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280 results on '"Paparella D."'

1. Incidence and predictors of heart failure events following cardiac surgery in patients with atrial fibrillation - insights from the LAAOS-III trial

Author

Xing, L Y, primary, Whitlock, R, additional, Belley-Cote, E, additional, Mcintyre, W F, additional, Paparella, D, additional, Svendsen, J H, additional, Diederichsen, S Z, additional, Brady, K, additional, Connolly, S, additional, Wong, J, additional, Conen, D, additional, Johnson, L, additional, and Healey, J S, additional

Published
2024
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5. Addressing inadequate blood flow during normothermic regional perfusion for in-situ donation after circulatory death grafts preservation

Author

Squiccimarro, E., Colombaro, C., Civita, A., Rociola, R., Buys, D., Gesualdo, L., Paparella, D., Lorusso, R., Squiccimarro, E., Colombaro, C., Civita, A., Rociola, R., Buys, D., Gesualdo, L., Paparella, D., and Lorusso, R.

Abstract

Donation after circulatory death (DCD) has emerged as attainable strategy to tackle the issue of organ shortage, expanding the donor pool. The DCD concept has been applied to the multiple declinations of circulatory arrest, as per the Modified Maastricht Classification. Notwithstanding, whichever the scenario, DCD donors experience a variable warm ischemia time whose correlation with graft dysfunction is ascertained. This applies to both "controlled" (cDCD) donors (i.e., the timespan from the withdrawal of life-sustaining therapies to the onset of in-situ perfusion), and "uncontrolled" DCD (uDCD) (i.e., the low-flow period during cardiopulmonary resuscitation - CPR). This sums up to the no-flow time from cardiac arrest to the start of CPR for uDCD donors, and to the no-touch period for both uDCDs and cDCDs. Static and hypothermic storage may not be appropriate for DCD grafts. In order to overcome this ischemic insult, extracorporeal membrane oxygenation devices are adopted to guarantee the in-situ grafts preservation by means of techniques such as the normothermic regional perfusion (NRP) which consists in a selective abdominal perfusion obtained via the endovascular or surgical occlusion of the thoracic aorta. The maintenance of an adequate pump flood throughout NRP is therefore a sine qua non to accomplish the DCD donation. The issue of insufficient pump flow during NRP is prevalent and clinically significant but its management remains technically challenging and not standardized. Hereby we propose a systematic algorithmic approach to address this relevant occurrence.

Published
2023

9. 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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10. 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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14. Acute iatrogenic complications after mitral valve repair

Author

Paparella, D., Squiccimarro, E., Di Mauro, M., Katsavrias, K., Calafiore, A.M., Paparella, D., Squiccimarro, E., Di Mauro, M., Katsavrias, K., and Calafiore, A.M.

Abstract

Background and Aim of the Study Mitral valve repair is the procedure of choice to correct mitral regurgitation. However, some dangerous iatrogenic complications can occur at the end of the procedure. Therefore, we sought to review the most frequent and clinically relevant acute iatrogenic complication following mitral valve repair. Methods A thorough review of the literature has been performed. Criteria for considering studies for this non-systematic review were as follows: observational and interventional studies investigating the acute iatrogenic complications following mitral valve repair, and essential review studies pertinent to the topic. Results The most frequent is the systolic anterior motion. Due to a systolic dislocation of the anterior leaflet toward the outflow tract, it causes both obstruction of the outflow tract and mitral regurgitation. Often it is due to excess of catecholamines or to reduced filling of the left ventricle but sometimes needs further surgical maneuvers, focused on moving posteriorly the coaptation line. It can be obtained by shortening the posterior leaflet or increasing the size of the ring or applying an Alfieri stitch to limit the movements of the anterior leaflet. Another complication, often underdiagnosed and potentially lethal, is the injury of the circumflex artery that happens at the level of the anterolateral commissure or P1 zone. Two mechanisms are involved. The first one is the direct injury of the artery by a stitch (roughly 25% of the patients present a distance artery-annulus <3 mm. The second one is the distortion of the artery, attracted toward the annulus by a misplaced stitch. The attraction causes kinking with stenosis of different degrees till functional occlusion. However, the artery has to be far from the annulus and the atrial tissue has to be stiff and resistant, as after an infective process, to move the circumflex artery toward the annulus without tearing. Positioning the stitches very close to the mitr

Published
2022

16. 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

17. Left Atrial Appendage Occlusion during Cardiac Surgery to Prevent Stroke

Author

Whitlock, RP, Belley-Cote, EP, Paparella, D, Healey, JS, Brady, K, Sharma, M, Reents, W, Budera, P, Baddour, AJ, Fila, P, Devereaux, PJ, Bogachev-Prokophiev, A, Boening, A, Teoh, KHT, Tagarakis, GI, Slaughter, MS, Royse, AG, McGuinness, S, Alings, M, Punjabi, PP, Mazer, CD, Folkeringa, RJ, Colli, A, Avezum, A, Nakamya, J, Balasubramanian, K, Vincent, J, Voisine, P, Lamy, A, Yusuf, S, Connolly, SJ, Whitlock, RP, Belley-Cote, EP, Paparella, D, Healey, JS, Brady, K, Sharma, M, Reents, W, Budera, P, Baddour, AJ, Fila, P, Devereaux, PJ, Bogachev-Prokophiev, A, Boening, A, Teoh, KHT, Tagarakis, GI, Slaughter, MS, Royse, AG, McGuinness, S, Alings, M, Punjabi, PP, Mazer, CD, Folkeringa, RJ, Colli, A, Avezum, A, Nakamya, J, Balasubramanian, K, Vincent, J, Voisine, P, Lamy, A, Yusuf, S, and Connolly, SJ

