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1. 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

2. 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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4. 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

5. 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

6. 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

7. 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

9. 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

12. Evoluzioni nel trattamento delle mediastiniti: Esperienza di un singolo centro

Author

DE FEO, Marisa, VICCHIO M, SANTE', Pasquale, PIROZZI F, MIRAGLIA M, MONTIBELLO M, BORRELLI M, DELLA RATTA E, CEFARELLI M, NAPPI, Gianantonio, DE FEO, Marisa, Vicchio, M, Sante', Pasquale, Pirozzi, F, Miraglia, M, Montibello, M, Borrelli, M, DELLA RATTA, E, Cefarelli, M, and Nappi, Gianantonio

Published
2011

13. Risk Factors and Complications Affecting Hospital Outcome after Redo Mitral Surgery

Author

Onorati, F., primary, Reichart, D., additional, Perrotti, A., additional, Mariscalo, G., additional, Della Ratta, E., additional, Santarpino, G., additional, Salsano, A., additional, Rubino, A., additional, Biancari, F., additional, Beghi, C., additional, De Feo, M., additional, Mignosa, C., additional, Fischlein, T., additional, Chocron, S., additional, Detter, C., additional, Santini, F., additional, Reichenspurner, H., additional, and Faggian, G., additional

Published
2016
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15. 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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16. 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

17. Surgical factors and complications affecting hospital outcome in redo mitral surgery: insights from a multicentre experience

Author

Marisa De Feo, Christian Detter, Giuseppe Santarpino, Francesco Onorati, Francesco Santini, Theodor Fischlein, Cesare Beghi, Andrea Perrotti, Aniello Pappalardo, Sidney Chocron, Ester Della Ratta, Fausto Biancari, Daniel Reichart, Antonio Salsano, Giovanni Mariscalco, Antonio Rubino, Giuseppe Faggian, Carmelo Mignosa, Giuseppe Gatti, Onorati, F, Perrotti, A, Reichart, D, Mariscalco, G, Della Ratta, E, Santarpino, G, Salsano, A, Rubino, A, Biancari, F, Gatti, G, Beghi, C, De Feo, M, Mignosa, C, Pappalardo, A, Fischlein, T, Chocron, S, Detter, C, Santini, F, and Faggian, G.

Subjects
Reoperation, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Blood transfusion, medicine.medical_treatment, Heart Valve Diseases, Outcomes, 030204 cardiovascular system & hematology, Valve disease, law.invention, 03 medical and health sciences, Postoperative Complications, 0302 clinical medicine, Risk Factors, law, Mitral valve, Cardiopulmonary bypass, Humans, Medicine, Myocardial infarction, Cardiac Surgical Procedures, Stroke, Outcome, Redo, Retrospective Studies, Mitral repair, Mitral surgery, Hospitalization, Mitral Valve, Treatment Outcome, Surgery, Cardiology and Cardiovascular Medicine, business.industry, Medicine (all), Retrospective cohort study, General Medicine, Odds ratio, Perioperative, medicine.disease, Mitral repair, Mitral surgery, Mitral valve, Outcomes, Redo, Valve disease, Heart Valve Diseases, Hospitalization, Humans, Mitral Valve, Postoperative Complications, Retrospective Studies, Risk Factors, Treatment Outcome, Cardiac Surgical Procedures, Reoperation, medicine.anatomical_structure, 030228 respiratory system, business
Abstract

