraino G., Mariscalco G., Maselli D., Foschi M., Parolari A., Nappi G., Di Mauro M., Di Mauro, M, Dato, G, Barili, F, Gelsomino, S, Sante, P, Corte, A, Carrozza, A, Ratta, E, Cugola, D, Galletti, L, Devotini, R, Casabona, R, Santini, F, Salsano, A, Scrofani, R, Antona, C, Botta, L, Russo, C, Mancuso, S, Rinaldi, M, De Vincentiis, C, Biondi, A, Beghi, C, Cappabianca, G, Tarzia, V, Gerosa, G, De Bonis, M, Pozzoli, A, Nicolini, F, Benassi, F, Rosato, F, Grasso, E, Livi, U, Sponga, S, Pacini, D, Di Bartolomeo, R, Demartino, A, Bortolotti, U, Onorati, F, Faggian, G, Lorusso, R, Vizzardi, E, Di Giammarco, G, Marinelli, D, Villa, E, Troise, G, Piciche, M, Musumeci, F, Paparella, D, Margari, V, Tritto, F, Damiani, G, Scrascia, G, Zaccaria, S, Renzulli, A, Serraino, G, Mariscalco, G, Maselli, D, Foschi, M, Parolari, A, Nappi, G, Di Mauro M., Dato G. M. A., Barili F., Gelsomino S., Sante P., Corte A. D., Carrozza A., Ratta E. D., Cugola D., Galletti L., Devotini R., Casabona R., Santini F., Salsano A., Scrofani R., Antona C., Botta L., Russo C., Mancuso S., Rinaldi M., De Vincentiis C., Biondi A., Beghi C., Cappabianca G., Tarzia V., Gerosa G., De Bonis M., Pozzoli A., Nicolini F., Benassi F., Rosato F., Grasso E., Livi U., Sponga S., Pacini D., Di Bartolomeo R., DeMartino A., Bortolotti U., Onorati F., Faggian G., Lorusso R., Vizzardi E., Di Giammarco G., Marinelli D., Villa E., Troise G., Piciche M., Musumeci F., Paparella D., Margari V., Tritto F., Damiani G., Scrascia G., Zaccaria S., Renzulli A., Serraino G., Mariscalco G., Maselli D., Foschi M., Parolari A., and Nappi G.

Abstract

The authors regret that the first name and last name of the author Sandro Sponga was published incorrectly in the original version and this has now been corrected.

Published
2018

16. The Monitoring of Psychosocial Factors During Hospitalization Before and After Cardiac Surgery Until Discharge From Cardiac Rehabilitation: A Research Protocol

Author

Callus, E, Pagliuca, S, Bertoldo, EG, Fiolo, V, Jackson, AC, Boveri, S, De Vincentiis, C, Castelvecchio, S, Volpe, M, Menicanti, L, Callus, E, Pagliuca, S, Bertoldo, EG, Fiolo, V, Jackson, AC, Boveri, S, De Vincentiis, C, Castelvecchio, S, Volpe, M, and Menicanti, L

Abstract

Introduction: There is considerable evidence that psychosocial factors contribute to the etiology and prognosis of cardiac illness. Currently, in Italy, psychologists are only obligatory in the cardiac rehabilitation setting, although there are indications that patients could be experiencing distress also during other moments of hospitalization, such as on admission for cardiac surgery. Objective and Methods: The objective of this protocol is to gain more information about cardiac patients, specifically during the various moments of hospitalization for cardiac surgery, by collecting data at admission before cardiac surgery (t0), at admission to cardiac rehabilitation (t1), and at discharge (t2) at the Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Donato hospital. A psychosocial questionnaire was constructed after consulting the relevant national and international guidelines. Patients admitted for cardiac surgery and attending a rehabilitation program will be evaluated by acquiring data about their civil status, religiosity, education and work capacity, social condition (including the presence and quality of intimate relationships and support received), previous psychological and psychiatric histories, psychological status, lifestyle (including questions on nutrition, smoking, alcohol, and substance abuse), adherence to therapy, quality of life (QoL), health perception, anxiety, and depression at t0. Health perception, anxiety, and depression are also measured at t1 and t2. Discussion and Conclusion: This study is an attempt to identify the recommended psychosocial variables which need to be monitored during cardiac patients' hospitalization for cardiac surgery, through to the completion of cardiac rehabilitation. After implementing this study at the IRCCS Policlinico San Donato, attempts will be made to create studies on a national and international level to generate more evidence regarding these variables, in order to create tailor-mad

Published
2020

17. Multiple hormonal and metabolic deficiency syndrome in chronic heart failure: rationale, design, and demographic characteristics of the T.O.S.CA. Registry

Author

Bossone, E., Arcopinto, M., Iacoviello, M., Triggiani, V., Cacciatore, F., Maiello, C., Limongelli, G., Masarone, D., Perticone, F., Sciacqua, A., Perrone-Filardi, P., Mancini, A., Volterrani, M., Vriz, O., Castello, R., Passantino, A., Campo, M., Modesti, P. A., de Giorgi, A., Monte, I., Puzzo, A., Ballotta, A., Caliendo, L., D’Assante, R., Marra, A. M., Salzano, A., Suzuki, T., Cittadini, A., Saccà, L., Monti, M. G., Napoli, R., Matarazzo, M., Stagnaro, F. M., Schiavo, A., Valente, P., Ferrara, F., Russo, V., Malinconico, M., Citro, R., Guastalamacchia, E., Leone, M., Amarelli, C., Mattucci, I., Calabrò, P., Calabrò, R., D’Andrea, A., Maddaloni, V., Pacileo, G., Scarafile, R., Belfiore, A., Cimellaro, A., Perrone Filardi, P., Casaretti, L., Paolillo, S., Gargiulo, P., Favuzzi, A. M. R., Di Segni, C., Bruno, C., Vergani, E., Massaro, R., Grimaldi, F., Frigo, A., Sorrentino, M. R., Malandrino, D., Manfredini, R., Fabbian, F., Ragusa, L., Carbone, L., Frigiola, A., Generali, T., Giacomazzi, F., de Vincentiis, C., Garofalo, P., Malizia, G., Milano, S., Misiano, G., Heaney, L. M., Bruzzese, D., Bossone E., Arcopinto M., Iacoviello M., Triggiani V., Cacciatore F., Maiello C., Limongelli G., Masarone D., Perticone F., Sciacqua A., Perrone-Filardi P., Mancini A., Volterrani M., Vriz O., Castello R., Passantino A., Campo M., Modesti P.A., De Giorgi A., Monte I., Puzzo A., Ballotta A., Caliendo L., D'Assante R., Marra A.M., Salzano A., Suzuki T., Cittadini A., Sacca L., Monti M.G., Napoli R., Matarazzo M., Stagnaro F.M., Schiavo A., Valente P., Ferrara F., Russo V., Malinconico M., Citro R., Guastalamacchia E., Leone M., Amarelli C., Mattucci I., Calabro P., Calabro R., D'Andrea A., Maddaloni V., Pacileo G., Scarafile R., Belfiore A., Cimellaro A., Casaretti L., Paolillo S., Gargiulo P., Favuzzi A.M.R., DiSegni C., Bruno C., Vergani E., Massaro R., Grimaldi F., Frigo A., Sorrentino M.R., Malandrino D., Manfredini R., DeGiorgi A., Fabbian F., Ragusa L., Carbone L., Frigiola A., Generali T., Giacomazzi F., DeVincentiis C., Garofalo P., Malizia G., Milano S., Misiano G., Heaney L.M., Bruzzese D., Bossone, E, Arcopinto, M, Iacoviello, M, Triggiani, V, Cacciatore, F, Maiello, C, Limongelli, G, Masarone, D, Perticone, F, Sciacqua, A, Perrone-Filardi, P, Mancini, A, Volterrani, M, Vriz, O, Castello, R, Passantino, A, Campo, M, A Modesti, P, De Giorgi, A, Monte, I, Puzzo, A, Ballotta, A, Caliendo, L, D'Assante, R, M Marra, A, Salzano, A, Suzuki, T, Cittadini, A, Investigators, Tosca, Bossone, E., Arcopinto, M., Iacoviello, M., Triggiani, V., Cacciatore, F., Maiello, C., Limongelli, G., Masarone, D., Perticone, F., Sciacqua, A., Perrone-Filardi, P., Mancini, A., Volterrani, M., Vriz, O., Castello, R., Passantino, A., Campo, M., Modesti, P. A., de Giorgi, A., Monte, I., Puzzo, A., Ballotta, A., Caliendo, L., D’Assante, R., Marra, A. M., Salzano, A., Suzuki, T., Cittadini, A., Saccà, L., Monti, M. G., Napoli, R., Matarazzo, M., Stagnaro, F. M., Schiavo, A., Valente, P., Ferrara, F., Russo, V., Malinconico, M., Citro, R., Guastalamacchia, E., Leone, M., Amarelli, C., Mattucci, I., Calabrò, P., Calabrò, R., D’Andrea, A., Maddaloni, V., Pacileo, G., Scarafile, R., Belfiore, A., Cimellaro, A., Perrone Filardi, P., Casaretti, L., Paolillo, S., Gargiulo, P., Favuzzi, A. M. R., Di Segni, C., Bruno, C., Vergani, E., Massaro, R., Grimaldi, F., Frigo, A., Sorrentino, M. R., Malandrino, D., Manfredini, R., Fabbian, F., Ragusa, L., Carbone, L., Frigiola, A., Generali, T., Giacomazzi, F., de Vincentiis, C., Garofalo, P., Malizia, G., Milano, S., Misiano, G., Heaney, L. M., and Bruzzese, D.

Subjects
Male, Anabolism, medicine.medical_treatment, 030204 cardiovascular system & hematology, law.invention, 0302 clinical medicine, Randomized controlled trial, law, Clinical endpoint, Medicine, Deficiency Disease, 030212 general & internal medicine, Prospective Studies, Registries, Prospective cohort study, Testosterone, Anabolic deficiency, Chronic heart failure, Heart failure metabolism, Multiple hormonal deficiency syndrome, Registry, Aged, Biomarkers, Chronic Disease, Deficiency Diseases, Disease Progression, Female, Heart Failure, Humans, Italy, Metabolic Diseases, Middle Aged, Internal Medicine, Emergency Medicine, Human, medicine.medical_specialty, Anabolic deficiency, Chronic heart failure, Heart failure metabolism, Multiple hormonal deficiency syndrome, Registry, Socio-culturale, 03 medical and health sciences, Internal medicine, business.industry, Settore MED/13 - ENDOCRINOLOGIA, Biomarker, medicine.disease, Metabolic Disease, Prospective Studie, Heart failure, Observational study, Hormone therapy, business
Abstract

Recent evidence supports the concept that progression of chronic heart failure (CHF) depends upon an imbalance of catabolic forces over the anabolic drive. In this regard, multiple hormonal deficiency syndrome (MHDS) significantly has impacts upon CHF progression, and is associated with a worse clinical status and increased mortality. The T.O.S.CA. (Trattamento Ormonale nello Scompenso CArdiaco; Hormone Therapy in Heart Failure) Registry (clinicaltrial.gov = NCT02335801) tests the hypothesis that anabolic deficiencies reduce survival in a large population of mild-to-moderate CHF patients. The T.O.S.CA. Registry is a prospective multicenter observational study coordinated by “Federico II” University of Naples, and involves 19 centers situated throughout Italy. Thyroid hormones, insulin-like growth factor-1, total testosterone, dehydroepiandrosterone , and insulin are measured at baseline and every year for a patient-average follow-up of 3years. Subjects with CHF are divided into two groups: patients with one or no anabolic deficiency, and patients with two or more anabolic deficiencies at baseline. The primary endpoint is the composite of all-cause mortality and cardiovascular hospitalization. Secondary endpoints include the composite of all-cause mortality and hospitalization, the composite of cardiovascular mortality and cardiovascular hospitalization, and change of VO 2 peak. Patient enrollment started in April 2013, and was completed in July 2017. Demographics and main clinical characteristics of enrolled patients are provided in this article. Detailed cross-sectional results will be available in late 2018. The T.O.S.CA. Registry represents the most robust prospective observational trial on MHDS in the field of CHF. The study findings will advance our knowledge with regard to the intimate mechanisms of CHF progression and hopefully pave the way for future randomized clinical trials of single or multiple hormonal replacement therapies in CHF.

Published
2017

18. Surgery for prosthetic valve endocarditis: A retrospective study of a national registry

Author

Corte, A, Di Mauro, M, Dato, G, Barili, F, Cugola, D, Gelsomino, S, Sante, P, Carozza, A, Ratta, E, Galletti, L, Devotini, R, Casabona, R, Santini, F, Salsano, A, Scrofani, R, Antona, C, De Vincentiis, C, Biondi, A, Beghi, C, Cappabianca, G, De Bonis, M, Pozzoli, A, Nicolini, F, Benassi, F, Pacini, D, Di Bartolomeo, R, De Martino, A, Bortolotti, U, Lorusso, R, Vizzardi, E, Di Giammarco, G, Marinelli, D, Villa, E, Troise, G, Paparella, D, Margari, V, Tritto, F, Damiani, G, Scrascia, G, Zaccaria, S, Renzulli, A, Serraino, G, Mariscalco, G, Maselli, D, Parolari, A, Nappi, G, Corte A. D., Di Mauro M., Dato G. A., Barili F., Cugola D., Gelsomino S., Sante P., Carozza A., Ratta E. D., Galletti L., Devotini R., Casabona R., Santini F., Salsano A., Scrofani R., Antona C., De Vincentiis C., Biondi A., Beghi C., Cappabianca G., De Bonis M., Pozzoli A., Nicolini F., Benassi F., Pacini D., Di Bartolomeo R., De Martino A., Bortolotti U., Lorusso R., Vizzardi E., Di Giammarco G., Marinelli D., Villa E., Troise G., Paparella D., Margari V., Tritto F., Damiani G., Scrascia G., Zaccaria S., Renzulli A., Serraino G., Mariscalco G., Maselli D., Parolari A., Nappi G., Corte, A, Di Mauro, M, Dato, G, Barili, F, Cugola, D, Gelsomino, S, Sante, P, Carozza, A, Ratta, E, Galletti, L, Devotini, R, Casabona, R, Santini, F, Salsano, A, Scrofani, R, Antona, C, De Vincentiis, C, Biondi, A, Beghi, C, Cappabianca, G, De Bonis, M, Pozzoli, A, Nicolini, F, Benassi, F, Pacini, D, Di Bartolomeo, R, De Martino, A, Bortolotti, U, Lorusso, R, Vizzardi, E, Di Giammarco, G, Marinelli, D, Villa, E, Troise, G, Paparella, D, Margari, V, Tritto, F, Damiani, G, Scrascia, G, Zaccaria, S, Renzulli, A, Serraino, G, Mariscalco, G, Maselli, D, Parolari, A, Nappi, G, Corte A. D., Di Mauro M., Dato G. A., Barili F., Cugola D., Gelsomino S., Sante P., Carozza A., Ratta E. D., Galletti L., Devotini R., Casabona R., Santini F., Salsano A., Scrofani R., Antona C., De Vincentiis C., Biondi A., Beghi C., Cappabianca G., De Bonis M., Pozzoli A., Nicolini F., Benassi F., Pacini D., Di Bartolomeo R., De Martino A., Bortolotti U., Lorusso R., Vizzardi E., Di Giammarco G., Marinelli D., Villa E., Troise G., Paparella D., Margari V., Tritto F., Damiani G., Scrascia G., Zaccaria S., Renzulli A., Serraino G., Mariscalco G., Maselli D., Parolari A., and Nappi G.

Abstract

OBJECTIVES: We described clinical-epidemiological features of prosthetic valve endocarditis (PVE) and assessed the determinants of early surgical outcomes in multicentre design. METHODS: Data regarding 2823 patients undergoing surgery for endocarditis at 19 Italian Centers between 1979 and 2015 were collected in a database. Of them, 582 had PVE: in this group, the determinants of early mortality and complications were assessed, also taking into account the different chronological eras encompassed by the study. RESULTS: Overall hospital (30-day) mortality was 19.2% (112 patients). Postoperative complications of any type occurred in 256 patients (44%). Across 3 eras (1980-2000, 2001-08 and 2009-14), early mortality did not significantly change (20.4%, 17.1%, 20.5%, respectively, P = 0.60), whereas complication rate increased (18.5%, 38.2%, 52.8%, P < 0.001), consistent with increasing mean patient age (56 ± 14, 64 ± 15, 65 ± 14 years, respectively, P < 0.001) and median logistic EuroSCORE (14%, 21%, 23%, P = 0.025). Older age, female sex, preoperative serum creatinine > -2 mg/dl, chronic pulmonary disease, low ejection fraction, non-streptococcal aetiology, active endocarditis, preoperative intubation, preoperative shock and triple valve surgery were significantly associated with mortality. In multivariable analysis, age (OR = 1.02; P = 0.03), renal insufficiency (OR = 2.1; P = 0.05), triple valve surgery (OR = 6.9; P = 0.004) and shock (OR = 4.5; P < 0.001) were independently associated with mortality, while streptococcal aetiology, healed endocarditis and ejection fraction with survival. Adjusting for study era, preoperative shock (OR = 3; P < 0.001), Enterococcus (OR = 2.3; P = 0.01) and female sex (OR = 1.5; P = 0.03) independently predicted complications, whereas ejection fraction was protective. CONCLUSIONS: PVE surgery remains a high-risk one. The strongest predictors of early outcome of PVE surgery are related to patient's haemodynamic status an

Published
2017

19. A predictive model for early mortality after surgical treatment of heart valve or prosthesis infective endocarditis. The EndoSCORE

Author

Di Mauro, M, Dato, G, Barili, F, Gelsomino, S, Sante, P, Corte, A, Carrozza, A, Ratta, E, Cugola, D, Galletti, L, Devotini, R, Casabona, R, Santini, F, Salsano, A, Scrofani, R, Antona, C, Botta, L, Russo, C, Mancuso, S, Rinaldi, M, De Vincentiis, C, Biondi, A, Beghi, C, Cappabianca, G, Tarzia, V, Gerosa, G, De Bonis, M, Pozzoli, A, Nicolini, F, Benassi, F, Rosato, F, Grasso, E, Livi, U, Sandro, S, Pacini, D, Di Bartolomeo, R, De Martino, A, Bortolotti, U, Onorati, F, Faggian, G, Lorusso, R, Vizzardi, E, Di Giammarco, G, Marinelli, D, Villa, E, Troise, G, Piciche, M, Musumeci, F, Paparella, D, Margari, V, Tritto, F, Damiani, G, Scrascia, G, Zaccaria, S, Renzulli, A, Serraino, G, Mariscalco, G, Maselli, D, Foschi, M, Parolari, A, Nappi, G, Di Mauro M., Dato G. M. A., Barili F., Gelsomino S., Sante P., Corte A. D., Carrozza A., Ratta E. D., Cugola D., Galletti L., Devotini R., Casabona R., Santini F., Salsano A., Scrofani R., Antona C., Botta L., Russo C., Mancuso S., Rinaldi M., De Vincentiis C., Biondi A., Beghi C., Cappabianca G., Tarzia V., Gerosa G., De Bonis M., Pozzoli A., Nicolini F., Benassi F., Rosato F., Grasso E., Livi U., Sandro S., Pacini D., Di Bartolomeo R., De Martino A., Bortolotti U., Onorati F., Faggian G., Lorusso R., Vizzardi E., Di Giammarco G., Marinelli D., Villa E., Troise G., Piciche M., Musumeci F., Paparella D., Margari V., Tritto F., Damiani G., Scrascia G., Zaccaria S., Renzulli A., Serraino G., Mariscalco G., Maselli D., Foschi M., Parolari A., Nappi G., Di Mauro, M, Dato, G, Barili, F, Gelsomino, S, Sante, P, Corte, A, Carrozza, A, Ratta, E, Cugola, D, Galletti, L, Devotini, R, Casabona, R, Santini, F, Salsano, A, Scrofani, R, Antona, C, Botta, L, Russo, C, Mancuso, S, Rinaldi, M, De Vincentiis, C, Biondi, A, Beghi, C, Cappabianca, G, Tarzia, V, Gerosa, G, De Bonis, M, Pozzoli, A, Nicolini, F, Benassi, F, Rosato, F, Grasso, E, Livi, U, Sandro, S, Pacini, D, Di Bartolomeo, R, De Martino, A, Bortolotti, U, Onorati, F, Faggian, G, Lorusso, R, Vizzardi, E, Di Giammarco, G, Marinelli, D, Villa, E, Troise, G, Piciche, M, Musumeci, F, Paparella, D, Margari, V, Tritto, F, Damiani, G, Scrascia, G, Zaccaria, S, Renzulli, A, Serraino, G, Mariscalco, G, Maselli, D, Foschi, M, Parolari, A, Nappi, G, Di Mauro M., Dato G. M. A., Barili F., Gelsomino S., Sante P., Corte A. D., Carrozza A., Ratta E. D., Cugola D., Galletti L., Devotini R., Casabona R., Santini F., Salsano A., Scrofani R., Antona C., Botta L., Russo C., Mancuso S., Rinaldi M., De Vincentiis C., Biondi A., Beghi C., Cappabianca G., Tarzia V., Gerosa G., De Bonis M., Pozzoli A., Nicolini F., Benassi F., Rosato F., Grasso E., Livi U., Sandro S., Pacini D., Di Bartolomeo R., De Martino A., Bortolotti U., Onorati F., Faggian G., Lorusso R., Vizzardi E., Di Giammarco G., Marinelli D., Villa E., Troise G., Piciche M., Musumeci F., Paparella D., Margari V., Tritto F., Damiani G., Scrascia G., Zaccaria S., Renzulli A., Serraino G., Mariscalco G., Maselli D., Foschi M., Parolari A., and Nappi G.

Abstract

Background The aim of this large retrospective study was to provide a logistic risk model along an additive score to predict early mortality after surgical treatment of patients with heart valve or prosthesis infective endocarditis (IE). Methods From 2000 to 2015, 2715 patients with native valve endocarditis (NVE) or prosthesis valve endocarditis (PVE) were operated on in 26 Italian Cardiac Surgery Centers. The relationship between early mortality and covariates was evaluated with logistic mixed effect models. Fixed effects are parameters associated with the entire population or with certain repeatable levels of experimental factors, while random effects are associated with individual experimental units (centers). Results Early mortality was 11.0% (298/2715); At mixed effect logistic regression the following variables were found associated with early mortality: age class, female gender, LVEF, preoperative shock, COPD, creatinine value above 2 mg/dl, presence of abscess, number of treated valve/prosthesis (with respect to one treated valve/prosthesis) and the isolation of Staphylococcus aureus, Fungus spp., Pseudomonas Aeruginosa and other micro-organisms, while Streptococcus spp., Enterococcus spp. and other Staphylococci did not affect early mortality, as well as no micro-organisms isolation. LVEF was found linearly associated with outcomes while non-linear association between mortality and age was tested and the best model was found with a categorization into four classes (AUC = 0.851). Conclusions The following study provides a logistic risk model to predict early mortality in patients with heart valve or prosthesis infective endocarditis undergoing surgical treatment, called “The EndoSCORE”.

Published
2017

20. Early Treatment of Acute Infective Tricuspid and Aortic Valve Active Endocarditis: The 'Bio' Solution

Author

Andrea Daprati, Menicanti L, Katsuhiko Mikoshiba, De Vincentiis C, Keijiro Saku, Garatti A, Mancho N, Akihiro Inazu, Eugenio Mossuto, Saitto G, and Jordi Carratalà

Subjects
Aortic valve, medicine.medical_specialty, Hyperkalemia, business.industry, Respiratory murmur, Tricuspid valvectomy, General Medicine, Hospital mortality, medicine.disease, medicine.anatomical_structure, Antibiotic therapy, Internal medicine, medicine, Cardiology, Endocarditis, Hyperlactatemia, medicine.symptom, business
Published
2018
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22. OC69 SURGERY FOR BENTALL ENDOCARDITIS

Author

Sponga, S., Di Mauro, M., Pacini, D., Murara, G., Di Bartolomeo, R., Cappabianca, G., Beghi, C., Weltert, L., De Paulis, R., De Vincentiis, C., Biondi, A., Santini, F., Salsano, A., Salvador, L., Picichè, M., Mariscalco, G., Maselli, D., Rinaldi, M., Mancuso, S., Scrofani, R., Cagnoni, G., Antona, C., Dato, G. M. A., Centofani, P., De Bonis, M., Pozzoli, A., Cugola, D., Galletti, L., Villa, E., Dossena, Y., Troise, G., Barili, F., Paparella, D., Margari, V., Lorusso, R., Parolari, A., and Livi, U.

