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3. Experimental Investigation on the Behavior of Artificial Magnetic Cilia

Author

Marucci, A, Romano, GP, and 4th Micro and Nano Flows Conference (MNF2014)

Subjects
Magnetic cilia, Micro flow, Micro-mixer, Micro-pump
Abstract

This paper was presented at the 4th Micro and Nano Flows Conference (MNF2014), which was held at University College, London, UK. The conference was organised by Brunel University and supported by the Italian Union of Thermofluiddynamics, IPEM, the Process Intensification Network, the Institution of Mechanical Engineers, the Heat Transfer Society, HEXAG - the Heat Exchange Action Group, and the Energy Institute, ASME Press, LCN London Centre for Nanotechnology, UCL University College London, UCL Engineering, the International NanoScience Community, www.nanopaprika.eu. In the present work, the flow fields induced by the movement of artificial cilia under the effect of a magnetic field are investigated. In order to obtain almost steady conditions, the set-up consists of fixed cilia which oscillate under the action of a rotating magnetic field. The aim of the work is to determine under which geometrical configurations a net flow rate or a global mixing is obtained. The results show that cilia mounted in the direction of rotation allow net fluid flow, whereas those in radial position have larger turbulent kinetic energy. Thus, the former could be used as micro-pump, whereas the latter as micro-mixer.

Published
2014

6. Preemptive strategy for the treatment of CMV infection. Lights and shadows on a 8 year single-centre experience of 260 patients

Author

UTILI, Riccardo, Amarelli C, Romano GP, De Santo LS, Marra C, Ursomando F, Mastroianni C, Casillo R, Ragone E, Maiello C, Cotrufo M., DURANTE MANGONI, Emanuele, Utili, Riccardo, Amarelli, C, Romano, Gp, DE SANTO, Luca Salvatore, Marra, C, Ursomando, F, Mastroianni, C, DURANTE MANGONI, Emanuele, Casillo, R, Ragone, E, Maiello, C, and Cotrufo, M.

Abstract

Abs #P180

Published
2007

8. Prevenzione del danno polmonare nella chirurgia delle dissezioni aortiche di tipo A: nessun beneficio della perfusione dell'arteria polmonare con Celsior

Author

BIONDI A, PETRAIO A, MARESCA L, QUARTO C, TIZZANO F, MASTROIANNI C, URSOMANDO F, DE SANTO LS, ROMANO GP, DELLA CORTE, Alessandro, MARRA C, TORELLA M, NAPPI GA, GIANNOLO B, COTRUFO M., DE FEO, Marisa, Biondi, A, Petraio, A, Maresca, L, Quarto, C, Tizzano, F, Mastroianni, C, Ursomando, F, DE SANTO, Luca Salvatore, Romano, Gp, DELLA CORTE, Alessandro, Marra, C, DE FEO, Marisa, Torella, M, Nappi, Ga, Giannolo, B, and Cotrufo, M.

Published
2003

9. Graft cardiaci ad alto rischio: conservazione efficace con soluzione Celsior

Author

BIONDI A, MASTROIANNI C, URSOMANDO F, PETRAIO A, MARESCAL, TIZZANO F, QUARTO C, AMARELLI C, DE SANTO LS, ROMANO GP, DELLA CORTE, Alessandro, MARRA C, TORELLA M, NAPPI GA, COTRUFO M., DE FEO, Marisa, Biondi, A, Mastroianni, C, Ursomando, F, Petraio, A, Marescal, Tizzano, F, Quarto, C, Amarelli, C, DE SANTO, Luca Salvatore, Romano, Gp, DELLA CORTE, Alessandro, Marra, C, DE FEO, Marisa, Torella, M, Nappi, Ga, and Cotrufo, M.

Published
2003

10. Studio prospettico policentico sui risultati a breve termini di interventi di rivascolarizzazione miocardica: dati preliminari

Author

PETRAIO A, NAPPI GA, MARESCA L, CERASUOLO F, TORELLA M, DE SANTO LS, URSOMANDO F, MASTROIANNI C, ROMANO GP, CAROZZA A, VICCHIO M, SANTARPINO G, COTRUFO M., DE FEO, Marisa, Petraio, A, Nappi, Ga, Maresca, L, DE FEO, Marisa, Cerasuolo, F, Torella, M, DE SANTO, Luca Salvatore, Ursomando, F, Mastroianni, C, Romano, Gp, Carozza, A, Vicchio, M, Santarpino, G, and Cotrufo, M.