OBJECTIVES: Several single-centre experiences have reported significant operative mortality and morbidity after mitral valve surgery in redo scenarios (ReMVS). Several preoperative risk factors outlining 'high-risk' categories have been reported, but scanty data on the impact of different operative techniques for these major challenging procedures have been analysed to date. The aim of the study is to investigate those intraoperative factors and postoperative events affecting early survival after redo mitral procedures.METHODS: Operative mortality and major morbidity events from a large multicentre registry enrolling 832 consecutive redo mitral procedures were analysed. Intraoperative technical issues and postoperative complications impacting operative mortality were identified.RESULTS: ReMVS was associated with significant operative mortality (12.5%), acute myocardial infarction (AMI; 5.9%), stroke (4.9%), acute respiratory insufficiency (14.8%), pneumonia (7.0%), acute renal insufficiency (16.1%) and failure (12.6%), reintervention for bleeding (7.6%), massive transfusion (28.0%), need for permanent pacemaker (10.1%). Injury of a previous patent left internal mammary artery (LIMA) graft [odds ratio (OR) 4.2, 95% confidence interval (CI): 1.6-11.5; P = 0.005], major cardiovascular iatrogenic lesions at re-entry (OR 19.2, 95% CI: 9.2-39.9; P < 0.001), extracellular crystalloid cardioplegia (OR 7.3, 95% CI: 1.4-37.8; P = 0.018), and incremental cardiopulmonary bypass time (OR 1.1, 95% CI: 1.0-1.2; P = 0.001) independently predicted operative mortality, whereas combined antegrade + retrograde cardioplegia (OR 0.2, 95% CI: 0.09-0.4; P = 0.001) was the only protective factor against mortality. Among complications, AMI (OR 4.1, 95% CI: 1.8-9.6; P = 0.001), need for intra-aortic balloon pumping (IABP; OR 3.1, 95% CI: 1.5-6.1; P = 0.001), prolonged intubation >48 h (OR 5.3, 95% CI: 2.9-9.4; P = 0.001) and massive (>6 units) transfusions (OR 4.4, 95% CI: 2.4-8.0; P = 0.001) also predicted operative mortality.CONCLUSIONS: ReMVS still carries the risk of significant early mortality and major morbidity. Major lesion to cardiovascular structures is the most dreadful iatrogenic complication, and injury of a previous LIMA graft identifies patients at higher risk of operative mortality. Prolonged cross-clamp times, extracellular crystalloid cardioplegia and massive transfusions have profound impact on early outcome, as well as the development of perioperative AMI, eventually requiring IABP and prolonged intubation. The combination of antegrade and retrograde cardioplegia seems to offer a better myocardial protection in these high-risk patients.

Published
2016
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18. 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

19. First-time, isolated surgical aortic valve replacement after prior coronary artery bypass surgery: results from the RECORD multicenter registry

Author

Biancari, Fausto, Onorati, Francesco, Mariscalco, Giovanni, De Feo, Marisa, Messina, Antonio, Santarpino, Giuseppe, Santini, Francesco, Beghi, Cesare, Della Ratta, Ester, Troise, Giovanni, Fischlein, Theodor, Passerone, Giancarlo, Juvonen, Tatu, Mazzucco, Alessandro, Heikkinen, Jouni, Faggian, Giuseppe, Biancari, F, Onorati, F, Mariscalco, G, DE FEO, Marisa, Messina, Antonietta, Santarpino, G, Santini, F, Beghi, C, Della Ratta, E, Troise, G, Fischlein, T, Passerone, G, Juvonen, T, Mazzucco, A, Heikkinen, J, and Faggian, G.

Subjects
Male, Time Factors, Hypothermia, Aged, Aged 80 and over, Aortic Valve, Constriction, Female, Heart Arrest Induced, Humans, Hypothermia Induced, Male, Mammary Arteries, Middle Aged, Sternotomy, Survival Rate, Time Factors, Treatment Outcome, Coronary Artery Bypass, Heart Valve Prosthesis Implantation, Registries, Hypothermia, Induced, 80 and over, Humans, Registries, Coronary Artery Bypass, Mammary Arteries, Aged, Aged, 80 and over, Aortic Valve, Constriction, Female, Heart Arrest, Induced, Middle Aged, Sternotomy, Survival Rate, Treatment Outcome, Heart Valve Prosthesis Implantation, Cardiology and Cardiovascular Medicine, Surgery, Medicine (all), Induced, Heart Arrest, Aged 80 and over, Heart Arrest Induced, Hypothermia Induced
Abstract

This multicenter study was undertaken to determine the immediate and long-term outcomes in patients undergoing a primary surgical aortic valve replacement (AVR) who had a previous coronary artery bypass graft surgery with patent grafts.One hundred and thirteen consecutive patients (mean EuroSCORE II, 10.3 ± 7.7%, median 8.0%) who underwent first-time isolated AVR after coronary artery bypass grafting (CABG) were the subjects of this multicenter study. The procedure was performed through a full sternotomy in 95.7% of cases, a patent internal mammary artery graft was clamped in 76.6% of patients. The temperature of cardioplegia was ≤12 °C in 62.8% of patients and systemic temperature was32 °C in 23.9% of patients.Thirty-day mortality was 4.4%. Stroke was observed in 8.0% of patients, low cardiac output syndrome in 14.1%, prolonged tracheal intubation in 20.8%, and intensive care unit stay was longer than five days in 19.5% of patients. Among patients with a patent internal mammary graft (91 patients), clamping of this graft (5.7% vs. 0%, p = 0.57) was associated with a nonsignificant trend toward increased 30-day mortality. One-, three- and five-year survival rates were 91.5%, 90.4%, and 88.4%, respectively.Patients undergoing isolated AVR after prior CABG have a good immediate and late survival. A history of prior CABG should not be considered an absolute indication for transcatheter AVR.