Published
2018

23. Corrigendum to “A predictive model for early mortality after surgical treatment of heart valve or prosthesis infective endocarditis. The EndoSCORE”. [Int. J. Cardiol. 241 (Aug 15 2017) 97–102](S0167527317309877)(10.1016/j.ijcard.2017.03.148)

Author

Di Mauro, M, Di Mauro, M, Dato, G, Barili, F, Gelsomino, S, Sante, P, Corte, A, Carrozza, A, Ratta, E, Cugola, D, Galletti, L, Devotini, R, Casabona, R, Santini, F, Salsano, A, Scrofani, R, Antona, C, Botta, L, Russo, C, Mancuso, S, Rinaldi, M, De Vincentiis, C, Biondi, A, Beghi, C, Cappabianca, G, Tarzia, V, Gerosa, G, De Bonis, M, Pozzoli, A, Nicolini, F, Benassi, F, Rosato, F, Grasso, E, Livi, U, Sponga, S, Pacini, D, Di Bartolomeo, R, DeMartino, A, Bortolotti, U, Onorati, F, Faggian, G, Lorusso, R, Vizzardi, E, Di Giammarco, G, Marinelli, D, Villa, E, Troise, G, Piciche, M, Musumeci, F, Paparella, D, Margari, V, Tritto, F, Damiani, G, Scrascia, G, Zaccaria, S, Renzulli, A, Serraino, G, Mariscalco, G, Maselli, D, Foschi, M, Parolari, A, Nappi, G, Di Mauro, M, Di Mauro, M, Dato, G, Barili, F, Gelsomino, S, Sante, P, Corte, A, Carrozza, A, Ratta, E, Cugola, D, Galletti, L, Devotini, R, Casabona, R, Santini, F, Salsano, A, Scrofani, R, Antona, C, Botta, L, Russo, C, Mancuso, S, Rinaldi, M, De Vincentiis, C, Biondi, A, Beghi, C, Cappabianca, G, Tarzia, V, Gerosa, G, De Bonis, M, Pozzoli, A, Nicolini, F, Benassi, F, Rosato, F, Grasso, E, Livi, U, Sponga, S, Pacini, D, Di Bartolomeo, R, DeMartino, A, Bortolotti, U, Onorati, F, Faggian, G, Lorusso, R, Vizzardi, E, Di Giammarco, G, Marinelli, D, Villa, E, Troise, G, Piciche, M, Musumeci, F, Paparella, D, Margari, V, Tritto, F, Damiani, G, Scrascia, G, Zaccaria, S, Renzulli, A, Serraino, G, Mariscalco, G, Maselli, D, Foschi, M, Parolari, A, and Nappi, G

Abstract

The authors regret that the first name and last name of the author Sandro Sponga was published incorrectly in the original version and this has now been corrected.

Published
2018

24. Simple risk models to predict surgical mortality in acute type A aortic dissection: the International Registry of Acute Aortic Dissection score

Author

Rampoldi V, Trimarchi S, Eagle KA, Nienaber CA, Oh JK, Bossone E, Myrmel T, Sangiorgi GM, De Vincentiis C, Cooper JV, Fang J, Smith D, Tsai T, Raghupathy A, Sechtem U, Deeb MG, Sundt TM 3rd, Isselbacher EM, International Registry of Acute Aortic Dissection Investigators, FATTORI, ROSSELLA, Rampoldi V, Trimarchi S, Eagle KA, Nienaber CA, Oh JK, Bossone E, Myrmel T, Sangiorgi GM, De Vincentiis C, Cooper JV, Fang J, Smith D, Tsai T, Raghupathy A, Fattori R, Sechtem U, Deeb MG, Sundt TM 3rd, Isselbacher EM, International Registry of Acute Aortic Dissection (IRAD) Investigators., Rampoldi, V, Trimarchi, S, Eagle, Ka, Nienaber, Ca, Oh, Jk, Bossone, E, Myrmel, T, Sangiorgi, Gm, De Vincentiis, C, Cooper, Jv, Fang, Jm, Smith, D, Tsai, T, Raghupathy, A, Fattori, R, Sechtem, U, Deeb, Mg, Sundt, Tm, and Isselbacher, Em

Subjects
Adult, Male, Risk, Pulmonary and Respiratory Medicine, Thorax, medicine.medical_specialty, Infarction, Aneurysm, Cardiac tamponade, medicine, Humans, Hospital Mortality, Registries, Risk factor, Aged, Aortic dissection, business.industry, Middle Aged, Models, Theoretical, medicine.disease, Aortic Aneurysm, Surgery, Cardiac surgery, Aortic Dissection, Blood pressure, Acute Disease, Female, Cardiology and Cardiovascular Medicine, business
Abstract

BACKGROUND: Surgical mortality for acute type A aortic dissection is frequently related to preoperative clinical conditions. We report a predictive score to identify risk of death that may be helpful to assist surgeons who are considering whether to proceed with surgical correction in the case of patients in extreme clinical risk. METHODS: Surgical outcome of 682 patients enrolled in the International Registry of Acute Aortic Dissection from 1996 to 2003 was analyzed. Two different models were used. The initial model included only preoperative variables such as demographics, history, symptoms, signs, and diagnostic methods (model 1). The second model also tested intraoperative hemodynamic and surgical variables (model 2). A bedside risk prediction tool to predict operative mortality in individual patients was developed. RESULTS: The overall in-hospital surgical mortality was 23.9%. Independent preoperative predictors of mortality in model 1 were age greater than 70 years, prior cardiac surgery, hypotension (systolic blood pressure less than 100 mm Hg) or shock at presentation, migrating pain, cardiac tamponade, any pulse deficit, and electrocardiogram with findings of myocardial ischemia or infarction. In model 2, other predictors of surgical death were intraoperative hypotension, a right ventricle dysfunction at surgery, and a necessity to perform coronary revascularization. An independent predictor for favorable surgical outcome was right hemiarch replacement. CONCLUSIONS: Surgery in unstable patients with acute type A aortic dissection can be highly unsuccessful. The International Registry of Acute Aortic Dissection risk models predict in-hospital mortality using a multivariable risk prediction tool, useful for surgeons and patients as they consider their surgical risk and the pros and cons of embarking on high-risk surgery.

Published
2007

25. Simple risk model to predict surgical mortality in acute type a aortic dissection: The IRAD score

Author

Rampoldi V, Trimarchi S, Eagle KA, Nienaber C, Oh J, Bossone E, Myrmel T, De Vincentiis C, Cooper JV, Fang JM, Fattori R, Sechtem U, Isselbacher EM, Donato PS, Milanese SD, Rampoldi, V, Trimarchi, S, Eagle, Ka, Nienaber, C, Oh, J, Bossone, E, Myrmel, T, De Vincentiis, C, Cooper, Jv, Fang, Jm, Fattori, R, Sechtem, U, Isselbacher, Em, Donato, P, and Milanese, Sd

Published
2006

26. PACEMAKER DEPENDENCY FOLLOWING CARDIAC SURGERY PROCEDURES: A COMPREHENSIVE LONG-TERM POSTOPERATIVE EVALUATION OF 1158 INHOSPITAL IMPLANTS FROM A MULTICENTER ITALIAN EXPERIENCE

Author

Lorusso, R., Barili, F., Miceli, A., Parolari, A., Daprati, A., Myasoedova, V., Alamanni, F., De Vincentiis, C., Grimaldi, F., Aimè, E., Gonzi, G. L., Gherli, T., Colli, A., Gerosa, G., De Bonis, M., Pozzoli, A., Paglino, G., Della Bella, P., Actis Dato, G., Varone, E., Parisi, F., Casabona, R., Sponga, S., Toniolo, M., Proclemer, A., Livi, U., Mariscalco, G., Scannapieco, A., Beghi, C., Scrofani, R., Foresti, D., Antona, C., Tritto, F., Gregorio, R., Miraglia, M., Piazza, L., Villa, E., Dalla Tomba, M., Pecora, D., Troise, G., Serraino, F., Renzulli, A., Rosato, F., Grasso, E., Grossi, C., Paparella, D., Amorese, L., de Luca Tupputi Schinosa, L., Coletti, G., Curnis, Antonio, Vizzardi, Enrico, and Glauber, M.

Published
2014

29. Risk factors and outcome in European cardiac surgery: analysis of the EuroSCORE multinational database of 19030 patients.

Author

Roques, F, Nashef, S A, Michel, P, Gauducheau, E, de Vincentiis, C, Baudet, E, Cortina, J, David, M, Faichney, A, Gabrielle, F, Gams, E, Harjula, A, Jones, M T, Pintor, P P, Salamon, R, and Thulin, L

Abstract

To assess risk factors for mortality in cardiac surgical adult patients as part of a study to develop a European System for Cardiac Operative Risk Evaluation (EuroSCORE).

Published
1999
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32. Surgical treatment of isolated tricuspid valve infective endocarditis: 25-year results from a multicenter registry

Author

Giosuè Falcetta, Ester Della Ratta, Roberto Lorusso, Daniele Maselli, Roberto Scrofani, Vito Margari, Francesco Nicolini, Antonio Salsano, Lorenzo Galletti, Alessandro Parolari, Carla Lucarelli, Davide Pacini, Michele Di Mauro, Giacomo Murana, Francesco Musumeci, Giuseppe Scrascia, Samuel Mancuso, Giuseppe Faggian, Massimiliano Foschi, Francesco Onorati, Mauro Rinaldi, Giovanni Troise, Yudit Dossena, Ugolino Livi, Marco Picichè, Domenico Paparella, Giovanni Mariscalco, Loris Salvador, Giangiuseppe Cappabianca, Cesare Beghi, Uberto Bortolotti, Guglielmo Mario Actis Dato, Carlo Antona, Filippo Benassi, Sandro Sponga, Paolo Centofanti, Enrico Vizzardi, Alessandro Della Corte, Carlo De Vincentiis, Fabio Barili, Alberto Pozzoli, Andrea Biondi, Giovanni Cagnoni, Riccardo Gherli, Michele De Bonis, Emmanuel Villa, Francesco Santini, Diego Cugola, Giovanni Casali, Di Mauro, M, Foschi, M, Dato, G, Centofanti, P, Barili, F, Corte, A, Ratta, E, Cugola, D, Galletti, L, Santini, F, Salsano, A, Rinaldi, M, Mancuso, S, Cappabianca, G, Beghi, C, De Vincentiis, C, Biondi, A, Livi, U, Sponga, S, Pacini, D, Murana, G, Scrofani, R, Antona, C, Cagnoni, G, Nicolini, F, Benassi, F, De Bonis, M, Pozzoli, A, Casali, G, Scrascia, G, Falcetta, G, Bortolotti, U, Musumeci, F, Gherli, R, Vizzardi, E, Salvador, L, Piciche, M, Paparella, D, Margari, V, Troise, G, Villa, E, Dossena, Y, Lucarelli, C, Onorati, F, Faggian, G, Mariscalco, G, Maselli, D, Parolari, A, Lorusso, R, MUMC+: MA Med Staf Spec CTC (9), RS: CARIM - R2.12 - Surgical intervention, CTC, RS: Carim - V04 Surgical intervention, Di Mauro M., Foschi M., Dato G.M.A., Centofanti P., Barili F., Corte A.D., Ratta E.D., Cugola D., Galletti L., Santini F., Salsano A., Rinaldi M., Mancuso S., Cappabianca G., Beghi C., De Vincentiis C., Biondi A., Livi U., Sponga S., Pacini D., Murana G., Scrofani R., Antona C., Cagnoni G., Nicolini F., Benassi F., De Bonis M., Pozzoli A., Casali G., Scrascia G., Falcetta G., Bortolotti U., Musumeci F., Gherli R., Vizzardi E., Salvador L., Piciche M., Paparella D., Margari V., Troise G., Villa E., Dossena Y., Lucarelli C., Onorati F., Faggian G., Mariscalco G., Maselli D., Parolari A., Lorusso R., Di Mauro, M., Foschi, M., Dato, G. M. A., Centofanti, P., Barili, F., Della Corte, A., Ratta, E. D., Cugola, D., Galletti, L., Santini, F., Salsano, A., Rinaldi, M., Mancuso, S., Cappabianca, G., Beghi, C., De Vincentiis, C., Biondi, A., Livi, U., Sponga, S., Pacini, D., Murana, G., Scrofani, R., Antona, C., Cagnoni, G., Nicolini, F., Benassi, F., De Bonis, M., Pozzoli, A., Casali, G., Scrascia, G., Falcetta, G., Bortolotti, U., Musumeci, F., Gherli, R., Vizzardi, E., Salvador, L., Piciche, M., Paparella, D., Margari, V., Troise, G., Villa, E., Dossena, Y., Lucarelli, C., Onorati, F., Faggian, G., Mariscalco, G., Maselli, D., Parolari, A., Lorusso, R., and Corte, A. D.