Published
2003

12. La trombo-embolia dopo Starr in sede mitralica: 25 anni di follow-up

Author

PETRAIO A, DE SANTO LS, ROMANO GP, ONORATI F, RENZULLI A, MARESCA L, QUARTO C, MASTROIANNI C, URSOMANDO F, CERASUOLO F, COTRUFO M., DE FEO, Marisa, Petraio, A, DE FEO, Marisa, DE SANTO, Luca Salvatore, Romano, Gp, Onorati, F, Renzulli, A, Maresca, L, Quarto, C, Mastroianni, C, Ursomando, F, Cerasuolo, F, and Cotrufo, M.

Published
2003

13. Un raro caso di rottura post infartuale del setto interventricolare a coronarie integre

Author

MARESCA L, DE SANTO LS, TORELLA M, PETRAIO A, URSOMANDO F, DELLA CORTE, Alessandro, ROMANO GP, CAROZZA A, AMARELLI C, NAPPI GA, COTRUFO M., DE FEO, Marisa, Maresca, L, DE FEO, Marisa, DE SANTO, Luca Salvatore, Torella, M, Petraio, A, Ursomando, F, DELLA CORTE, Alessandro, Romano, Gp, Carozza, A, Amarelli, C, Nappi, Ga, and Cotrufo, M.

Published
2003

15. Endocardite su valvola nativa versus endocardite primaria su protesi valvolare: confronto tra caratteristiche cliniche e risultati a lungo termine in 353 pazienti

Author

VICCHIO M, MASTRIANNI C, PETRAIO A, URSOMANDO F, MARESCA L, ROMANO GP, CAROZZA A, AMARELLI C, DELLA CORTE, Alessandro, DE SANTO LS, TORELLA, Michele, DE FEO, Marisa, NAPPI, Gianantonio, CERASUOLO F, COTRUFO M., Vicchio, M, Mastrianni, C, Petraio, A, Ursomando, F, Maresca, L, Romano, Gp, Carozza, A, Amarelli, C, DELLA CORTE, Alessandro, DE SANTO, Luca Salvatore, Torella, Michele, DE FEO, Marisa, Nappi, Gianantonio, Cerasuolo, F, and Cotrufo, M.

Published
2003

17. Trattamento della dissezione aortica acuta tipo A: determinanti della mortalitaà e dell'incidenza di complicanze neurologiche

Author

MASTROIANNI C, NAPPI GA, BIONDI A, ROMANO GP, DE SANTO LS, AMARELLI C, ONORATI F, DELLA CORTE, Alessandro, TORELLA M, URSOMANDO F, MARESCA L, PETRAIO A, CERASUOLO F, COTRUFO M., DE FEO, Marisa, Mastroianni, C, DE FEO, Marisa, Nappi, Ga, Biondi, A, Romano, Gp, DE SANTO, Luca Salvatore, Amarelli, C, Onorati, F, DELLA CORTE, Alessandro, Torella, M, Ursomando, F, Maresca, L, Petraio, A, Cerasuolo, F, and Cotrufo, M.

Published
2003

18. LETTERS TO THE EDITOR: REPLY

Author

COTRUFO M., CAROZZA A., ROMANO GP, DELLA CORTE, Alessandro, DE SANTO LS, DE FEO, Marisa, Cotrufo, M., Carozza, A., Romano, Gp, DE FEO, Marisa, DELLA CORTE, Alessandro, and DE SANTO, Luca Salvatore

Published
2002

21. Il rischio di recidiva nelle endocarditi su valvola nativa e su protesi

Author

CAROZZA A, RENZULLI A, ROMANO GP, DELLA CORTE, Alessandro, CRESCE GD, VICCHIO M, UTILI, Riccardo, COTRUFO M., DE FEO, Marisa, Carozza, A, Renzulli, A, Romano, Gp, DE FEO, Marisa, DELLA CORTE, Alessandro, Cresce, Gd, Vicchio, M, