7 results on '"Raffa, G. M."'
Search Results
2. The bird-beak stent-graft configuration: The end of aortic arch endograft collapse?
- Author
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Pasta S., Raffa G. M., D'Ancona G., Pilato M., Pasta S., Raffa G.M., D'Ancona G., and Pilato M.
- Subjects
Male ,Blood Vessel Prosthesis Implantation ,Endovascular Procedure ,Aortic Aneurysm, Thoracic ,Hemodynamics ,Settore ING-IND/34 - Bioingegneria Industriale ,Aorta, Thoracic ,Human - Abstract
The bird-beak stent-graft configuration: The end of aortic arch endograft collapse?
- Published
- 2014
3. Bicuspidy does not affect reoperation risk following aortic valve reimplantation
- Author
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Malvindi, P. G., primary, Raffa, G. M., additional, Basciu, A., additional, Citterio, E., additional, Cappai, A., additional, Ornaghi, D., additional, Tarelli, G., additional, and Settepani, F., additional
- Published
- 2012
- Full Text
- View/download PDF
4. In-hospital outcome of post-cardiotomy extracorporeal life support in adult patients: The 2007–2017 maastricht experience
- Author
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Raffa, G. M., Gelsomino, S., Sluijpers, N., Meani, P., Alenizy, K., Natour, E., Bidar, E., Dan Johnson, Makhoul, M., Heuts, S., Lozekoot, P., Kats, S., Schreurs, R., Delnoij, T., Montalti, A., Sels, J. W., Poll, M., Roekaerts, P., Maessen, J., Lorusso, R., RS: CARIM - R2.12 - Surgical intervention, CTC, MUMC+: MA Med Staf Spec CTC (9), MUMC+: MA Med Staf Artsass CTC (9), MUMC+: MA Cardiothoracale Chirurgie (3), Promovendi CD, Fysiologie, RS: CARIM - R2.08 - Electro mechanics, MUMC+: MA Med Staf Spec Cardiologie (9), MUMC+: MA Medische Staf IC (9), Intensive Care, MUMC+: MA Heelkunde (9), RS: NUTRIM - R2 - Liver and digestive health, RS: NUTRIM - R2 - Gut-liver homeostasis, and MUMC+: MA Intensive Care (3)
- Subjects
endocrine system ,Journal Article - Abstract
OBJECTIVES: The use of post-cardiotomy extracorporeal life support (PC-ECLS) has increased worldwide over the past years but a concurrent decrease in survival to hospital discharge has also been observed. We analysed use and outcome of PC-ECLS at the Maastricht University Medical Center. DESIGN: A retrospective study of a single-centre PC-ECLS cohort. Patient characteristics and in-hospital outcomes were evaluated. SETTING: Patients who underwent PC-ECLS due to intra- or peri-operative cardiogenic shock or cardiac arrest were included. Descriptive statistics were analysed and frequency analysis and testing of group differences were performed. PARTICIPANTS: Eighty-six patients who received PC-ECLS between October 2007 and June 2017 were included. The mean age of the population was 65 years (range, 31-86 years), and 65% were men. MAIN OUTCOME MEASURES: Survival rates were calculated and PC-ECLS management data and complications were assessed. RESULTS: Pre-ECLS procedures were isolated coronary artery bypass grafting (CABG) (22%), isolated valve surgery (16%), thoracic aorta surgery (4%), a combination of CABG and valve surgery (21%) or other surgery (24%). PC-ECLS was achieved via central cannulation in 17%, peripheral cannulation in 65%, or by a combination in 17%. The median duration of PC-ECLS was 5.0 days (IQR, 6.0 days). Weaning was achieved in 49% of patients, and 37% survived to discharge. Post-operative bleeding (overall rate, 42%) showed a trend towards a reduced rate over more recent years. CONCLUSIONS: Our experience confirms an increased use of PC-ECLS during the last 10 years and shows that, by carefully addressing patient management and complications, survival rat e may be satisfactory, and improved outcome may be achieved in such a challenging ECLS setting.