Abstract

BACKGROUND: Surgical occlusion of the left atrial appendage has been hypothesized to prevent ischemic stroke in patients with atrial fibrillation, but this has not been proved. The procedure can be performed during cardiac surgery undertaken for other reasons. METHODS: We conducted a multicenter, randomized trial involving participants with atrial fibrillation and a CHA2DS2-VASc score of at least 2 (on a scale from 0 to 9, with higher scores indicating greater risk of stroke) who were scheduled to undergo cardiac surgery for another indication. The participants were randomly assigned to undergo or not undergo occlusion of the left atrial appendage during surgery; all the participants were expected to receive usual care, including oral anticoagulation, during follow-up. The primary outcome was the occurrence of ischemic stroke (including transient ischemic attack with positive neuroimaging) or systemic embolism. The participants, research personnel, and primary care physicians (other than the surgeons) were unaware of the trial-group assignments. RESULTS: The primary analysis population included 2379 participants in the occlusion group and 2391 in the no-occlusion group, with a mean age of 71 years and a mean CHA2DS2-VASc score of 4.2. The participants were followed for a mean of 3.8 years. A total of 92.1% of the participants received the assigned procedure, and at 3 years, 76.8% of the participants continued to receive oral anticoagulation. Stroke or systemic embolism occurred in 114 participants (4.8%) in the occlusion group and in 168 (7.0%) in the no-occlusion group (hazard ratio, 0.67; 95% confidence interval, 0.53 to 0.85; P = 0.001). The incidence of perioperative bleeding, heart failure, or death did not differ significantly between the trial groups. CONCLUSIONS: Among participants with atrial fibrillation who had undergone cardiac surgery, most of whom continued to receive ongoing antithrombotic therapy, the risk of ischemic stroke or systemic embolism was

Published
2021

19. 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

20. Transcatheter aortic valve replacement with self-expandable ACURATE neo as compared to balloon-expandable SAPIEN 3 in patients with severe aortic stenosis: Meta-analysis of randomized and propensity-matched studies (J. Clin. Med., (2020) 9, 10.3390/jcm9020397)

Author

Gozdek, M., Zielinski, K., Pasierski, M., Matteucci, M., Fina, D., Jiritano, F., Meani, P., Raffa, G. M., Malvindi, P. G., Pilato, M., Paparella, D., Slomka, A., Kubica, J., Jagielak, D., Lorusso, R., Suwalski, P., and Kowalewski, M.

Published
2020

26. 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

27. 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

28. MID–TERM OUTCOMES OF ENDOSCOPIC MITRAL VALVE REPAIR VIA RIGHT ANTERIOR MINI–THORACOTOMY

Author

Squiccimarro, E, Margari, V, Kounakis, G, Visicchio, G, Pascarella, C, Carbone, C, and Paparella, D

Abstract

The adoption of less–invasive mitral repair (MVr) surgery is increasing, backed by evidence of satisfactory short–term results and lower major morbidity. We assessed mid–term follow–up results of our experience, and compared two techniques: isolated leaflet resection and neochord implantation for posterior leaflet (PML) prolapse. Between 2012–2021, 700+ operations were performed with a video–assisted right mini–thoracotomy (RMT) approach. We report 309 consecutive patients who had endoscopic MVr, including those receiving concomitant tricuspid repair, ablation for atrial fibrillation, closure of patent foramen ovale and/or left atrial appendage. The early and mid–term follow–up results were ascertained. Primary outcome was the incidence of mortality and significant mitral regurgitation (MR) during follow–up which were summarized by Kaplan–Meier estimator and compared between treatment arms via log–rank test. Secondary outcomes were the early–postoperative results including 30–days mortality and major complications. All patients had endoscopic MVr via RMT at the 3rd/4th intercostal space (IS). A soft–tissue retractor is used, accompanied or not by a rib spreader, and two ports in the fourth and sixth IS are used for 3D thoracoscopy and carbon dioxide insufflation. Femoral vessels exposure through a right groin incision and echo–guided cannulation sec. Seldinger is achieved post–heparinization. Thoracic fascia bisection is performed during single–lung ventilation using a double–lumen endotracheal tube, integral to our anesthetic management, including percutaneous right internal jugular vein cannulation. The pericardium is opened and an aortic root cannula for cardioplegia delivery and venting is placed via working incision. After establishing cardiopulmonary bypass, a Chitwood clamp is passed through the second IS and cardioplegia is delivered. Endoaortic balloon clamping is primarily used in redo cases. With ring annuloplasty, 136 (44%) patients received PML resection (122 isolated) and 97 (31%) PML chords implantation (88 isolated). Forty–nine patients had annuloplasty alone. In–hospital mortality was 1.0%. Mean follow–up was 29±22 months (max 8.3 years). Kaplan–Meier 5–year survival was 97.3±1.0%. MR (3/4+) free–survival at 5 years was 94.5±2.3%. Subgroup time–to–event analysis for the indexed outcomes showed no statistical significance between techniques. In conclusion, endoscopic MVr is safe with excellent mid–term outcomes.