Subjects
Male, Time Factors, SURGERY, medicine.medical_treatment, Heart Valve Diseases, 030204 cardiovascular system & hematology, Prosthesis, 0302 clinical medicine, Tricuspid Valve Insufficiency, Tricuspid valve, 80 and over, Acute infective endocarditis, Cardiac implantable electronic device, Intravenous drug use, Tricuspid valve, Registries, 030212 general & internal medicine, Acute infective endocarditis, Aged, 80 and over, OUTCOMES, Endocarditis, Cardiac implantable electronic device, Hazard ratio, Middle Aged, medicine.anatomical_structure, Italy, Infective endocarditis, HEART, Female, Cardiology and Cardiovascular Medicine, Adult, medicine.medical_specialty, Adolescent, Intravenous drug use, Young Adult, 03 medical and health sciences, MANAGEMENT, medicine, Humans, Dialysis, Aged, business.industry, MORTALITY, Acute infective endocarditi, Odds ratio, medicine.disease, TRENDS, Surgery, INVASIVENESS, business
Abstract

Background: To assess early and late mortality in patients with isolated acute tricuspid valve infective endocarditis (TVIE) using data from a multicenter registry.Methods: From 1983 to 2018, isolated acute TVIE was surgically treated in 157 (3.8%) patients [mean age 47 +/- 16 years (range 15-86 years), 25% females]. Of these, 142 (90%) had native tricuspid regurgitation, 7 (5%) native tricuspid valve (TV) steno-regurgitation, and 8 (5%) prosthetic TVIE. Intravenous drug use (IVDU) was recorded in 38% of patients, infection involved cardiac implantable electronic device leads in 21%, and vascular catheters for dialysis in 1%; in the remaining cases, the cause was unknown. The primary endpoint was in-hospital outcome, long-term freedom from recurrence and overall survival.Results: Overall, 77 (49%) patients underwent TV repair, 72 (46%) TV replacement, and 8 (5%) prosthetic TV replacement. Early mortality was 11% (n = 17). Expected early mortality according to EndoSCORE was 12%, with age (odds ratio 1.06) and redo (odds ratio 6.64) as risk factors. Late deaths occurred in 31 patients and TVIE recurrences in 4. Survival rates at 10, 20, and 25 years were 66%, 60%, and 44%, respectively. Risk factors were age [hazard ratio (HR) 1.06], mycotic TVIE (HR 4.2), IVDU (HR 4.90), infected prosthesis replacement (HR 4.4), and presence of cardiac implantable electronic device leads (HR 3.0). No significant difference was found in valve repair vs. replacement and in IVDUs vs. non-IVDUs.Conclusions: Patients with isolated acute TVIE undergoing surgical treatment show acceptable early and late outcomes. TVIE recurrence was low, and repair of the affected valve does not seem to confer any advantage either at early or long term up to 25 years. (C) 2019 Elsevier B.V. All rights reserved.

Published
2019
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33. Surgery for Bentall endocarditis: short- and midterm outcomes from a multicentre registry

Author

Francesco Santini, Giovanni Troise, Ugolino Livi, Sandro Sponga, Michele Danilo Pierri, Antonio Salsano, Antonio Messina, Roberto Lorusso, Marco Picichè, Marco Di Eusanio, Daniele Maselli, Diego Cugola, Giuseppe Cagnoni, Uberto Bortolotti, Michele De Bonis, Michele Di Mauro, Domenico Paparella, Ruggero De Paulis, Cesare Beghi, Pietro Giorgio Malvindi, Guglielmo Mario Actis Dato, Carlo Antona, Giangiuseppe Cappabianca, Paolo Centofanti, Mauro Rinaldi, Davide Pacini, Carlo De Vincentiis, Samuel Mancuso, Alberto Pozzoli, Luca Weltert, Lorenzo Galletti, Alessandro Parolari, Loris Salvador, Giacomo Murana, CTC, MUMC+: MA Med Staf Spec CTC (9), RS: Carim - V04 Surgical intervention, Sponga S., Mauro M.D., Malvindi P.G., Paparella D., Murana G., Pacini D., Weltert L., De Paulis R., Cappabianca G., Beghi C., De Vincentiis C., Parolari A., Messina A., Troise G., Salsano A., Santini F., Pierri M.D., Eusanio M.D., Maselli D., Dato G.A., Centofanti P., Mancuso S., Rinaldi M., Cagnoni G., Antona C., Marco Piciche, Salvador L., Cugola D., Galletti L., Pozzoli A., De Bonis M., Lorusso R., Bortolotti U., Livia U., Sponga, S., Di Mauro, M., Malvindi, P. G., Paparella, D., Murana, G., Pacini, D., Weltert, L., De Paulis, R., Cappabianca, G., Beghi, C., De Vincentiis, C., Parolari, A., Messina, A., Troise, G., Salsano, A., Santini, F., Pierri, M. D., Di Eusanio, M., Maselli, D., Actis Dato, G., Centofanti, P., Mancuso, S., Rinaldi, M., Cagnoni, G., Antona, C., Piciche, M., Salvador, L., Cugola, D., Galletti, L., Pozzoli, A., De Bonis, M., Lorusso, R., Bortolotti, U., and Livi, U.

Subjects
Aortic valve, Male, Bentall procedure, 030204 cardiovascular system & hematology, AORTIC ROOT REPLACEMENT, 0302 clinical medicine, Mitral valve, Aortic root, Registries, Heart Valve Prosthesis Implantation, Endocarditis, Hazard ratio, General Medicine, Middle Aged, Mediastinitis, medicine.anatomical_structure, Treatment Outcome, Heart Valve Prosthesis, SURGICAL-TREATMENT, Female, Cardiology and Cardiovascular Medicine, Aortic surgery, Adult, Aged, Aortic Valve, Humans, Reoperation, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Preoperative care, 03 medical and health sciences, medicine, MANAGEMENT, INFECTIVE ENDOCARDITIS, TERM-FOLLOW-UP, business.industry, GRAFT, Perioperative, medicine.disease, Surgery, 030228 respiratory system, PROSTHETIC VALVE ENDOCARDITIS, ASCENDING AORTA, business
Abstract

OBJECTIVES Endocarditis after the Bentall procedure is a severe disease often complicated by a pseudoaneurysm or mediastinitis. Reoperation is challenging but conservative therapy is not effective. The aim of this study was to assess short- and midterm outcomes of patients reoperated on for Bentall-related endocarditis. METHODS Seventy-three patients with Bentall procedure-related endocarditis were recorded in the Italian registry. The mean age was 57 ± 14 years and 92% were men; preoperative comorbidities included hypertension (45%), diabetes (12%) and renal failure (11%). The logistic EuroSCORE was 25%; the EuroSCORE II was 8%. RESULTS Preoperatively, 12% of the patients were in septic shock; left ventricular-aortic discontinuity was present in 63% and mitral valve involvement occurred in 12%. The most common pathogens were Staphylococcus aureus (22%) and Streptococci (14%). Reoperations after a median interval of 30 months (1–221 months) included a repeat Bentall with a bioconduit (41%), a composite mechanical (33%) or biological valved conduit (19%) and a homograft (6%). In 1 patient, a heart transplant was required (1%); in 12%, a mitral valve procedure was needed. The hospital mortality rate was 15%. The postoperative course was complicated by renal failure (19%), major bleeding (14%), pulmonary failure (14%), sepsis (11%) and multiorgan failure (8%). At multivariate analysis, urgent surgery was a risk factor for early death [hazard ratio 20.5 (1.9–219)]. Survival at 5 and 8 years was 75 ± 6% and 71 ± 7%, with 3 cases of endocarditis relapse. CONCLUSIONS Surgery is effective in treating endocarditis following the Bentall procedure although it is associated with high perioperative mortality and morbidity rates. Endocarditis relapse seems to be uncommon.

Published
2020

34. Relation of Prolonged Pacemaker Dependency After Cardiac Surgery to Mortality

Author

Giroc Investigators, Andrea Colli, Ezio Aime, Egidio Varone, Domenico Paparella, Michele De Bonis, Giuseppe Arena, Francesco Alamanni, Roberto Scrofani, Paolo Della Bella, Francesco Paolo Tritto, Emmanuel Villa, Elena Grasso, Giovanni Troise, Fabio Barili, Veronika A. Myasoedova, Caterina Simon, Elham Bidar, Kevin Vernooy, Francesco Rosato, Antonio Miceli, Enrico Vizzardi, Mattia Glauber, Domenico Pecora, Marzia Cottini, Sandro Sponga, Giovanni Mariscalco, Carlo De Vincentiis, Roberto Lorusso, Cesare Beghi, Daniele Maselli, Filiberto Serraino, Alessandro Parolari, Davide Foresti, Francesco Nicolini, Gianluca Gonzi, Lilla Amorese, Mauro Toniolo, Alessandro Proclemer, Gabriele Paglino, Guglielmo Mario Actis Dato, Maurizio Merlo, Rosario Gregorio, Michele Di Mauro, Andrea Daprati, Justine M Ravaux, Gino Gerosa, Ugolino Livi, Marco Solinas, Federica Jiritano, Lorusso, R., Ravaux, J. M., Barili, F., Bidar, E., Vernooy, K., Mauro, M. D., Miceli, A., Parolari, A., Daprati, A., Myasoedova, V., Alamanni, F., De Vincentiis, C., Aime, E., Nicolini, F., Gonzi, G., Colli, A., Gerosa, G., De Bonis, M., Paglino, G., Bella, P. D., Dato, G. A., Varone, E., Sponga, S., Toniolo, M., Proclemer, A., Livi, U., Mariscalco, G., Cottini, M., Beghi, C., Scrofani, R., Foresti, D., Tritto, F. P., Gregorio, R., Villa, E., Troise, G., Pecora, D., Serraino, F., Jiritano, F., Rosato, F., Grasso, E., Paparella, D., Amorese, L., Vizzardi, E., Solinas, M., Arena, G., Maselli, D., Simon, C., Glauber, M., Merlo, M., CTC, MUMC+: MA Med Staf Spec CTC (9), RS: Carim - V04 Surgical intervention, MUMC+: MA Med Staf Artsass CTC (9), Cardiologie, MUMC+: MA Med Staf Spec Cardiologie (9), RS: Carim - H01 Clinical atrial fibrillation, and RS: Carim - H06 Electro mechanics

Subjects
Male, Pacemaker, Artificial, 030204 cardiovascular system & hematology, Postoperative Complications, 0302 clinical medicine, Aortic valve replacement, 80 and over, Sinus rhythm, implantation, Coronary Artery Bypass, Atrioventricular Block, Permanent pacemaker, cardiac surgery, mortality, pacemaker dependency, Aged, 80 and over, Heart Valve Prosthesis Implantation, OUTCOMES, Hazard ratio, Cardiac Pacing, Artificial, Middle Aged, Cardiac surgery, Pacemaker, medicine.anatomical_structure, Artificial, Cardiology, Female, Cardiology and Cardiovascular Medicine, Aged, Bradycardia, Humans, Proportional Hazards Models, Retrospective Studies, Cardiac Surgical Procedures, Mortality, Artery, medicine.medical_specialty, aortic-valve-replacement, conduction, 03 medical and health sciences, Internal medicine, medicine, Proportional hazards model, business.industry, LONG-TERM SURVIVAL, Retrospective cohort study, medicine.disease, 030228 respiratory system, Cardiac Pacing, business, Complication
Abstract

Permanent pacemaker implantation (PPI) represents a rare complication after cardiac surgery, with no uniform agreement on timing and no information on follow-up. A multi-center retrospective study was designed to assess pacemaker dependency (PMD) and long-term mortality after cardiac surgery procedures. Between 2004 and 2016, PPI-patients from 18 centers were followed. Time-to-event data were evaluated with semiparametric regression Cox models and semiparametric Fine and Gray model for competing risk framework. Of 859 (0.90%) PPI-patients, 30% were pacemaker independent (PMI) at 6 months. PMD showed higher mortality compared with PMI (10-year survival 80.1% +/- 2.6% and 92.2% +2.4%, respectively, log-rank p-value < 0.001) with an unadjusted hazard ratio for death of 0.36 (95% CI 0.20 to 0.65, p< 0.001 favoring PMI) and an adjusted hazard ratio of 0.19 (95% CI 0.08 to 0.45, p< 0.001 with PMD as reference). Crude cumulative incidence function of restored PMI rhythm at follow-up at 6 months, 1 year and 12 years were 30.5% (95% CI 27.3% to 33.7%), 33.7% (95% CI 30.4% to 36.9%) and 37.2% (95% CI 33.8% to 40.6%) respectively. PMI was favored by preoperative sinus rhythm with normal conduction (SR) (HR 2.37, 95% CI 1.65 to 3.40, p< 0.001), whereas coronary artery bypass grafting and aortic valve replacement were independently associated with PMD (HR 0.63, 95% CI 0.45 to 0.88, p = 0.006 and HR 0.807, 95% CI 0.65 to 0.99, p = 0.047 respectively). Time-to-implantation was not associated with increased rate of PMI. Although 30% of PPI-patients are PMI after 6 months, PMD is associated with higher mortality at long term. (C) 2020 The Author(s). Published by Elsevier Inc.