5. In Silico Shear and Intramural Stresses are Linked to Aortic Valve Morphology in Dilated Ascending Aorta.
- Author
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Pasta S, Gentile G, Raffa GM, Bellavia D, Chiarello G, Liotta R, Luca A, Scardulla C, and Pilato M
- Subjects
- Aged, Aorta diagnostic imaging, Aortic Aneurysm diagnostic imaging, Aortic Aneurysm etiology, Aortic Valve diagnostic imaging, Aortic Valve physiopathology, Aortography methods, Bicuspid Aortic Valve Disease, Blood Flow Velocity, Computed Tomography Angiography, Dilatation, Pathologic, Female, Heart Valve Diseases complications, Heart Valve Diseases diagnostic imaging, Humans, Male, Middle Aged, Models, Cardiovascular, Patient-Specific Modeling, Regional Blood Flow, Risk Factors, Stress, Mechanical, Aorta physiopathology, Aortic Aneurysm physiopathology, Aortic Valve abnormalities, Heart Valve Diseases physiopathology, Hemodynamics
- Abstract
Objective/background: The development of ascending aortic dilatation in patients with bicuspid aortic valve (BAV) is highly variable, and this makes surgical decision strategies particularly challenging. The purpose of this study was to identify new predictors, other than the well established aortic size, that may help to stratify the risk of aortic dilatation in BAV patients., Methods: Using fluid-structure interaction analysis, both haemodynamic and structural parameters exerted on the ascending aortic wall of patients with either BAV (n = 21) or tricuspid aortic valve (TAV; n = 13) with comparable age and aortic diameter (42.7 ± 5.3 mm for BAV and 45.4 ± 10.0 mm for TAV) were compared. BAV phenotypes were stratified according to the leaflet fusion pattern and aortic shape., Results: Systolic wall shear stress (WSS) of BAV patients was higher than TAV patients at the sinotubular junction (6.8 ± 3.3 N/m
2 for BAV and 3.9 ± 1.3 N/m2 for TAV; p = .006) and mid-ascending aorta (9.8 ± 3.3 N/m2 for BAV and 7.1 ± 2.3 N/m2 for TAV; p = .040). A statistically significant difference in BAV versus TAV was also observed for the intramural stress along the ascending aorta (e.g., 2.54 × 105 ± 0.32 × 105 N/m2 for BAV and 2.04 × 105 ± 0.34 × 105 N/m2 for TAV; p < .001) and pressure index (0.329 ± 0.107 for BAV and 0.223 ± 0.139 for TAV; p = .030). Differences in the BAV phenotypes (i.e., BAV type 1 vs. BAV type 2) and aortopathy (i.e., isolated tubular vs. aortic root dilatations) were associated with asymmetric WSS distributions in the right anterior aortic wall and right posterior aortic wall, respectively., Conclusion: These findings suggest that valve mediated haemodynamic and structural parameters may be used to identify which regions of aortic wall are at greater stress and enable the development of a personalised approach for the diagnosis and management of aortic dilatation beyond traditional guidelines., (Copyright © 2017 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.)- Published