Published
2024
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29. Effect of methylprednisolone on acute kidney injury in patients undergoing cardiac surgery with a cardiopulmonary bypass pump: a randomized controlled trial

Author

Garg, Amit X, Chan, Matthew TV, Cuerden, Meaghan S, Devereaux, PJ, Abbasi, Seyed Hesameddin, Hildebrand, Ainslie, Lamontagne, Francois, Lamy, Andre, Noiseux, Nicolas, Parikh, Chirag R, Perkovic, Vlado, Quantz, Mackenzie, Rochon, Antoine, Royse, Alistair, Sessler, Daniel I, Shah, Pallav J, Sontrop, Jessica M, Tagarakis, Georgios I, Teoh, Kevin H, Vincent, Jessica, Walsh, Michael, Yared, Jean-Pierre, Yusuf, Salim, Whitlock, Richard P, Whitlock, R, Semelhago, L, Chu, V, Dyub, A, Cybulsky, I, Van Oosteen, R, Cordova, G, Quantz, MA, McKenzie, FN, Fox, S, Chase, L, Stevens, LM, Prieto, I, Basile, F, Finegan, BA, Bryden, C, Meyer, S, Chappell, A, Mazer, CD, Dixon, J, Yagnik, S, Crescini, C, Verma, S, Legare, JF, Greentree, D, Coutu, M, Teijeira, J, Wiley, W, Peniston, C, Teng, C, Rochon, AG, Lamarche, Y, Deschamps, A, Voisine, P, Dagenais, F, Singal, RK, Brown, CD, Kieser, TM, Robinson, R, Fremes, SE, Christakis, GT, Melvin, KN, Parsons, M, Zheng, H, Yu, J, Xu, W, Zhang, Q, Chen, C, Yu, H, Zeng, J, Zuo, Y, Liu, J, Zhang, T, Sun, Y, Song, D, Dong, H, Chen, M, Zhao, J, Tao, L, Huang, W, Cheng, Y, Long, YS, Lei, W, Zhang, W, Xu, MY, Qing, E, Xiao, YB, Karunakaran, J, Pillai, VV, Reddy, PB, Kundan, S, Jain, AR, Mallya, SS, Mehta, CB, Shukla, V, Kuruvila, K, Karthikeyan, G, Devagourou, V, Hote, MP, Airan, B, Padmanabhan, C, Srinivasan, M, Agarwal, SK, Pande, S, Rao, P Simha Mohan, Math, R, Shankar, BPR, Vaijyanath, PH, Nair, SK, Ayapati, DR, Kurz, A, Awais, A, Panjasawatwong, K, Kashy, BK, Huffmyer, JL, Scalzo, DC, Kazemi, A, Huang, KF, Parvathaneni, SV, Gardner, JC, Malik, MR, Eshraghi, Y, Kramer, RS, Essandoh, MK, Portillo, J, Ayad, SS, Akhtar, Z, Castresana, MR, Collard, CD, Rodriguez-Blanco, YF, Eaton, MP, Villar, JC, Umana, JP, Dominguez, CL, Alvarado, PA, Zuluaga, D, Abello, M, Sarquis, T, Vaquiro, E, Oliveros, CA, Manrique, EJ, Vasquez, S, Ortiz, LM, Holliday, J, Griffin, R, Royse, AG, Royse, CF, Williams, Z, Paparella, D, Rotunno, C, De Palo, M, Margari, V, Alfieri, O, Ferrara, D, Schiavi, D, Parolari, A, Myasoedova, VA, Daprati, A, De Feo, M, Bancone, C, Di Bartolomeo, R, Pacini, D, Ribezzo, M, Karimi, A, Salehiomran, A, Hajighasemi, A, Bina, P, Straka, Z, Hlavicka, J, Lukac, P, Vik, K, Mosna, F, Tsilimingas, NB, Simopoulos, VN, Tsolaki, F, Rivilla, MT, Galan, J, Nunez, JAF, Gonzalez, A, Ruiz, D, Orts Rodriguez, M, Issa, M, Vila Nova, DC, Maia, LN, Nakazone, MA, Lico e Cividanes, GV, Hajjar, LA, Neto, V Avila, Lucchese, FA, Stolf, NA, Hutschala, D, Ruetzler, K, Sima, B, Engelen, S, Borms, S, Van De Velde, M, Rex, S, De Hert, SG, Ho, AMH, Chan, MTV, Underwood, MJ, Deluca Bisurgi, D, Torres, D, and Buggy, DJ

Subjects
Male, medicine.medical_specialty, medicine.medical_treatment, Anti-Inflammatory Agents, 030204 cardiovascular system & hematology, Methylprednisolone, Drug Administration Schedule, law.invention, 03 medical and health sciences, Medicine, General & Internal, 0302 clinical medicine, Postoperative Complications, Randomized controlled trial, law, General & Internal Medicine, Cardiopulmonary bypass, SIRS, Medicine, Humans, 030212 general & internal medicine, Cardiac Surgical Procedures, Glucocorticoids, Dialysis, Aged, Science & Technology, Cardiopulmonary Bypass, business.industry, STEROIDS, Research, Acute kidney injury, General Medicine, Perioperative, Acute Kidney Injury, Middle Aged, medicine.disease, Cardiac surgery, HIGH-DOSE DEXAMETHASONE, Anesthesia, Female, business, Life Sciences & Biomedicine, Kidney disease, medicine.drug
Abstract