Published
2014

20. Observed versus predicted mortality after isolated tricuspid valve surgery.

Author

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

Subjects
Female, Hospital Mortality, Humans, Male, ROC Curve, Retrospective Studies, Risk Assessment, Risk Factors, Cardiac Surgical Procedures, Tricuspid Valve surgery
Abstract

Background: Aim of this study is to analyse the performances of Clinical Risk Score (CRS) and European System for Cardiac Operative Risk Evaluation (EuroSCORE)-II in isolated tricuspid surgery., Methods: Three hundred and eighty-three patients (54 ± 16 year; 54% female) were enrolled. Receiver operating characteristic analysis was performed to evaluate the relationship between the true positive fraction of test results and the false-positive fraction for a procedure., Results: Considering the 30-day mortality the area under the curve was 0.6 (95% confidence interval [CI] 0.50-0.72) for EuroSCORE II and 0.7 (95% CI 0.56-0.84) for CRS-score. The ratio of expected/observed mortality showed underestimation when considering EuroSCORE-II (min. 0.46-max. 0.6). At multivariate analysis, the CRS score (p = .005) was predictor of late cardiac death., Conclusion: We suggest using both scores to obtain a range of expected mortality. CRS to speculate on late survival., (© 2022 The Authors. Journal of Cardiac Surgery published by Wiley Periodicals LLC.)

Published
2022
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21. 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 DB, 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
Europe epidemiology, Female, Follow-Up Studies, Humans, Incidence, Male, Middle Aged, Reoperation, Retrospective Studies, Risk Factors, Survival Rate trends, Time Factors, Heart Arrest, Induced methods, Heart Valve Prosthesis Implantation methods, Postoperative Complications epidemiology, Propensity Score, Tricuspid Valve surgery, Tricuspid Valve Insufficiency surgery
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., (Copyright © 2022 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.)

Published
2022
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22. Surgery for prosthetic valve endocarditis: a retrospective study of a national registry.

Author

Della Corte A, Di Mauro M, Actis Dato G, Barili F, Cugola D, Gelsomino S, Santè P, Carozza A, Della 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, and Nappi G

Subjects
Aged, Endocarditis, Bacterial epidemiology, Female, Follow-Up Studies, Hospital Mortality trends, Humans, Italy epidemiology, Male, Middle Aged, Prognosis, Prosthesis-Related Infections epidemiology, Retrospective Studies, Risk Factors, Survival Rate trends, Time Factors, Cardiac Surgical Procedures methods, Endocarditis, Bacterial surgery, Heart Valve Prosthesis adverse effects, Prosthesis-Related Infections surgery, Registries, Risk Assessment
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 and microbiological factors., (© The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.)

Published
2017
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23. Impact of failed mitral valve repair on hospital outcome of redo mitral valve procedures.

Author

Onorati F, Gatti G, Perrotti A, Mariscalco G, Reichart D, Milano A, Della Ratta E, Rubino A, Santarpino G, Salsano A, Biancari F, Detter C, Chocron S, Beghi C, De Feo M, Mignosa C, Fischlein T, Pappalardo A, D'Errigo P, Santini F, and Faggian G

Subjects
Aged, Female, Hospital Mortality, Humans, Male, Middle Aged, Mitral Valve Insufficiency surgery, Retrospective Studies, Treatment Outcome, Heart Valve Prosthesis Implantation adverse effects, Heart Valve Prosthesis Implantation mortality, Heart Valve Prosthesis Implantation statistics & numerical data, Mitral Valve surgery, Reoperation mortality, Reoperation statistics & numerical data
Abstract

