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3 results on '"Marcello Raimondi Lucchetti"'

1. Ten-Year Experience with Endomyocardial Biopsy after Orthotopic Heart Transplantation: Comparison between Trans-Jugular and Trans-Femoral Approach

Author

Antonella Galeone, Annalisa Bernabei, Gabriele Pesarini, Marcello Raimondi Lucchetti, Francesco Onorati, and Giovanni Battista Luciani

Subjects
endomyocardial biopsy, heart transplantation, jugular vein, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Background: Endomyocardial biopsy (EMB) is considered the gold standard for monitoring allograft rejection after heart transplantation. EMB is an invasive procedure that may be performed via a trans-jugular or a trans-femoral approach with a complication rate reported as less than 6%. The aim of this study was to evaluate the complication rate after EMBs in heart recipients and to compare the results of EMBs performed via a trans-jugular or a trans-femoral approach. Methods: Medical records of heart recipients undergoing EMBs between January 2012 and December 2022 were retrospectively reviewed. EMB-related complications were classified as major (death, pericardial effusion, hemopericardium, cardiac tamponade requiring a pericardiocentesis or an urgent cardiac surgery, ventricular arrythmias, permanent atrio-ventricular block requiring permanent pacing, hemothorax, pneumothorax and retroperitoneal bleeding) and minor (de novo tricuspid regurgitation, arrhythmias, coronary artery fistula, vascular access site complications). Results: A total of 1698 EMBs were performed during the study period at our institution in 212 heart recipients. There were 927 (55%) EMBs performed through a trans-jugular approach (TJ group) and 771 (45%) EMBs performed through a trans-femoral approach (TF group). A total of 60 (3.5%) complications were recorded, including nine (0.5%) major complications (six cardiac tamponades, two pneumothorax and one retroperitoneal bleeding) and 51 (3%) minor complications (seven coronary fistulae, five de novo tricuspid regurgitation, four supraventricular arrythmias and thirty-five vascular access site complications). No difference was found in total (38 [4%] vs. 22 [3%]; p = 0.16) and major (6 [1%} vs. 3 [0.4%]; p = 0.65) complications (32 [3%] vs. 19 [2%]; p = 0.23) between the TJ group and the TF group. No difference was found in male sex, age at time of EMB and time from HT between complicated and not complicated EMBs. Conclusions: EMBs represent a safe procedure with a low risk of complications. In our experience, EMBs performed via a trans-jugular approach are as safe as the trans-femoral approach.

Published
2024
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2. Do we need aspirin in HeartMate 3 patients?

Author

Filippo Consolo, Corrado Tramontin, Marcello Raimondi Lucchetti, Elisabetta Lapenna, Federico Pappalardo, Consolo, Filippo, Raimondi Lucchetti, Marcello, Tramontin, Corrado, Lapenna, Elisabetta, and Pappalardo, Federico

Subjects
Adult, Heart Failure, Male, medicine.medical_specialty, Aspirin, business.industry, Middle Aged, medicine.disease, Heart failure, Internal medicine, Thromboembolism, medicine, Cardiology, Humans, Female, Heart-Assist Devices, Cardiology and Cardiovascular Medicine, business, Platelet Aggregation Inhibitors, medicine.drug
Published
2019

3. Second cross-clamping after mitral valve repair for degenerative disease in contemporary practice

Author

Roberta Meneghin, Michele De Bonis, Ottavio Alfieri, Elisabetta Lapenna, Federico Pappalardo, Marcello Raimondi Lucchetti, Alessandro Castiglioni, Ilaria Giambuzzi, Andrea Giacomini, Nicola Buzzatti, Cinzia Trumello, Giovanni Affronti, De Bonis, Michele, Lapenna, Elisabetta, Giambuzzi, Ilaria, Meneghin, Roberta, Affronti, Giovanni, Pappalardo, Federico, Castiglioni, Alessandro, Trumello, Cinzia, Buzzatti, Nicola, Giacomini, Andrea, Raimondi Lucchetti, Marcello, and Alfieri, Ottavio

Subjects
Pulmonary and Respiratory Medicine, Male, Reoperation, medicine.medical_specialty, medicine.medical_treatment, Cardiopulmonary bypa, 030204 cardiovascular system & hematology, law.invention, 03 medical and health sciences, 0302 clinical medicine, Interquartile range, law, Recurrence, medicine, Cardiopulmonary bypass, Humans, Systole, Mitral regurgitation, Aged, Retrospective Studies, Second cross-clamping, Mitral valve repair, Cardiopulmonary Bypass, business.industry, Incidence (epidemiology), Mitral Valve Insufficiency, Retrospective cohort study, General Medicine, Middle Aged, Constriction, Confidence interval, Surgery, 030228 respiratory system, Second pump run, Mitral Valve, Female, Cardiology and Cardiovascular Medicine, business, Echocardiography, Transesophageal, Follow-Up Studies
Abstract

Objectives Scanty data are available on 'second cross-clamping' following mitral valve repair in contemporary practice. The aim of this study was to evaluate the incidence, causes and outcomes of this event in patients referred for mitral repair for severe degenerative mitral regurgitation (MR). Methods The study population included 2318 patients with severe degenerative MR referred for mitral repair. A second cross-clamping was performed in 94 (4%) patients. Causes of the second cross-clamping, revising repair procedures, immediate echocardiographic outcomes and postoperative course were assessed and compared with the 'single cross-clamping cases' (2224 patients used as control). Clinical and echocardiographic follow-up information was available for 91 of the 94 second cross-clamping patients (97% complete) (median time 6 years, interquartile range 3-11). Results The most frequent causes of the second cross-clamping were residual MR >1+/4+ and systolic anterior motion. A residual prolapse was identified in 41 (43.5%) patients, systolic anterior motion in 22 (23.5%), untreated clefts in 14 (15%) and other mechanisms in 17 (18%). Second cardiopulmonary bypass and aortic cross-clamping times were 36 (range 28-50) and 23 (range 17-34) min, respectively. Hospital mortality was 0% in the second cross-clamping and 0.3% in the control group (P = 0.2). Postoperative complications and length of hospital stay were similar. At discharge, residual MR ≥2+/4+ was 2.1% in the second cross-clamping and 2.7% in the control group (P = 0.99). In the second cross-clamping, at 12 years, the cumulative incidence function of reoperation, recurrent MR ≥3+ and MR ≥2+ with death as competing risk were 5.7 ± 2.5% (95% confidence interval 2-12), 10.3 ± 4.3% (95% confidence interval 3.8-20) and 17 ± 5.2% (95% confidence interval 8-29), respectively. Conclusions In a large volume centre for mitral repair, a second cross-clamping is still performed in 3-5% of the patients. Because suboptimal immediate results are associated with impaired late outcomes of mitral reconstruction, a low threshold for a second cross-clamping seems to be justified. If the second repair is carried out with a relatively shorter additional cross-clamping time, mortality and morbidity are not increased and immediate and long-term results are very satisfactory.

Published
2017

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