BACKGROUND: Perioperative corticosteroid use may reduce acute kidney injury. We sought to test whether methylprednisolone reduces the risk of acute kidney injury after cardiac surgery. METHODS: We conducted a prespecified substudy of a randomized controlled trial involving patients undergoing cardiac surgery with cardiopulmonary bypass (2007-2014); patients were recruited from 79 centres in 18 countries. Eligibility criteria included a moderate-to-high risk of perioperative death based on a preoperative score of 6 or greater on the European System for Cardiac Operative Risk Evaluation I. Patients (n = 7286) were randomly assigned (1:1) to receive intravenous methylprednisolone (250 mg at anesthetic induction and 250 mg at initiation of cardiopulmonary bypass) or placebo. Patients, caregivers, data collectors and outcome adjudicators were unaware of the assigned intervention. The primary outcome was postoperative acute kidney injury, defined as an increase in the serum creatinine concentration (from the preoperative value) of 0.3 mg/dL or greater (≥ 26.5 μmol/L) or 50% or greater in the 14-day period after surgery, or use of dialysis within 30 days after surgery. RESULTS: Acute kidney injury occurred in 1479/3647 patients (40.6%) in the methylprednisolone group and in 1426/3639 patients (39.2%) in the placebo group (adjusted relative risk 1.04, 95% confidence interval 0.96 to 1.11). Results were consistent across several definitions of acute kidney injury and in patients with preoperative chronic kidney disease. INTERPRETATION: Intraoperative corticosteroid use did not reduce the risk of acute kidney injury in patients with a moderate-to-high risk of perioperative death who had cardiac surgery with cardiopulmonary bypass. Our results do not support the prophylactic use of steroids during cardiopulmonary bypass surgery. Trial registration: ClinicalTrials.gov, no. NCT00427388. ispartof: CANADIAN MEDICAL ASSOCIATION JOURNAL vol:191 issue:9 pages:E247-E256 ispartof: location:Canada status: published

Published
2019

30. 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

31. Interaction between peri-operative blood transfusion, tidal volume, airway pressure and postoperative ARDS: an individual patient data meta-analysis

Author

Neto, AS, Juffermans, NP, Hemmes, SNT, Barbas, CSV, Beiderlinden, M, Biehl, M, Fernandez-Bustamante, A, Futier, E, Gajic, O, Jaber, S, Kozian, A, Licker, M, Lin, WQ, Memtsoudis, SG, Miranda, DR, Moine, P, Paparella, D, Ranieri, M, Scavonetto, F, Schilling, T, Selmo, G, Severgnini, P, Sprung, J, Sundar, S, Talmor, D, Treschan, T, Unzueta, C, Weingarten, TN, Wolthuis, EK, Wrigge, H, de Abreu, MG, Pelosi, P, Schultz, MJ, and PROVE Network Investigators

Subjects
surgery, tidal volume, Acute respiratory distress syndrome (ARDS), ventilator-associated lung injury, respiratory system, transfusion
Abstract

Background: Transfusion of blood products and mechanical ventilation with injurious settings are considered risk factors for postoperative lung injury in surgical Patients. Methods: A systematic review and individual patient data meta-analysis was done to determine the independent effects of peri-operative transfusion of blood products, intra-operative tidal volume and airway pressure in adult patients undergoing mechanical ventilation for general surgery, as well as their interactions on the occurrence of postoperative acute respiratory distress syndrome (ARDS). Observational studies and randomized trials were identified by a systematic search of MEDLINE, CINAHL, Web of Science, and CENTRAL and screened for inclusion into a meta-analysis. Individual patient data were obtained from the corresponding authors. Patients were stratified according to whether they received transfusion in the perioperative period [ red blood cell concentrates (RBC) and/or fresh frozen plasma (FFP)], tidal volume size [ 10 mL/kg PBW] and airway pressure level used during surgery ( 20 cmH(2)O). The primary outcome was development of postoperative ARDS. Results: Seventeen investigations were included (3,659 patients). Postoperative ARDS occurred in 40 (7.2%) patients who received at least one blood product compared to 40 patients (2.5%) who did not [ adjusted hazard ratio (HR), 2.32; 95% confidence interval (CI), 1.25-4.33; P=0.008]. Incidence of postoperative ARDS was highest in patients ventilated with tidal volumes of > 10 mL/kg PBW and having airway pressures of > 20 cmH(2)O receiving both RBC and FFP, and lowest in patients ventilated with tidal volume of

Published
2018

32. 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

33. MECHANICAL HEART VALVES AND ORAL ANTICOAGULATION: A SURVEY OF THE ITALIAN SOCIETY OF CARDIAC SURGERY

Author

Santarpino, G, Di Mauro, M, De Feo, M, Menicanti, L, Paparella, D, Mastroroberto, P, Speziale, G, Pollari, F, Mauro, M, Torella, M, Coscioni, E, Barili, F, Cardetta, F, and Parolari, A