Published
2021
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35. Beating vs Arrested Heart Isolated Tricuspid Valve Surgery: Long-term Outcomes

Author

Sandro Sponga, Ugolino Livi, Michele Di Mauro, Antonio Lio, Maurizio Taramasso, Francesco Maisano, Alfred Kocher, Marco Solinas, Paolo Berretta, Martin Andreas, Paul Werner, Ernesto Greco, Ester Della Ratta, Guglielmo Saitto, Carlo Antona, Dror B. Leviner, Fabio Miraldi, Roberto Scrofani, Andrea Biondi, Giacomo Bianchi, Francesco Musumeci, Marco Di Eusanio, Matteo Saccocci, Marco Russo, Alessandro Della Corte, Erez Sharoni, Guenther Laufer, Carlo De Vincentiis, Giovanni Troise, Antonio M. Calafiore, Russo, Marco, Di Mauro, Michele, Saitto, Guglielmo, Lio, Antonio, Berretta, Paolo, Taramasso, Maurizio, Scrofani, Roberto, Della Corte, Alessandro, Sponga, Sandro, Greco, Ernesto, Saccocci, Matteo, Calafiore, Antonio, Bianchi, Giacomo, Leviner, Dror B, Biondi, Andrea, Della Ratta, Ester, Livi, Ugolino, Sharoni, Erez, Werner, Paul, De Vincentiis, Carlo, Di Eusanio, Marco, Kocher, Alfred, Antona, Carlo, Miraldi, Fabio, Troise, Giovanni, Solinas, Marco, Maisano, Francesco, Laufer, Guenther, Musumeci, Francesco, Andreas, Martin, RS: Carim - V04 Surgical intervention, CTC, Russo, M, Di Mauro, M, Saitto, G, Lio, A, Berretta, P, Taramasso, M, Scrofani, R, Della Corte, A, Sponga, S, Greco, E, Saccocci, M, Calafiore, A, Bianchi, G, Leviner, D, Biondi, A, Della Ratta, E, Livi, U, Sharoni, E, Werner, P, De Vincentiis, C, Di Eusanio, M, Kocher, A, Antona, C, Miraldi, F, Troise, G, Solinas, M, Maisano, F, Laufer, G, Musumeci, F, and Andreas, M

Subjects
Male, Reoperation, Pulmonary and Respiratory Medicine, Isolated tricuspid valve disease, medicine.medical_specialty, Time Factors, Tricuspid Valve Surgery, REGURGITATION, survival, beating heart, surgery, Postoperative Complications, Risk Factors, Tricuspid valve, medicine, Humans, Propensity Score, Survival rate, Stroke, Retrospective Studies, FORGOTTEN, Heart Valve Prosthesis Implantation, REPAIR, Ejection fraction, business.industry, Incidence, Mortality rate, EuroSCORE, Retrospective cohort study, Perioperative, Middle Aged, medicine.disease, Tricuspid Valve Insufficiency, Surgery, Europe, Survival Rate, medicine.anatomical_structure, Heart Arrest, Induced, Female, Cardiology and Cardiovascular Medicine, business, Follow-Up Studies
Abstract

BACKGROUND Isolated tricuspid valve (TV) surgery is a rare procedure generally considered at high risk for perioperative mortality and poor long-term outcomes. Surgical treatment can be performed with either an arrested heart (AH) or beating heart (BH) technique. The aim of this study was to compare the outcomes of isolated tricuspid surgery with 2 different approaches.METHODS The Surgical-Tricuspid Study is a multicenter international retrospective study enrolling adult patients who un- derwent isolated TV procedures (n = 406; age 56 +/- 16 years; 56% female) at 13 international sites. The AH and BH strategies were performed in 253 and 153 patients, respectively. Propensity score-matched analysis was used to compare groups.RESULTS After matching, 129 pairs were obtained and analyzed. The 30-day mortality rate was 6.2% versus 5.0% in the AH and BH groups, respectively (P = .9). The rates of acute renal failure requiring replacement therapy (10% versus 3%; P = .02) and stroke (1.6% versus 0%; P = .08) were numerically higher in the AH group. The 6-year survival rate was 67% +/- 6% versus 78% +/- 5% in the AH and BH groups, respectively (P = .18), whereas freedom from cardiac death was 75% +/- 5% versus 84% +/- 4% (P = .21). The 6-year composite cardiac end point of cardiac death and reoperation rate was 60% +/- 9% versus 86% +/- 5% (P - .024) comparing AH-TV replacement and BH-TV repair groups.CONCLUSIONS Isolated TV surgery performed with a BH strategy is a safe option and resulted in a trend of increased long-term survival and freedom from reoperation compared with the standard AH technique. Patients undergoing BH valve repair had the best long-term outcome. (C) 2022 by The Society of Thoracic Surgeons

Published
2022

36. Surgical Treatment of Postinfarction Ventricular Septal Rupture

Author

Massimiliano Carrozzini, Nikolaos Bonaros, Bart Meyns, Roberto Scrofani, Giosuè Falcetta, Matteo Pozzi, Antonio Fiore, Stefano D'Alessandro, Salman Almobayedh, Giuseppe Filiberto Serraino, Matteo Matteucci, Vittoria Lodo, Matthias Thielmann, Piotr Suwalski, Carlo Fino, Nikolaos Kalampokas, Shabir Hussain Shah, Marek A. Deja, Dario Fina, Roberto Lorusso, Nawwar Al-Attar, Theodor Fischlein, Udo Boeken, Guglielmo Maria Actis Dato, Francesco Formica, Sandro Sponga, Adam Kowalówka, Fareed A Khouqeer, Carlo De Vincentiis, Giulio Massimi, Igor Vendramin, Jean-François Obadia, Thierry Folliguet, Daniele Ronco, Giovanni Troise, Federica Jiritano, Michele De Bonis, Cesare Beghi, Caterina Simon, Emmanuel Villa, Mariusz Kowalewski, Jurij M. Kalisnik, Shiho Naito, Marco Ranucci, Claudio Russo, CTC, RS: Carim - V04 Surgical intervention, MUMC+: MA Med Staf Spec CTC (9), CarMeN, laboratoire, Maastricht University Medical Centre (MUMC), Maastricht University [Maastricht], Universitá degli Studi dell’Insubria = University of Insubria [Varese] (Uninsubria), Central Clinical Hospital of the Ministry of the Interior & Administration [Warsaw, Poland] (2CHMIA), Ministry of the Interior and Administration [Warsaw, Poland] (MIA), Universita Vita Salute San Raffaele = Vita-Salute San Raffaele University [Milan, Italie] (UniSR), Università degli Studi di Milano-Bicocca = University of Milano-Bicocca (UNIMIB), Università degli studi di Parma = University of Parma (UNIPR), Università degli Studi 'Magna Graecia' di Catanzaro = University of Catanzaro (UMG), Università degli Studi di Milano, IRCCS Policlinico San Donato, CHU Henri Mondor, Innsbruck Medical University = Medizinische Universität Innsbruck (IMU), Niguarda Hospital [Milan, Italy], Università degli Studi di Udine - University of Udine [Italie], University of Pisa - Università di Pisa, Klinikum Nürnberg Nord, Paracelsus Medizinische Privatuniversität = Paracelsus Medical University (PMU), Fondazione Poliambulanza, Mauriziano Umberto Hospital [Turin, Italy] (MUH), King Fahad Medical City [Riyadh, Saudi Arabia], Luigi Sacco University Hospital [Milan], Medical University of Silesia (SUM), Upper Silesian Medical Centre [Katowice, Poland] (USMC), West German Heart Center, Universität Duisburg-Essen [Essen], University Hospitals Leuven [Leuven], King Faisal Specialist Hospital and Resarch Centre [Riyadh, Saudi Arabia] (KFSHRC), Golden Jubilee National Hospital, Glasgow, Hôpital Louis Pradel [CHU - HCL], Hospices Civils de Lyon (HCL), Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), University Hospital Düsseldorf, Hospital Papa Giovanni XXIII (Hosp P Giovanni XXIII), University Heart Center [Hamburg], Cardiovascular Research Institute Maastricht (CARIM), Università degli Studi di Brescia = University of Brescia (UniBs), Services de Pneumologie, Exploration Fonctionnelle Respiratoire et Cardiologie (Hôpital Louis Pradel), Ronco, D., Matteucci, M., Kowalewski, M., De Bonis, M., Formica, F., Jiritano, F., Fina, D., Folliguet, T., Bonaros, N., Russo, C. F., Sponga, S., Vendramin, I., De Vincentiis, C., Ranucci, M., Suwalski, P., Falcetta, G., Fischlein, T., Troise, G., Villa, E., Dato, G. A., Carrozzini, M., Serraino, G. F., Shah, S. H., Scrofani, R., Fiore, A., Kalisnik, J. M., D'Alessandro, S., Lodo, V., Kowalowka, A. R., Deja, M. A., Almobayedh, S., Massimi, G., Thielmann, M., Meyns, B., Khouqeer, F. A., Al-Attar, N., Pozzi, M., Obadia, J. -F., Boeken, U., Kalampokas, N., Fino, C., Simon, C., Naito, S., Beghi, C., and Lorusso, R.

Subjects
Male, MORTALITY-RATES, [SDV]Life Sciences [q-bio], medicine.medical_treatment, Medizin, Myocardial Infarction, Cohort Studies, Odds Ratio, Myocardial infarction, Prospective Studies, Coronary Artery Bypass, Prospective cohort study, Original Investigation, Ventricular Septal Rupture, OUTCOMES, Cardiogenic shock, Mortality rate, CARDIAC RUPTURE, General Medicine, MECHANICAL CIRCULATORY SUPPORT, Middle Aged, [SDV] Life Sciences [q-bio], Online Only, Female, Life Sciences & Biomedicine, Cohort study, medicine.medical_specialty, Preoperative care, EXTRACORPOREAL MEMBRANE-OXYGENATION, Medicine, General & Internal, General & Internal Medicine, medicine, Extracorporeal membrane oxygenation, Humans, cardiovascular diseases, Aged, Retrospective Studies, REPAIR, Science & Technology, business.industry, Research, ELEVATION MYOCARDIAL-INFARCTION, Perioperative, medicine.disease, Surgery, DEFECT, RISK-FACTORS, business, TASK-FORCE
Abstract

Key Points Question What are the early outcomes of surgical treatment of postinfarction ventricular septal rupture? Findings In this cohort study of 475 patients from 26 different centers worldwide, the early mortality rate for surgically treated ventricular septal rupture was 40.4%, mostly due to low cardiac output, and it did not improve in the last 2 decades. Meaning The findings of this study suggest that patient-tailored preoperative and perioperative management of postinfarction ventricular septal rupture should be addressed to improve the current suboptimal survival rates., This cohort study assesses the clinical characteristics and early outcomes for patients who received surgery for postinfarction ventricular septal rupture and identifies factors independently associated with mortality., Importance Ventricular septal rupture (VSR) is a rare but life-threatening mechanical complication of acute myocardial infarction associated with high mortality despite prompt treatment. Surgery represents the standard of care; however, only small single-center series or national registries are usually available in literature, whereas international multicenter investigations have been poorly carried out, therefore limiting the evidence on this topic. Objectives To assess the clinical characteristics and early outcomes for patients who received surgery for postinfarction VSR and to identify factors independently associated with mortality. Design, Setting, and Participants The Mechanical Complications of Acute Myocardial Infarction: an International Multicenter Cohort (CAUTION) Study is a retrospective multicenter international cohort study that includes patients who were treated surgically for mechanical complications of acute myocardial infarction. The study was conducted from January 2001 to December 2019 at 26 different centers worldwide among 475 consecutive patients who underwent surgery for postinfarction VSR. Exposures Surgical treatment of postinfarction VSR, independent of the technique, alone or combined with other procedures (eg, coronary artery bypass grafting). Main Outcomes and Measures The primary outcome was early mortality; secondary outcomes were postoperative complications. Results Of the 475 patients included in the study, 290 (61.1%) were men, with a mean (SD) age of 68.5 (10.1) years. Cardiogenic shock was present in 213 patients (44.8%). Emergent or salvage surgery was performed in 212 cases (44.6%). The early mortality rate was 40.4% (192 patients), and it did not improve during the nearly 20 years considered for the study (median [IQR] yearly mortality, 41.7% [32.6%-50.0%]). Low cardiac output syndrome and multiorgan failure were the most common causes of death (low cardiac output syndrome, 70 [36.5%]; multiorgan failure, 53 [27.6%]). Recurrent VSR occurred in 59 participants (12.4%) but was not associated with mortality. Cardiogenic shock (survived: 95 [33.6%]; died, 118 [61.5%]; P

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

Author

Mario Gaudino, Michele De Bonis, Antonino Di Franco, Francesco Formica, Mattia Glauber, Antonio Messina, Giovanni Troise, Cesare Beghi, Antonio M. Calafiore, Marco Ranucci, Roberto Lorusso, Carlo De Vincentiis, Antonio Miceli, Carlo Antona, Francesco Nicolini, Giovanni Mariscalco, Michele Di Mauro, Roberto Scrofani, Cinzia Trumello, RS: Carim - V04 Surgical intervention, CTC, MUMC+: MA Med Staf Spec CTC (9), Mauro, M. D., Calafiore, A. M., Di Franco, A., Nicolini, F., Formica, F., Scrofani, R., Antona, C., Messina, A., Troise, G., Mariscalco, G., Beghi, C., De Bonis, M., Trumello, C., Miceli, A., Glauber, M., Ranucci, M., De Vincentiis, C., Gaudino, M., and Lorusso, R.

Subjects
Atrial fibrillation, Blood cardioplegia, Cold cardioplegia, Coronary artery bypass, Crystalloid cardioplegia, Stroke, Warm cardioplegia, blood cardioplegia, Coronary surgery, heart-surgery, 030204 cardiovascular system & hematology, Postoperative Complications, 0302 clinical medicine, cold cardioplegia, oxidative stress, atrial fibrillation, Prospective Studies, 030212 general & internal medicine, bypass, education.field_of_study, stroke, Cardiac surgery, medicine.anatomical_structure, Italy, Cohort, Heart Arrest, Induced, Cardiology, Cardiology and Cardiovascular Medicine, Artery, myocardial protection, medicine.medical_specialty, Population, nitric-oxide, 03 medical and health sciences, Internal medicine, medicine, warm cardioplegia, Humans, education, propensity score, Retrospective Studies, ARTERY, business.industry, INFLAMMATORY RESPONSE, medicine.disease, cardiac-surgery, Propensity score matching, business
Abstract

Objective: The aim of this multicenter study was to evaluated whether cold or warm cardioplegia are associated with postoperative atrial fibrillation (POAF) and the prognostic role of the latter on early stroke and neurological mortality.Method: This was a retrospective analysis of prospective collected data from 9 cardiac centers in Italy and the United States including patients undergoing surgery between 2010 and 2018. From the 9 institutional databases, 17,231 patients underwent isolated CABG on-pump, using either warm cardioplegia (n = 7730) or cold cardioplegia (n = 9501); among the latter group blood and crystalloid cardioplegia were used in 691 and 8810 patients, respectively. After matching, two pairs of 4162 patients (overall cohort 8324) were analyzed.Results: In matched population, the rate of POAF was 18% (1472 cases), 15% (608) in warm group versus 21% (864) in cold group (p < 0.001). Multivariable analysis confirmed that cold cardioplegia was associated with higher rate of POAF, along with age, hypercholesterolemia, LVEF, reoperation, preoperative IABP, previous stroke, cardiopulmonary and cross-clamp. Moreover, cold cardioplegia as well as POAF increased the rate of postoperative stroke as well as early mortality and neurological mortality Propensity-weighted cohort included 11,830 (70%) patients out of 17,231. After adjustment, both cold blood and cold crystalloid cardioplegia negatively influenced POAF, stroke and neurological mortality.Conclusions: Warm cardioplegia may reduce the rate of POAF in CABG patients with respect to cold cardioplegia, either blood or crystalloid. This has a prognostic impact on postoperative stroke and neurological mortality. (C) 2020 Elsevier B.V. All rights reserved.

Published
2021

38. First reorganization in Europe of a regional cardiac surgery system to deal with the coronavirus-2019 pandemic

Author

Alessandro Frigiola, Giovanni Troise, Elena Bottinelli, Benedetto Del Forno, Maurizio Roberto, Alessandro Giamberti, Fabrizio Monaco, Luca Merlino, Giulio Pompilio, Michele De Bonis, Ottavio Alfieri, Francesco Alamanni, Alessandro Triboldi, Lorenzo Menicanti, Igor Belluschi, Fulvio Edoardo Odinolfi, Alessandro Castiglioni, Germano Di Credico, Gianluca Polvani, Alberto Ambrosio, Giulio Melisurgo, Carlo De Vincentiis, Anna Mara Scandroglio, Belluschi, I., De Bonis, M., Alfieri, O., Del Forno, B., Alamanni, F., Polvani, G., Pompilio, G., Roberto, M., Merlino, L. G., Troise, G., Triboldi, A., Di Credico, G., Odinolfi, F. E., Giamberti, A., Frigiola, A., De Vincentiis, C., Menicanti, L., Monaco, F., Melisurgo, G., Scandroglio, A. M., Ambrosio, A., Bottinelli, E., and Castiglioni, A.

Subjects
Pulmonary and Respiratory Medicine, Adult, Male, medicine.medical_specialty, 2019-20 coronavirus outbreak, Coronavirus disease 2019 (COVID-19), Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Pneumonia, Viral, medicine.disease_cause, Severe Acute Respiratory Syndrome, Pandemic, medicine, Humans, Elective surgery, Intensive care medicine, Pandemics, Coronavirus, Aged, Cross Infection, Infection Control, Coronavirus disease 2019, business.industry, COVID-19, Thoracic Surgery, General Medicine, Cardiac surgery, Middle Aged, Organizational Innovation, Editorial, Italy, Elective Surgical Procedures, Surgery, Female, business, Cardiology and Cardiovascular Medicine, Coronavirus Infections
Published
2020

39. Association Between Coronary Artery Bypass Surgical Techniques and Postoperative Stroke

Author

Mattia Glauber, Cesare Beghi, Antonio Miceli, Mario Gaudino, Tiziano Gherli, Giovanni Mariscalco, Michele De Bonis, Antonino Di Franco, Valentina Grazioli, Giovanni Troise, Emmanuel Villa, Carlo Antona, Carlo De Vincentiis, Roberto Scrofani, Francesco Nicolini, Roberto Lorusso, Maurizio Taramasso, Marco Moscarelli, Marco Ranucci, Lorusso, R., Moscarelli, M., Di Franco, A., Grazioli, V., Nicolini, F., Gherli, T., De Bonis, M., Taramasso, M., Villa, E., Troise, G., Scrofani, R., Antona, C., Mariscalco, G., Beghi, C., Miceli, A., Glauber, M., Ranucci, M., De Vincentiis, C., Gaudino, M., CTC, MUMC+: MA Med Staf Spec CTC (9), RS: Carim - V04 Surgical intervention, RS: CARIM - R2.12 - Surgical intervention, and University of Zurich

Subjects
Male, PREDICTOR, off-pump, Bypass grafting, SURGERY, Coronary Artery Bypass, Off-Pump, coronary artery bypass grafting, 030204 cardiovascular system & hematology, off‐pump, Postoperative Complications, 0302 clinical medicine, Medicine, Coronary Artery Bypass, Stroke, Aorta, Original Research, RISK, OUTCOMES, Cardiovascular Surgery, on-pump, Incidence, Middle Aged, Constriction, stroke, medicine.anatomical_structure, Cardiology, Female, Cardiology and Cardiovascular Medicine, Artery, AORTIC MANIPULATION, medicine.medical_specialty, PUMP, 610 Medicine & health, aortic clamp, 2705 Cardiology and Cardiovascular Medicine, MORBIDITY, 03 medical and health sciences, Postoperative stroke, Internal medicine, Humans, METAANALYSIS, Aged, Retrospective Studies, business.industry, on‐pump, medicine.disease, 10020 Clinic for Cardiac Surgery, CLAMP, 030228 respiratory system, business
Abstract

Background The impact of the coronary artery bypass grafting ( CABG ) technique (on‐ versus off‐pump, single versus multiple aortic clamping) on postoperative neurological outcome remains a matter of controversy. The aim of this study was to assess the association between the incidence of postoperative stroke and the degree of aortic manipulation in one of the largest contemporary CABG series. Methods and Results A retrospective, multicenter, international study was conducted in 25 388 patients undergoing isolated CABG procedures with on‐pump CABG ( ONCAB ) or off‐pump CABG ( OPCAB ) technique including single or multiple aortic clamping. Postoperative stroke was defined as a postoperative neurological deficit lasting more than 24 hours and associated with evidence of a brain lesion on computed tomography. The degree of aortic manipulation was assumed to be higher for on‐pump versus off‐pump surgery and for multiple versus single or no aortic clamping. Logistic regression and propensity matching were used. ONCAB procedures were performed in 17 231 cases and OPCAB in 8157. The incidence of postoperative stroke was significantly lower in the OPCAB group even after propensity matching (0.4% OPCAB versus 1.2% ONCAB , P =0.02). In the ONCAB group (but not in the OPCAB arm) the use of single aortic clamping was associated with significantly reduced postoperative stroke rate (odds ratio, 0.05; 95% CI , 0.008 to 0.07 [ P Conclusions OPCAB and the use of single aortic clamping in the ONCAB arm were associated with a reduced incidence of postoperative stroke. Our data confirm a strong association between aortic manipulation and neurological outcome after CABG surgery.

Published
2019
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40. Surgical repair of bicuspid aortopathy at small diameters: Clinical and institutional factors

Author

Alexander P. Nissen, Van Thi Thanh Truong, Bader A. Alhafez, Jyothy J. Puthumana, Anthony L. Estrera, Simon C. Body, Siddharth K. Prakash, Eduardo Bossone, Rodolfo Citro, Simon Body, J. Daniel Muehlschlegel, Jasmine T. Shahram, Thy B. Nguyen, Vicenza Stefano Nistri, Dan Gilon, Ronen Durst, Carlo de Vincentiis, Francesca R. Pluchinotta, Thoralf M. Sundt, Hector I. Michelena, Giuseppe Limongelli, Patrick M. McCarthy, S. Chris Malaisrie, Aakash Bavishi, Malenka M. Bissell, Gordon S. Huggins, Victor Dayan, Francois Dagenais, Alessandro Della Corte, Evaldas Girdsaukas, Bo Yang, Kim Eagle, Dianna M. Milewicz, Tom C. Nguyen, Harleen K. Sandhu, Hazim J. Safi, Josh C. Denny, Arturo Evangelista, Laura Galian-Gay, Kim A. Eagle, Williams Ravekes, Harry C. Dietz, Kathryn W. Holmes, Jennifer Habashi, Scott A. LeMaire, Joseph S. Coselli, Shaine A. Morris, Cheryl L. Maslen, Howard K. Song, G. Michael Silberbach, Reed E. Pyeritz, Joseph E. Bavaria, Karianna Milewski, Richard B. Devereux, Jonathan W. Weinsaft, Mary J. Roman, Ralph V. Shohet, Nazli McDonnell, Federico M. Asch, H. Eser Tolunay, Patrice Desvigne-Nickens, Hung Tseng, Barbara L. Kroner, Nissen, A. P., Truong, V. T. T., Alhafez, B. A., Puthumana, J. J., Estrera, A. L., Body, S. C., Prakash, S. K., Bossone, E., Citro, R., Body, S., Muehlschlegel, J. D., Shahram, J. T., Nguyen, T. B., Stefano Nistri, V., Gilon, D., Durst, R., de Vincentiis, C., Pluchinotta, F. R., Sundt, T. M., Michelena, H. I., Limongelli, G., Mccarthy, P. M., Malaisrie, S. C., Bavishi, A., Bissell, M. M., Huggins, G. S., Dayan, V., Dagenais, F., Corte, A. D., Girdsaukas, E., Yang, B., Eagle, K., Milewicz, D. M., Nguyen, T. C., Sandhu, H. K., Safi, H. J., Denny, J. C., Evangelista, A., Galian-Gay, L., Eagle, K. A., Ravekes, W., Dietz, H. C., Holmes, K. W., Habashi, J., Lemaire, S. A., Coselli, J. S., Morris, S. A., Maslen, C. L., Song, H. K., Silberbach, G. M., Pyeritz, R. E., Bavaria, J. E., Milewski, K., Devereux, R. B., Weinsaft, J. W., Roman, M. J., Shohet, R. V., Mcdonnell, N., Asch, F. M., Tolunay, H. E., Desvigne-Nickens, P., Tseng, H., and Kroner, B. L.

Subjects
Registrie, Male, Time Factors, thoracic aortic aneurysm, Heart Valve Diseases, Patient characteristics, ascending aortic intervention, thoracic aortic dissection, 030204 cardiovascular system & hematology, 0302 clinical medicine, Bicuspid aortic valve, Aortic valve replacement, Bicuspid Aortic Valve Disease, Risk Factors, Registries, Heart Valve Prosthesis Implantation, Middle Aged, Dissection, Heart Valve Disease, Treatment Outcome, Elective Surgical Procedures, Aortic Valve, cardiovascular system, Cardiology, Female, Cardiology and Cardiovascular Medicine, Vascular Surgical Procedures, Human, Pulmonary and Respiratory Medicine, United State, Adult, medicine.medical_specialty, bicuspid aortic valve, Time Factor, Aortic Valve Insufficiency, Clinical Decision-Making, Thoracic aortic aneurysm, Risk Assessment, 03 medical and health sciences, Internal medicine, medicine, Humans, Limited evidence, Risk factor, Aged, Surgical repair, Cross-Sectional Studie, Elective Surgical Procedure, Aortic Aneurysm, Thoracic, business.industry, Risk Factor, Patient Selection, Aortic Valve Stenosis, medicine.disease, Aortic Valve Stenosi, United States, Cross-Sectional Studies, 030228 respiratory system, Surgery, business
Abstract

Objective: Bicuspid aortic valve is a common risk factor for thoracic aortic aneurysm and dissection. Guidelines for elective ascending aortic intervention (AAI) in bicuspid aortic valve are derived from limited evidence, and the extent of practice variation due to patient and provider characteristics is unknown. Using data from 2 large cardiovascular registries, we investigated factors that influence decisions for AAI. Methods: All bicuspid aortic valve cases with known aortic diameters and surgical status were included. We used multivariable logistic regression to profile predictors of isolated aortic valve replacement (AVR) or AVR+AAI, stratified by patient characteristics, surgical indications, and institution. Results: We studied 2861 subjects at 18 institutions from 1996 to 2015. The median aortic diameter of patients who underwent AVR+AAI varied widely across institutions (39-52 mm). Aortic diameters were

Published
2019

41. Role of age in acute type A aortic dissection outcome: Report from the International Registry of Acute Aortic Dissection (IRAD)

Author

Santi, Trimarchi, Kim A, Eagle, Christoph A, Nienaber, Vincenzo, Rampoldi, Frederik H W, Jonker, Carlo, De Vincentiis, Alessandro, Frigiola, Lorenzo, Menicanti, Thomas, Tsai, Jim, Froehlich, Arturo, Evangelista, Daniel, Montgomery, Eduardo, Bossone, Jeanna V, Cooper, Jin, Li, Michael G, Deeb, Gabriel, Meinhardt, Thoralf M, Sundt, Eric M, Isselbacher, Trimarchi, S, Eagle, Ka, Nienaber, Ca, Rampoldi, V, Jonker, Fhw, De Vincentiis, C, Frigiola, A, Menicanti, L, Tsai, T, Froehlich, J, Evangelista, A, Montgomery, D, Bossone, E, Cooper, Jv, Li, J, Deeb, Mg, Meinhardt, G, Sundt, Tm, Isselbacher, Em, Trimarchi, S., Eagle, K. A., Nienaber, C. A., Rampoldi, V., Jonker, F. H. W., De Vincentiis, C., Frigiola, A., Menicanti, L., Tsai, T., Froehlich, J., Evangelista, A., Montgomery, D., Bossone, E., Cooper, J. V., Li, J., Deeb, M. G., Meinhardt, G., Sundt, T. M., and Isselbacher, E. M.