- 2017
- Full Text
- View/download PDF
6. David operation: single center 10-year experience.
- Author
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Malvindi PG, Cappai A, Basciu A, Raffa GM, Barbone A, Citterio E, Ornaghi D, Tarelli G, and Settepani F
- Subjects
- Acute Disease, Adult, Aged, Aged, 80 and over, Aortic Dissection complications, Aortic Dissection diagnosis, Aortic Dissection mortality, Aortic Aneurysm complications, Aortic Aneurysm diagnosis, Aortic Aneurysm mortality, Aortic Valve Insufficiency diagnosis, Aortic Valve Insufficiency etiology, Aortic Valve Insufficiency mortality, Bicuspid Aortic Valve Disease, Blood Vessel Prosthesis, Blood Vessel Prosthesis Implantation adverse effects, Blood Vessel Prosthesis Implantation instrumentation, Blood Vessel Prosthesis Implantation mortality, Cardiac Surgical Procedures adverse effects, Cardiac Surgical Procedures mortality, Chronic Disease, Disease-Free Survival, Female, Heart Valve Diseases complications, Heart Valve Diseases diagnosis, Heart Valve Diseases mortality, Humans, Italy, Kaplan-Meier Estimate, Male, Middle Aged, Postoperative Complications surgery, Prosthesis Design, Reoperation, Replantation, Risk Factors, Time Factors, Treatment Outcome, Aortic Dissection surgery, Aortic Aneurysm surgery, Aortic Valve abnormalities, Aortic Valve surgery, Aortic Valve Insufficiency surgery, Blood Vessel Prosthesis Implantation methods, Cardiac Surgical Procedures methods, Heart Valve Diseases surgery
- Abstract
Aim: Aortic valve-sparing operation has been progressively widely performed for the treatment of aortic root aneurysm. Nowadays, this procedure has been proposed even in presence of a bicuspid aortic valve, severe aortic regurgitation or in primary aortic dissection repair. We present our ten-year experience focusing on mid-term echocardiographic follow-up., Methods: Between June 2002 and February 2012, 139 patients (mean age of 61±12 years) underwent aortic valve-sparing operation with valve reimplantation. Twenty-seven patients (19%) had bicuspid aortic valve; in eighteen cases (13%) cusp motion or anatomical abnormalities concurred in determining aortic regurgitation and needed an adjunct cusp repair. A Gelweave Valsalva™ graft was implanted in all the patients., Results: The mortality pre-discharge was 0.7% (1 patient). The cumulative 1-year, 5-years and 8-years survival rates were 99%, 93% and 87% respectively. Postoperative aortic regurgitation more than mild degree (>2+/4+) was the only significant risk factors for redo aortic valve surgery Freedom from reoperation due to aortic valve regurgitation was 96% at 1 year, 90% at 5 years and 86% at 8 years. When comparing freedom from reoperation in patients with bicuspid vs tricuspid aortic valve, no differences were found (P=0.31) and the rate of aortic valve reoperation was significantly higher (P<0.001) in patients who received leaflet's repair., Conclusion: The durability of valve reimplantation was found to be excellent in patients with tricuspid aortic valve and normal or nearly normal cusps. Cusp prolapse and complication after cusp repair turned out to be the main causes for early failure.
- Published
- 2015
7. Domino heart transplantation: long-term outcome of recipients and their living donors: single center experience.
- Author
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Raffa GM, Pellegrini C, and Viganò M
- Subjects
- Adolescent, Adult, Communicable Diseases etiology, Female, Graft Rejection etiology, Graft Survival, Heart Diseases etiology, Humans, Italy, Male, Middle Aged, Neoplasms etiology, Retrospective Studies, Survival Rate, Time Factors, Transplantation, Homologous, Treatment Outcome, Young Adult, Heart Transplantation adverse effects, Heart Transplantation mortality, Heart-Lung Transplantation adverse effects, Heart-Lung Transplantation mortality, Living Donors
- Abstract
Background: "Domino" cardiac procedure is an effective option to increase the donor pool when heart-lung transplantation (HLT) is the only treatment for patients with terminal cardiopneumopathy. We reviewed the long-term outcomes of domino cardiac donors and recipients at our institution., Methods: Ten of 35 patients who underwent HLT from 1991 onward served as domino cardiac donors. They included eight female and two male subjects of overall mean age of 33 years and mean weight of 55 kg. Their diagnoses were primary pulmonary hypertension (n = 6) as well as cystic fibrosis, bronchiectasis, Eisenmenger's syndrome, and bronchiolitis obliterans (n = 1 each). The domino cardiac recipients included six males and four females of overall mean age of 47 years and mean weight of 61 kg. They were affected by ischemic heart disease (n = 5), cardiomyopathy (n = 4), and valvular heart disease (n = 1). Mean pulmonary vascular resistance was 3 Wood units. The heart was used either in the orthotopic (n = 8) or in the heterotopic position (n = 2)., Results: The 1-, 5-, and 10-year survivals for the domino cardiac donors versus their recipients were 60%, 40%, 30% versus 90%, 70%, 60%, respectively. Five domino donors developed bronchiolitis obliterans syndrome. Among the domino recipients group, cardiac allograft vasculopathy was rare (n = 1). Common causes of late death were in the domino recipients infections in the domino donors (n = 2) and malignancies., Conclusions: Our experience suggested good long-term results of the domino procedure., (Copyright © 2010 Elsevier Inc. All rights reserved.)
- Published
- 2010
- Full Text
- View/download PDF
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