Abstract

In the latest European guidelines for the management of valvular heart disease, mechanical valve prostheses maintain a strategic role, particularly for certain patient subsets and age groups. Despite the high number of devices implanted in clinical practice, particularly in non–European and North American regions, current scientific literature and debate seem to suggest a limited use of mechanical heart valves. The cardiac surgery community seems to be highly interested in biological and transcatheter valve prostheses but less interested in mechanical heart valves, including possible strategies for self–management of anticoagulation therapy. In this respect, the Italian Society of Cardiac Surgery (SICCH), in particular the Italian Group of Research for Outcome in Cardiac Surgery (GIROC), has promoted a survey among its members to stimulate the interest in this topic and express their opinion on this issue that, due to the prevalence of the affected population and the new treatment options for improving patient’s quality of life, should be more appraised and debated in the cardiac surgery community. The recorded results, obtained on the answers to 111 questionnaires, seem to divide the specialists into "pros" and "contras" on a useful tool for the entire cardiac surgery community. For this reason, SICCH proposes in conclusion to declare its unified and institutional opinion on this topic.

Published
2024
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34. EARLY RESULTS OF MINIMALLY INVASIVE CORONARY ARTERY BYPASS GRAFTING

Author

Squiccimarro, E, Margari, V, Kounakis, G, Visicchio, G, Pascarella, C, Carbone, C, and Paparella, D

Abstract

Coronary artery bypass grafting (CABG) is the benchmark in elective revascularization for Coronary Artery Disease (CAD), particularly for complex or multivessel CAD, left main coronary involvement, diabetes, or impaired heart function. Traditional CABG, via median sternotomy using cardiopulmonary bypass (CPB), has limitations like CPB–related morbidity and sternal complications. Alternatives like Minimally Invasive Cardiac Surgery (MICS CABG) and Hybrid Revascularization (HR) aim to address these drawbacks. We present a series of 215 consecutive patients (mean age 67±9 years, 27.9% females, EuroSCORE II 1.5±1.3%) between 2017–2023 who underwent elective minimally invasive surgical revascularization. Among the cohort, 164 (76.3%) had Minimally Invasive Direct Coronary Artery Bypass (MIDCAB) via anterolateral left mini–thoracotomy (ALMT) at the fifth intercostal space (IS), with 140 (85.4%) receiving a single left internal thoracic artery (LITA) graft to the left anterior descending (LAD) artery and 24 (14.6%) an additional distal anastomosis. Thirty–four (20.7%) had HR via percutaneous coronary intervention (PCI) on the right coronary artery (RCA). Of the total cohort, 35/215 patients (16.3%) underwent multivessel MICS CABG via ALMT, with mean 2.3±0.5 distal anastomoses using LITA, right ITA, radial artery, or saphenous vein. Heart manipulation was via a subxiphoid device. Four MICS CABG patients (11.4%) had HR. More than half of MICS CABG cases were performed with planned peripheral CPB, without cross–clamping the Aorta. Of the total cohort, 16/215 patients (7.4%) received MICS CABG in an endoscopic fashion, using 3D thoracoscopy for LITA and RITA harvesting via bilateral ports in the 2nd, 3rd, and 4th IS, employing peripheral CPB and aortic clamping by Chitwood clamp at the second IS, with cardioplegia delivery via a 4 cm right anterior MT. Distal anastomoses were performed via left anterior MT, with easy subxiphoid manipulation of the emptied heart. Transit time flowmetry was used in all cases. Conversion to sternotomy was needed in 3 cases, all were MIDCAB. Thirty–day mortality was 1.4%, median ventilation was 4 [2–5] hours, and Intensive Care Unit–stay was 1 [1–2] days. All patients received graft evaluation via computerized tomography before hospital discharge. Mean follow–up was 2.9±1.9 years (max 5 years), with no deaths and 4 (1.9%) requiring follow–up PCI. MICS CABG is a promising future technique for heart revascularization by dedicated teams.

Published
2024
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35. COMBINED ENDOSCOPIC MITRAL REPAIR AND DIRECT CORONARY ARTERY BYPASS VIA BILATERAL MINI–THORACOTOMY

Author

Squiccimarro, E, Margari, V, Kounakis, G, Visicchio, G, Pascarella, C, Carbone, C, and Paparella, D