Subjects
Time Factors, experience, Risk Factors, Odds Ratio, Hospital Mortality, Registries, intervention, Aortic dissection, Aged, 80 and over, education.field_of_study, surgical-treatment, Mortality rate, Age Factors, Cardiac surgery, Aortic Aneurysm, Europe, Treatment Outcome, Acute Disease, cardiovascular system, Cardiology, Cardiology and Cardiovascular Medicine, valve, Vascular Surgical Procedures, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Asia, Population, Risk Assessment, nonagenarian, Aneurysm, medicine.artery, Internal medicine, older, medicine, Humans, education, Aged, Retrospective Studies, octogenarian, Aorta, Chi-Square Distribution, business.industry, Patient Selection, Irad, Cardiovascular Agents, Odds ratio, medicine.disease, mortality, United States, Surgery, Aortic Dissection, cardiac-surgery, repair, business
Abstract

Objective: The increasing life expectancy of the population will likely be accompanied by a rise in the incidence of acute type A aortic dissection. However, because of an increased risk of cardiac surgery in an elderly population, it is important to define when, if at all, the risks of aortic repair outweigh the risk of death from unoperated type A aortic dissection. Methods: We analyzed 936 patients with type A aortic dissection enrolled in the International Registry of Acute Aortic Dissection from 1996 to 2004. Patients with type A aortic dissection were categorized according to patient age by decade and by surgical versus medical management, and outcomes of both management types were investigated in the different age groups. Results: The rate of surgical aortic repair decreased progressively with age, whereas surgical mortality significantly increased with age. Age 70 years or more was an independent predictor for mortality (38.2% vs 26.0%; P < .0001, odds ratio 1.73). The in-hospital mortality rate was significantly lower after surgical management compared with medical management until the age of 80 years. For patients aged 80 to 90 years, the in-hospital mortality appeared to be lower after surgical management (37.9% vs 55.2%; P = .188); however, this failed to reach clinical significance owing to the limited patient number in this age group. Conclusions: Although the surgical mortality significantly increased with increased age, surgical management was still associated with significantly lower in-hospital mortality rates compared with medical management until the age of 80 years. Surgery may decrease the in-hospital mortality rate for octogenarians with type A aortic dissection and might be considered in all patients with type A aortic dissection regardless of age.

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42. Surgery for prosthetic valve endocarditis: a retrospective study of a national registry

Author

Pasquale Santè, Roberto Di Bartolomeo, Alberto Pozzoli, Carlo De Vincentiis, Attilio Renzulli, Sandro Gelsomino, Lorenzo Galletti, Alessandro Parolari, Giuseppe Filiberto Serraino, Francesco Santini, Riccardo Casabona, Carlo Antona, Enrico Vizzardi, Roberto Lorusso, Francesco Paolo Tritto, Antonio Salsano, Diego Cugola, Giangiuseppe Cappabianca, Daniele Maselli, Giovanni Troise, Daniele Marinelli, Andrea De Martino, Giuseppe Scrascia, Domenico Paparella, Cesare Beghi, Michele Di Mauro, Giovanni Mariscalco, Roger Devotini, Salvatore Zaccaria, Ester Della Ratta, Alessandro Della Corte, Antonio Carozza, Uberto Bortolotti, Fabio Barili, Andrea Biondi, Girolamo Damiani, G. Nappi, Michele De Bonis, Emmanuel Villa, Roberto Scrofani, Guglielmo Mario Actis Dato, Filippo Benassi, Gabriele Di Giammarco, Vito Margari, Francesco Nicolini, Davide Pacini, Della Corte, Alessandro, Di Mauro, Michele, Actis Dato, Guglielmo, Barili, Fabio, Cugola, Diego, Gelsomino, Sandro, Santè, Pasquale, Carozza, Antonio, Della Ratta, Ester, Galletti, Lorenzo, Devotini, Roger, Casabona, Riccardo, Santini, Francesco, Salsano, Antonio, Scrofani, Roberto, Antona, Carlo, De Vincentiis, Carlo, Biondi, Andrea, Beghi, Cesare, Cappabianca, Giangiuseppe, DE BONIS, Michele, Pozzoli, Alberto, Nicolini, Francesco, Benassi, Filippo, Pacini, Davide, Di Bartolomeo, Roberto, De Martino, Andrea, Bortolotti, Uberto, Lorusso, Roberto, Vizzardi, Enrico, Di Giammarco, Gabriele, Marinelli, Daniele, Villa, Emmanuel, Troise, Giovanni, Paparella, Domenico, Margari, Vito, Tritto, Francesco, Damiani, Girolamo, Scrascia, Giuseppe, Zaccaria, Salvatore, Renzulli, Attilio, Serraino, Giuseppe, Mariscalco, Giovanni, Maselli, Daniele, Parolari, Alessandro, Nappi, Giannantonio, CTC, RS: CARIM - R2.12 - Surgical intervention, MUMC+: MA Med Staf Spec CTC (9), Corte, A, Di Mauro, M, Dato, G, Barili, F, Cugola, D, Gelsomino, S, Sante, P, Carozza, A, Ratta, E, Galletti, L, Devotini, R, Casabona, R, Santini, F, Salsano, A, Scrofani, R, Antona, C, De Vincentiis, C, Biondi, A, Beghi, C, Cappabianca, G, De Bonis, M, Pozzoli, A, Nicolini, F, Benassi, F, Pacini, D, Di Bartolomeo, R, De Martino, A, Bortolotti, U, Lorusso, R, Vizzardi, E, Di Giammarco, G, Marinelli, D, Villa, E, Troise, G, Paparella, D, Margari, V, Tritto, F, Damiani, G, Scrascia, G, Zaccaria, S, Renzulli, A, Serraino, G, Mariscalco, G, Maselli, D, Parolari, A, Nappi, G, De Bonis, Michele, Dato, Guglielmo Acti, Santã, Pasquale, and Ratta, Ester Della

Subjects
Male, Time Factors, medicine.medical_treatment, Early outcomes, Infective endocarditis, Predictors, Prosthetic valve endocarditis, Surgery, Pulmonary and Respiratory Medicine, Cardiology and Cardiovascular Medicine, Infective endocarditi, 030204 cardiovascular system & hematology, Aged, Cardiac Surgical Procedures, Endocarditis, Bacterial, Female, Follow-Up Studies, Heart Valve Prosthesis, Hospital Mortality, Humans, Italy, Middle Aged, Prognosis, Prosthesis-Related Infections, Retrospective Studies, Risk Factors, Survival Rate, Registries, Risk Assessment, 0302 clinical medicine, Epidemiology, Intubation, EPIDEMIOLOGY, 030212 general & internal medicine, Early outcomes, Infective endocarditis, Predictors, Prosthetic valve endocarditis, Surgery, Ejection fraction, Endocarditis, Bacterial, General Medicine, medicine.medical_specialty, Preoperative care, 03 medical and health sciences, Prosthetic valve endocarditi, medicine, MANAGEMENT, INTERNATIONAL-COLLABORATION, business.industry, MORTALITY, Retrospective cohort study, medicine.disease, Early outcome, Etiology, business, Predictor
Abstract

OBJECTIVES: We described clinical-epidemiological features of prosthetic valve endocarditis (PVE) and assessed the determinants of early surgical outcomes in multicentre design.METHODS: Data regarding 2823 patients undergoing surgery for endocarditis at 19 Italian Centers between 1979 and 2015 were collected in a database. Of them, 582 had PVE: in this group, the determinants of early mortality and complications were assessed, also taking into account the different chronological eras encompassed by the study.RESULTS: Overall hospital (30-day) mortality was 19.2% (112 patients). Postoperative complications of any type occurred in 256 patients (44%). Across 3 eras (1980-2000, 2001-08 and 2009-14), early mortality did not significantly change (20.4%, 17.1%, 20.5%, respectively, P = 0.60), whereas complication rate increased (18.5%, 38.2%, 52.8%, P -2 mg/dl, chronic pulmonary disease, low ejection fraction, non-streptococcal aetiology, active endocarditis, preoperative intubation, preoperative shock and triple valve surgery were significantly associated with mortality. In multivariable analysis, age (OR = 1.02; P = 0.03), renal insufficiency (OR = 2.1; P = 0.05), triple valve surgery (OR = 6.9; P = 0.004) and shock (OR = 4.5; P CONCLUSIONS: PVE surgery remains a high-risk one. The strongest predictors of early outcome of PVE surgery are related to patient's haemodynamic status and microbiological factors.

Published
2017

43. A Case of Fatal Bleeding Following Emergency Surgery on an Ascending Aorta Intramural Hematoma in a Patient Taking Dabigatran

Author

Carlo De Vincentiis, Andrea Biondi, Giuseppe Isgrò, Marco Ranucci, Paolo Bianchi, Giulia Beatrice Crapelli, Crapelli, G, Bianchi, P, Isgro, G, Biondi, A, de Vincentiis, C, and Ranucci, M

Subjects
medicine.medical_specialty, Aortic Diseases, 030204 cardiovascular system & hematology, Postoperative Hemorrhage, Antithrombins, Dabigatran, 03 medical and health sciences, 0302 clinical medicine, Hematoma, Fatal Outcome, Emergency surgery, Intramural hematoma, Intensive care, medicine.artery, Ascending aorta, medicine, Humans, 030212 general & internal medicine, Emergency Treatment, Aorta, Aged, 80 and over, business.industry, bleeding, coagulation point-of-care tests, dabigatran, emergency surgery, ROTEM, medicine.disease, Cardiac surgery, Surgery, Anesthesiology and Pain Medicine, Great vessels, Female, Cardiology and Cardiovascular Medicine, business, medicine.drug
Abstract

From the Departments of *Cardiothoracic Vascular Anesthesia and Intensive Care; and the †Cardiac Surgery, Great Vessels Disease, IRCCS Policlinico, San Donato Milanese, Italy. Address reprint requests to Giulia Beatrice Crapelli, MD, Department of Cardiothoracic-vascular Anesthesia and ICU, IRCCS Policlinico San Donato, Via Morandi 30, 20097 San Donato Milanese. E-mail: giulia.crapelli@gmail.com © 2016 Elsevier Inc. All rights reserved. 1053-0770/2602-0033$36.00/0 http://dx.doi.org/10.1053/j.jvca.2015.10.017

Published
2016

44. Permanent Pacemaker Implantation Following Heart Surgery: In-Hospital and Postoperative Retrospective Multicentre Evaluation in 1,156 Implants

Author

Roberto, Lorusso, Fabio, Barili, Antonio, Miceli, Alessandro, Parolari, Francesco, Alamanni, Carlo De Vincentiis, Ezio, Aimè, Francesco, Nicolini, Tiziano, Gherli, Andrea, Colli, Michele De Bonis, Gabriele, Paglino, Paolo Della Bella, Guglielmo Actis Dato, Riccardo, Casabona, Sandro, Sponga, Ugolino, Livi, Giovanni, Mariscalco, Cesare, Beghi, Roberto, Scrofani, Carlo, Antona, Tritto, Francesco P., Gino, Gerosa, Luigi, Piazza, Emanuel, Villa, Gianni, Troise, Filibertio, Serraino, Attilio, Renzulli, Francesco, Rosato, Claudio, Grossi, Domenico, Paparella, Lillà, Amorese, Vizzardi, Enrico, Marco, Solinas, Mattia, Glauber, Lorusso, R, Barili, F, Miceli, A, Parolari, A, Alamanni, F, De Vincentiis, C, Aimè, E, Nicolini, F, Gherli, T, Colli, A, De Bonis, M, Paglino, G, Della Bella, P, Actis Dato, G, Casabona, R, Sponga, S, Livi, U, Mariscalco, G, Beghi, C, Scrofani, R, Antona, C, Tritto, Fp, Gerosa, G, Piazza, L, Villa, E, Troise, G, Serraino, F, Renzulli, A, Rosato, F, Grossi, C, Paparella, D, Amorese, L, Vizzardi, E, Solinas, M, and Glauber, M.