Objectives: The prognostic impact of failed mitral valve repair (FMR) on in-hospital outcome after redo mitral valve surgery has not been thoroughly investigated., Methods: Hospital outcomes after redo mitral valve surgery because of an FMR in patients from nine European centres were reported. Logistic regressions identified predictors of mortality in combined or isolated redo mitral valve operations. Hospital outcome was compared between propensity-matched cohorts with FMR and native mitral valves in the context of redo surgery and FMR versus failed prostheses., Results: A total of 246 patients with FMR yielded a 6.5% mortality rate at redo surgery. FMR per se did not impact mortality at multivariable analysis ( P = 0.64). A preoperative Global Initiative for Chronic Obstructive Lung Disease (GOLD) score ≥2 chronic obstructive lung disease (COPD) (OR 15.2, P < 0.01), left ventricular ejection fraction <30% (odds ratio (OR) 21.5, P = 0.005), major injury to cardiovascular structures at re-entry (OR 27.2, P < 0.01) or injury to patent left internal mammary artery-coronary artery bypass graft (OR 7.6, P = 0.03) predicted mortality in the whole FMR population. GOLD ≥ 2 COPD (OR 12.3, P = 0.049), age at surgery (OR 1.15 for each incremental year, P = 0.049) and cardiopulmonary bypass duration (OR 1.02, P = 0.022) predicted mortality in isolated redo mitral valve surgery for FMR. The fourth (> 68 years = 13.8% mortality) and the fifth quintiles of age (≥73.4 years = 14.8%) reported the highest mortality (OR 3.8 and 4.2 respectively, P = 0.002) in this subgroup. Propensity-matched cohorts of FMR and native mitral valves in the context of redo surgery showed no differences in terms of mortality ( P = 0.69) and major morbidity (acute myocardial infarction P = 0.31, stroke P = 0.65, acute kidney injury P  = 1.0), whereas more perioperative dialysis ( P = 0.04) and transfusions ( P = 0.02) were noted in propensity-matched failed prostheses compared to FMR., Conclusions: A failed mitral repair does not impact hospital outcome of redo surgery. Given the role of severe left ventricular dysfunction and advanced age on hospital mortality rates, an early indication for redo surgery may improve outcome., (© The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.)

Published
2017
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24. Aortic Valve Replacement in Redo-Scenarios: A Comparison Between Traditional Aortic Valve Replacement (TAVR) and Transapical-TAVR from Two Real-World Multicenter Registries.

Author

Onorati F, D'Onofrio A, Biancari F, Salizzoni S, De Feo M, Agrifoglio M, Mariscalco G, Lucchetti V, Messina A, Musumeci F, Santarpino G, Esposito G, Santini F, Magagna P, Beghi C, Aiello M, Della Ratta E, Savini C, Troise G, Cassese M, Fischlein T, Glauber M, Passerone G, Punta G, Juvonen T, Alfieri O, Gabbieri D, Mangino D, Agostinelli A, Livi U, Di Gregorio O, Minati A, Rinaldi M, Gerosa G, and Faggian The Record Ita Investigators G

Abstract

Background: The study aim was to compare the outcome of transapical transcatheter aortic valve replacement (TaTAVR) and traditional aortic valve replacement (AVR) in redo from two real-world registries., Methods: The 30-day and follow up outcome of 462 patients enrolled in two multicenter redo registries, treated with redo-AVR (RAVR; n = 292 patients) or TaTAVR (n = 170 patients), were analyzed according to VARC-2 criteria, stratified also by propensity-matching analysis., Results: TaTAVR-patients were older and sicker than RAVR patients, and reported a higher all-cause 30-day mortality (p <0.01), a higher risk for all-cause mortality (p = 0.006) and cardiovascular mortality (p = 0.05) at follow up, but similar 30-day cardiovascular mortality (p = 0.12). Prolonged intubation (p <0.01) and Acute Kidney Injury Network (AKIN) 2/3 p = 0.02) prevailed in RAVR. TaTAVR patients reported a higher level of major/life-threatening/disabling bleeding (p <0.01) and 'early safety-events' (ES) (p = 0.04). Thirty-day acute myocardial infarction (AMI), stroke, and follow up freedom from acute heart failure (AHF), from stroke and from reinterventions were similar (p = NS). The NYHA class was better after RAVR (p <0.01). The intermediate-to-high risk (Logistic EuroSCORE RAVR 17.1 ± 8.5; TaTAVR 16.0 ± 17.0) propensity-matched population demonstrated comparable 30-day and follow up all-cause and cardiovascular mortality, ES, AMI, stroke, prolonged intubation, follow up freedom from AHF, from stroke and from reinterventions and NYHA class. TaTAVR still reported lower levels of AKIN 2/3 (2.2% versus 15.6%, p = 0.03) and shorter hospitalization (9.5 ± 3.4 days versus 12.0 ± 7.0 days, p = 0.03)., Conclusions: Outcome differences between RAVR and TaTAVR in redo-scenarios reflect methodological differences and different baseline risk profiles. Propensity-matched patients showed a better renal outcome after TaTAVR. *Drs. Onorati and D'Onofrio contributed equally to this article and should both be considered as first authors.

Published
2015

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