Abstract

Emerging evidence upholds minimally invasive approaches as the foremost surgical intervention for heart valve diseases, addressing detriments associated with traditional cardiac surgery. Yet, the comprehensive adoption of minimally invasive coronary surgery is disproportionately low, not to mention concurrent coronary and valve procedures. Bilateral mini–thoracotomy (MT) has been suggested as a feasible and safe technique for diverse isolated cardiac procedures. In 2021–2023, 7 patients were treated with minimally invasive mitral repair (MVr) and direct coronary artery bypass (MIDCAB): age was 66±4 years, 5 were males, and EuroSCORE II (%) was 2.6±1.2. For the procedure, a double–lumen endotracheal tube was employed, and heparin was administered. The right internal jugular vein was cannulated percutaneously. The MIDCAB involved a anterolateral left MT at the fifth intercostal space (IS). The left internal thoracic artery (LITA) was harvested under direct vision using a retractor. Mini–pericardiectomy was performed to facilitate off–pump anastomoses on the left anterior descending artery using a stabilizer, along with intracoronary shunts. Transit time flowmetry was performed. A right groin incision exposed the femoral vessels for echo–guided cannulation as per Seldinger. Endoscopic MVr was accomplished via a right MT above the nipple, at the fourth IS. A soft–tissue retractor and trocars at the fourth and sixth IS enabled 3D thoracoscopy and CO2 insufflation. After adjusting for selective ventilation, the chest was accessed for pericardiectomy. An aortic needle inserted via the main incision facilitated cardioplegia delivery and aortic venting. Cardiopulmonary bypass was established and aortic clamping achieved by Chitwood clamp at the second IS. Cardioplegia was delivered with the LITA graft temporarily closed. All patients received ring annuloplasty, 4 had posterior leaflet resection, 3 neochordal repair, and 2 had concomitant monopolar ablation and linear left atrial appendage closure. All patients were discharged healthy, after graft evaluation via computerized tomography. We report favorable outcome, satisfactory surgical times, early mechanical ventilation discontinuation (4±2 hours) and discharge from intensive care unit (3±1 days). No patient died at follow–up (maximum 2 years). In conclusion, minimally invasiveness should be embraced to ensure acceptance among patients and favorable long–term results, even when facing multifactorial pathology.

Published
2024
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36. OUTCOME AFTER ROSS PROCEDURE IN ADULT PATIENTS: A SYSTEMATIC REVIEW, META-ANALYSIS AND MICROSIMULATION

Author

Sibilio, S., primary, Koziarz, A., additional, McClure, G., additional, Alsagheir, A., additional, Alradaddi, H., additional, Lengyel, A., additional, Reza, S., additional, Um, K., additional, MacIsaac, S., additional, Mendoza, P., additional, Paparella, D., additional, El-Hamamsy, I., additional, Parry, D., additional, Belley-Côté, E., additional, and Whitlock, R., additional

Published
2018
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37. Antiplatelet versus oral anticoagulant therapy as antithrombotic prophylaxis after mitral valve repair

Author

Paparella, D, Di Mauro, M, Bitton Worms, K, Bolotin, G, Russo, C, Trunfio, S, Scrofani, R, Antona, C, Actis Dato, G, Casabona, R, Colli, A, Gerosa, G, Renzulli, A, Serraino, F, Scrascia, G, Zaccaria, S, De Bonis, M, Taramasso, M, Delgado, L, Tritto, F, Marmo, J, Parolari, A, Myaseodova, V, Villa, E, Troise, G, Nicolini, F, Gherli, T, Whitlock, R, Conte, M, Barili, F, Gelsomino, S, Lorusso, R, Sciatti, E, Marinelli, D, Di Giammarco, G, Calafiore, Am, Sheikh, A, Alfonso, Jj, Glauber, M, Miceli, A, Rotunno, C, Beckerman, Z, Martinelli, L, Lanfranconi, M, Foresti, D, Varone, E, Punta, G, Alfieri, O, Lapenna, E, Ismeno, G, Pulcino, A, Alamanni, F, Dalla Tomba, M, Coletti, G, Vizzardi, Enrico, Lio, A, Solinas, M, Foschi, M, and Giroc, Investigators

Published
2016

38. 2014 ESC/EACTS Guidelines on myocardial revascularization

Author

Kolh, P, Alfonso, F, Collet, JP, Cremer, J, Falk, V, Filippatos, G, Hamm, C, Head, SJ, Juni, P, Kappetein, AP, Kastrati, A, Landmesser, U, Laufer, G, Neumann, FJ, Richter, DJ, Schauerte, P, Stefanini, GG, Taggart, DP, Torracca, L, Valgimigli, M, Witkowski, A, Baumgartner, H, Bax, JJ, Bueno, H, Dean, V, Erol, C, Fagard, R, Ferrari, R, Hoes, AW, Knuuti, J, Lancellotti, P, Linhart, A, Nihoyannopoulos, P, Piepoli, MF, Ponikowski, P, Sirnes, PA, Tamargo, JL, Tendera, M, Torbicki, A, Wijns, W, Windecker, S, Uva, MS, Achenbach, S, Pepper, J, Anyanwu, A, Badimon, L, Bauersachs, J, Baumbach, A, Beygui, F, Bonaros, N, De Carlo, M, Deaton, C, Dobrev, D, Dunning, J, Eeckhout, E, Gielen, S, Hasdai, D, Kirchhof, P, Luckraz, H, Mahrholdt, H, Montalescot, G, Paparella, D, Rastan, AJ, Sanmartin, M, Sergeant, P, Silber, S, Tamargo, J, ten Berg, J, Thiele, H, van Geuns, RJ, Wagner, HO, Wassmann, S, Wendler, O, and Zamorano, JL

Subjects
Stable angina, Medical therapy, Revascularization, Coronary artery bypass grafting, Acute coronary syndromes, Guidelines, Myocardial ischaemia, Recommendation, EuroSCORE, Coronary artery disease, Percutaneous coronary intervention, SYNTAX score, ST-segment elevation myocardial infarction, Myocardial infarction, Bare-metal stents, Myocardial revascularization, Heart Team, Stents, Stable coronary artery disease, Drug-eluting stents, Risk stratification
Published
2014