Published
2014

45. TAVR-associated prosthetic valve infective endocarditis: Results of a large, multicenter registry

Author

Azeem, Latib, Charbel, Naim, Michele, De Bonis, Jan Malte, Sinning, Francesco, Maisano, Marco, Barbanti, Alessandro, Parolari, Roberto, Lorusso, Luca, Testa, Guglielmo Mario, Actis Dato, Antonio, Miceli, Sandro, Sponga, Francesco, Rosato, Carlo, De Vincentiis, Nikos, Werner, Claudia, Fiorina, Antonio, Bartorelli, Omar, Di Gregorio, Francesco, Casilli, Manuela, Muratori, Francesco, Alamanni, Mattia, Glauber, Ugolino, Livi, Georg, Nickenig, Corrado, Tamburino, Ottavio, Alfieri, Antonio, Colombo, Latib, A, Naim, C, DE BONIS, Michele, Sinning, Jm, Maisano, F, Barbanti, M, Parolari, A, Lorusso, R, Testa, L, Actis Dato Guglielmo, M, Miceli, A, Sponga, S, Rosato, F, De Vincentiis, C, Werner, N, Fiorina, C, Bartorelli, A, Di Gregorio, O, Casilli, F, Muratori, M, Alamanni, F, Glauber, M, Livi, U, Nickenig, G, Tamburino, C, Alfieri, Ottavio, Colombo, A., University of Zurich, and Latib, Azeem

Subjects
Heart Defects, Congenital, Male, Cardiac Catheterization, Heart Valve Diseases, Aged, Aged, 80 and over, Aortic Valve, Endocarditis, Bacterial, Female, Follow-Up Studies, Heart Valve Prosthesis, Humans, Retrospective Studies, Registries, Cardiology and Cardiovascular Medicine, Medicine (all), 610 Medicine & health, 2705 Cardiology and Cardiovascular Medicine, Congenital, Bicuspid Aortic Valve Disease, 80 and over, Ultrasonography, Heart Defects, Endocarditis, Bacterial, 10020 Clinic for Cardiac Surgery
Published
2014

46. Surgical pathology of the mitral valve: gross and histological study of 1288 surgically excised valves

Author

Carlo De Vincentiis, Fabrizio de Vivo, Maurizio Cotrufo, Salvatore Esposito, Antonio Falco, T S Luigi de Luca, L. Agozzino, Agozzino, Lucio, Falco, A, DE VIVO, F, DE VINCENTIIS, C, DE LUCA, L, Esposito, S, and Cotrufo, M.

Subjects
Adult, medicine.medical_specialty, Myocardial Infarction, Myocardial Ischemia, Mitral valve stenosis, Mitral valve, Internal medicine, medicine, Humans, Mitral Valve Stenosis, Mitral valve prolapse, Endocarditis, cardiovascular diseases, Myocardial infarction, Mitral Valve Prolapse, business.industry, Rheumatic Heart Disease, Mitral Valve Insufficiency, Endocarditis, Bacterial, Papillary Muscles, medicine.disease, Surgery, Stenosis, medicine.anatomical_structure, Mitral incompetence, Infective endocarditis, cardiovascular system, Cardiology, Mitral Valve, Cardiology and Cardiovascular Medicine, business
Abstract

A consecutive series of 1288 mitral valves surgically excised from 1981 through 1989 were studied macroscopically and histologically. The explanted valves were affected by: chronic rheumatic disease (1179, 91.5%), floppy mitral valve (84, 6.5%), bacterial endocarditis (19, 1.5%), and post-ischemic mitral incompetence (6, 0.5%). Among 1179 post-rheumatic cases, mixed mitral stenosis and incompetence was the most frequent malfunction (747, 58%). Isolated mitral incompetence was diagnosed in 72 (6.11%) cases only, and isolated stenosis in 360 cases. In 52 valves, excised because of chronic rheumatic disease, the histology showed unexpected signs of acute rheumatism of the leaflets and the papillary muscles. In these patients clinical symptoms and blood tests were negative for rheumatic disease. Mitral incompetence, possibly due to papillary muscle dysfunction, was the prevalent lesion (61.5%). A total of 181 patients (14.05%) with pure mitral incompetence underwent surgery. In 84 patients (46.4%), the floppy mitral valve was the most frequent cause of valve dysfunction, 72 (39.8%) had rheumatic disease, 19 (10.5%) infective endocarditis, and 6 (3.4%) ischemic heart disease. In the group with floppy mitral valve, males were more prevalent than females (51:33). The mean age of the 4 patients with Marfan's syndrome and non-Marfan patients was noticeably different (17 vs 49 yr). Moreover leaflet deformation, tendinous cord elongation and annulus dilatation were the most common causes of valve incompetence. Floppy mitral valve and infective endocarditis were the cause of cordal rupture in 43.5% of the cases. This was a severe complication which always required emergency surgery.

Published
1992
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47. Age-related multiple hormone deficiencies in chronic heart failure

Author

Arcopinto, M. Michele, Salzano, A., Bossone, E., Emanuele Bobbio, Sirico, D., Vincentiis, C., Matarazzo, M., Saldamarco, L., Vigorito, C., Cittadini, A., Arcopinto, Mm, Salzano, A, Bossone, E, Bobbio, E, Sirico, D, De Vincentiis, C, Matarazzo, M, Saldamarco, L, Vigorito, C, and Cittadini, A

48. Transcatheter management of residual mitral regurgitation after transcatheter edge-to-edge repair: a systematic review.

Author

Baudo M, Cuko B, Ternacle J, Sicouri S, Busuttil O, Denti P, Godino C, De Vincentiis C, Ramlawi B, Leroux L, Modine T, Palloshi A, and Maisano F

Abstract

Background: Treatment of residual mitral regurgitation (MR) with different percutaneous devices after transcatheter edge-to-edge repair (TEER) has been reported as an alternative option to reclipping or surgery. This review aims at describing the different transcatheter strategies available and their results when managing residual MR after TEER., Methods: A literature search was undertaken across Pubmed, ScienceDirect, SciELO, DOAJ, and Cochrane library databases, to identify article reporting patients with post-TEER residual MR managed by a transcatheter approach that did not involve only the implantation of new clips., Results: From 439 deduplicated studies, 24 articles ultimately met the inclusion criteria. Fifteen described an occluder device implantation, 12 with an Amplatzer and 3 with a Cardioform. The most feared complications were hemolysis and device embolization. Three cases of transcatheter annuloplasty were reported in patients with residual functional MR. An electrosurgical detachment of the TEER device from the anterior mitral leaflet (ELASTA-Clip) before mitral valve replacement was reported in 6 articles., Conclusions: Transcatheter procedures addressing residual MR after TEER in carefully selected patients are feasible in experienced centers. Outcomes are promising despite some technical issues. Percutaneous strategies and related complications should be anticipated using multimodality imaging., (© 2025. The Author(s) under exclusive licence to Japanese Association of Cardiovascular Intervention and Therapeutics.)

Published
2025
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49. Valve-sparing versus bio-Bentall aortic root replacement in patients aged 60-75 years: Survival, Reintervention and Aortic Regurgitation.

Author

Sala A, Di Mauro M, Zancanaro E, Bargagna M, Grimaldi F, D'Oria V, Menicanti L, Alfieri O, De Bonis M, and de Vincentiis C

Abstract

Background: Valve-sparing root replacement(VSRR) with the David technique is an established therapy for aortic root pathology in young patients. The aim of this study was to evaluate short and long-term outcomes between VSRR and aortic root replacement(ARR) with a biological-valved conduit in sexagenarians., Methods: A multicenter retrospective review from 2002-2022 identified 299-sexagenarians undergoing aortic root surgery, among whom 82(27.4%) underwent VSRR and 217(72.6%) bio-Bentall. Inverse probability of treatment weighting(IPTW) was applied to balance clinical variables. Median follow-up was 15-years[12-18 years]. Endpoints of the study were in-hospital mortality, long-term survival, freedom from reintervention and recurrence of at-least-moderate AR., Results: There were no major differences in baseline characteristics. The incidence of bicuspid valves(VSRR 4.9% vs ARR 19%), severe AR(42% vs 51%), type-A aortic dissection(1.2% vs 6.9%), and reoperation(4% vs 23%) were higher in ARR. Following IPTW, there was no difference in in-hospital mortality(VSRR 1.2% vs ARR 4.6%,p=0.3). The incidence of neurologic complications(p=0.003), and permanent pacemaker(PPM) implantation(p=0.022) were significantly higher in the bio-Bentall group. After IPTW, 10-year survival did not differ between VSRR(87%) and ARR(80%)(p=0.176). However, cardiac-survival was significantly higher in VSRR patients(98% vs 92%,p=0.018), with deaths mainly due to infective endocarditis and end-stage heart failure(HF). Regarding reoperation/recurrence of at-least-moderate AR, no difference was reported among groups at 10-years, with only 1-patient undergoing reintervention following bio-Bentall(p=0.117)., Conclusions: David and bio-Bentall procedures have low in-hospital mortality and good long-term survival in sexagenarians. VSRR is associated with improved long-term cardiac-survival, lower rates of infective endocarditis, PPM-implantation and HF-episodes, with similar rates of reintervention/recurrence of moderate AR., (Copyright © 2025. Published by Elsevier Inc.)

Published
2025
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50. Long-term outcomes after recurrent acute thoracic aortic dissection: Insights from the International Registry of Aortic Dissection.

Author

Ogami T, Arnaoutakis GJ, Isselbacher EM, Geuzebroek GSC, Coselli JS, De Vincentiis C, Kaiser CA, Hutchison S, Li QG, Brinster DR, Leshnower BG, Serna-Gallegos D, Pai CW, Taylor BS, Patel HJ, Eagle KA, and Sultan I

Subjects
Humans, Male, Female, Middle Aged, Aged, Time Factors, Risk Factors, Treatment Outcome, Acute Disease, Retrospective Studies, Incidence, Dissection, Thoracic Aorta, Aortic Dissection surgery, Aortic Dissection mortality, Aortic Dissection epidemiology, Aortic Dissection diagnostic imaging, Registries, Aortic Aneurysm, Thoracic surgery, Aortic Aneurysm, Thoracic mortality, Aortic Aneurysm, Thoracic epidemiology, Aortic Aneurysm, Thoracic diagnosis, Aortic Aneurysm, Thoracic diagnostic imaging, Recurrence
Abstract

Objective: With an aging population and advancements in imaging, recurrence of thoracic aortic dissection is becoming more common., Methods: All patients enrolled in the International Registry of Aortic Dissection from 1996 to 2023 with type A and type B acute aortic dissection were identified. Among them, initial dissection and recurrent dissection were discerned. The study period was categorized into 3 eras: historic era, 1996 to 2005; middle era, 2006 to 2015; most recent era, 2016 to 2023. Propensity score matching was applied between initial dissection and recurrent dissection. Outcome of interests included long-term survival and cumulative incidence of major aortic events defined by the composite of reintervention, aortic rupture, and new dissection., Results: The proportion of recurrent dissection increased from 5.9% in the historic era to 8.0% in the most recent era in the entire dissection cohort. In patients with type A dissection, propensity score matching between initial dissection and recurrent dissection yielded 326 matched pairs. Kaplan-Meier curves showed similar long-term survival between the 2 groups. However, the cumulative incidence of major aortic events was significantly higher in the recurrent dissection group (40.3% ± 6.2% vs 17.8% ± 5.1% at 4 years in the initial dissection group, P = .02). For type B dissection, 316 matched pairs were observed after propensity score matching. Long-term survival and the incidence of major aortic events were equivalent between the 2 groups., Conclusions: The case volume of recurrent dissection or the ability to detect recurrent dissection has increased over time. Acute type A recurrent dissection was associated with a higher risk of major aortic events than initial dissection. Further judicious follow-up may be crucial after type A recurrent dissection., Competing Interests: Conflict of Interest Statement G.J.A. receives consulting fees from Terumo Aortic. I.S. receives institutional research support from Abbott, AtriCure, Artivion, Boston Scientific, Edwards, Medtronic, and Terumo Aortic. None were related to this manuscript. All other authors reported no conflicts of interest. The Journal policy requires editors and reviewers to disclose conflicts of interest and to decline handling or reviewing manuscripts for which they may have a conflict of interest. The editors and reviewers of this article have no conflicts of interest., (Copyright © 2024 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.)

Published
2025
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