39. 2014 ESC/EACTS Guidelines on myocardial revascularization

Author

Windecker, S, Alfonso, F, Collet, JP, Cremer, J, Falk, V, Filippatos, G, Hamm, C, Head, SJ, Juni, P, Kappetein, AP, Kastrati, A, Landmesser, U, Laufer, G, Neumann, FJ, Richter, DJ, Schauerte, P, Uva, MS, Stefanini, GG, Taggart, DP, Torracca, L, Valgimigli, M, Wijns, W, Witkowski, A, Zamorano, JL, Achenbach, S, Baumgartner, H, Bax, JJ, Bueno, H, Dean, V, Deaton, C, Erol, C, Fagard, R, Ferrari, R, Hasdai, D, Hoes, AW, Kirchhof, P, Knuuti, J, Kolh, P, Lancellotti, P, Linhart, A, Nihoyannopoulos, N, Piepoli, MF, Ponikowski, P, Sirnes, PA, Tamargo, JL, Tendera, M, Torbicki, A, Pepper, J, Anyanwum, A, Badimon, L, Bauersachs, J, Baumbach, A, Beygui, F, Bonaros, N, De Carlo, M, Dobrev, D, Dunning, J, Eeckhout, E, Gielen, S, Luckraz, H, Mahrholdt, H, Montalescot, G, Paparella, D, Rastan, AJ, Sanmartin, M, Sergeant, P, Silber, S, Tamargo, J, ten Berg, J, Thiele, H, van Geuns, RJ, Wagner, HO, Wassmann, S, Wendler, O, Weidinger, F, Ibrahimov, F, Legrand, V, Terzic, I, Postadzhiyan, A, Skoric, B, Georgiou, GM, Zelizko, M, Junker, A, Eha, J, Romppanen, H, Bonnet, JL, Aladashvili, A, Hambrecht, R, Becker, D, Gudnason, T, Segev, A, Bugiardini, R, Sakhov, O, Mirrakhimov, A, Pereira, B, Felice, H, Trovik, T, Dudek, D, Pereira, H, Nedeljkovic, MA, Hudec, M, Cequier, A, Erlinge, D, Roffi, M, Kedev, S, Addad, F, Yildirir, A, and Davies, J

Subjects
Stable angina, Medical therapy, Revascularization, Coronary artery bypass grafting, Acute coronary syndromes, Guidelines, Myocardial ischaemia, Recommendation, EuroSCORE, Coronary artery disease, Percutaneous coronary intervention, SYNTAX score, ST-segment elevation myocardial infarction, Myocardial infarction, Bare-metal stents, Myocardial revascularization, Heart Team, Stents, Stable coronary artery disease, Drug-eluting stents, Risk stratification
Published
2014

40. 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

48. CLINICAL ACUTE KIDNEY INJURY 2

Author

Gonzalez Sanchidrian, S., primary, Cebrian Andrada, C. J., additional, Jimenez Herrero, M. C., additional, Deira Lorenzo, J. L., additional, Labrador Gomez, P. J., additional, Marin Alvarez, J. P., additional, Garcia-Bernalt Funes, V., additional, Gallego Dominguez, S., additional, Castellano Cervino, I., additional, Gomez-Martino Arroyo, J. R., additional, Parapiboon, W., additional, Boonsom, P., additional, Stadler, T., additional, Raddatz, A., additional, Poppleton, A., additional, Hubner, W., additional, Fliser, D., additional, Klingele, M., additional, Rosa, J., additional, Sydor, A., additional, Krzanowski, M., additional, Chowaniec, E., additional, Sulowicz, W., additional, Vidal, E., additional, Mergulhao, C., additional, Pinheiro, H., additional, Sette, L., additional, Amorim, G., additional, Fernandes, G., additional, Valente, L., additional, Ouaddi, F., additional, Tazi, I., additional, Mabrouk, K., additional, Zamd, M., additional, El Khayat, S., additional, Medkouri, G., additional, Benghanem, M., additional, Ramdani, B., additional, Dabo, G., additional, Badaoui, L., additional, Ouled Lahcen, A., additional, Sosqi, M., additional, Marih, L., additional, Chakib, A., additional, Marhoum El Filali, K., additional, Oliveira, M. J. C., additional, Silva Junior, G., additional, Sampaio, A. M., additional, Montenegro, B., additional, Alves, M. P., additional, Henn, G. A. L., additional, Rocha, H. A. L., additional, Meneses, G. C., additional, Martins, A. M. C., additional, Sanches, T. R., additional, Andrade, L. C., additional, Seguro, A. C., additional, Liborio, A. B., additional, Daher, E. F., additional, Haase, M., additional, Robra, B.-P., additional, Hoffmann, J., additional, Isermann, B., additional, Henkel, W., additional, Bellomo, R., additional, Ronco, C., additional, Haase-Fielitz, A., additional, Kee, Y. K., additional, Kim, Y. L., additional, Kim, E. J., additional, Park, J. T., additional, Han, S. H., additional, Yoo, T.-H., additional, Kang, S.-W., additional, Choi, K. H., additional, Oh, H. J., additional, Dharmendra, P., additional, Vinay, M., additional, Mohit, M., additional, Rajesh, G., additional, Dhananjai, A., additional, Pankaj, B., additional, Campos, P., additional, Pires, A., additional, Inchaustegui, L., additional, Avdoshina, S., additional, Villevalde, S., additional, Kobalava, Z., additional, Mukhopadhyay, P., additional, Das, B., additional, Mukherjee, D., additional, Mishra, R., additional, Kar, M., additional, Biswas, N. M., additional, Onuigbo, M., additional, Agbasi, N., additional, Ponce, D., additional, Albino, B. B., additional, Balbi, A. L., additional, Klin, P., additional, Zambrano, C., additional, Gutierrez, L. M., additional, Varela Falcon, L., additional, Zeppa, F., additional, Bilbao, A., additional, Klein, F., additional, Raffaele, P., additional, Chang, K. Y., additional, Park, H. S., additional, Kim, H. W., additional, Choi, B. S., additional, Park, C. W., additional, Yang, C. W., additional, Jin, D. C., additional, Checherita, I.-A., additional, Peride, I., additional, David, C., additional, Radulescu, D., additional, Ciocalteu, A., additional, Niculae, A., additional, Balbi, A., additional, Goes, C., additional, Buffarah, M., additional, Xavier, P., additional, Karimi, S. M., additional, Cserep, G., additional, Gannon, D., additional, Sinnamon, K., additional, Saudan, P., additional, Alves, C., additional, De La Fuente, V., additional, Ponte, B., additional, Carballo, S., additional, Rutschmann, O., additional, Martin, P.-Y., additional, Stucker, F., additional, Saurina, A., additional, Pardo, V., additional, Barba, N., additional, Jovell, E., additional, Pou, M., additional, Esteve, V., additional, Fulquet, M., additional, Duarte, V., additional, Ramirez De Arellano, M., additional, Sun, I. O., additional, Yoon, H. J., additional, Kim, J. G., additional, Lee, K. Y., additional, Tiranathanagul, K., additional, Sallapant, S., additional, Eiam-Ong, S., additional, Treeprasertsuk, S., additional, Checherita, I. A., additional, Geavlete, B., additional, Ando, M., additional, Shingai, N., additional, Morito, T., additional, Ohashi, K., additional, Nitta, K., additional, Duarte, D. B., additional, Vanderlei, L. A., additional, Bispo, R. K. A., additional, Pinheiro, M. E., additional, Si Nga, H., additional, Paes, A., additional, Medeiros, P., additional, Gentil, T. M. S., additional, Assis, L. S., additional, Amaral, A. P., additional, Alvares, V. R. C. A., additional, Scaranello, K. L. R. S., additional, Soeiro, E. M. D., additional, Castanho, V., additional, Castro, I., additional, Laranja, S. M., additional, Barreto, S., additional, Molina, M., additional, Silvisk, M., additional, Pereira, B. J., additional, Izem, A., additional, Amer Mhamed, D., additional, El Khayat, S. S., additional, Donadio, C., additional, Klimenko, A., additional, Andreoli, M. C., additional, Souza, N. K., additional, Ammirati, A. L., additional, Matsui, T. N., additional, Naka, E. L., additional, Carneiro, F. D., additional, Ramos, A. C., additional, Lopes, R. K., additional, Dias, E. S., additional, Coelho, M. P., additional, Afonso, R. C., additional, Ferraz-Neto, B.-H., additional, Almeida, M. D., additional, Durao, M., additional, Batista, M. C., additional, Monte, J. C., additional, Pereira, V. G., additional, Santos, O. P., additional, Santos, B. C., additional, Silva, V. C., additional, Raimann, J. G., additional, Nerbass, F. B., additional, Vieira, M. A., additional, Dabel, P., additional, Richter, A., additional, Callegari, J., additional, Carter, M., additional, Levin, N. W., additional, Winchester, J. F., additional, Kotanko, P., additional, Pecoits-Filho, R., additional, Gjyzari, A., additional, Thereska, N., additional, Barbullushi, M., additional, Koroshi, A., additional, Petrela, E., additional, Mumajesi, S., additional, Han, J. S., additional, Simone, S., additional, Scrascia, G., additional, Montemurno, E., additional, Rotunno, C., additional, Mastro, F., additional, Gesualdo, L., additional, Paparella, D., additional, Pertosa, G., additional, Lopes, D., additional, Santos, C., additional, Cunha, C., additional, Gomes, A. M., additional, Coelho, H., additional, Seabra, J., additional, Qasem, A., additional, Farag, S., additional, Hamed, E., additional, Emara, M., additional, Bihery, A., additional, Pasha, H., additional, Chhaya, S., additional, Mukhopadhyay, G., additional, Das, C., additional, Vieira, A. P. F., additional, Lima, L. L. L., additional, Nascimento, L. S., additional, Zawiasa, A., additional, Ko Odziejska, M., additional, Bia Asiewicz, P., additional, Nowak, D., additional, and Nowicki, M., additional

Published
2014
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49. Risk stratification for in-hospital mortality after cardiac surgery: external validation of EuroSCORE II in a prospective regional registry

Author

Paparella, D., primary, Guida, P., additional, Di Eusanio, G., additional, Caparrotti, S., additional, Gregorini, R., additional, Cassese, M., additional, Fanelli, V., additional, Speziale, G., additional, Mazzei, V., additional, Zaccaria, S., additional, De Luca Tupputi Schinosa, L., additional, and Fiore, T., additional

Published
2014
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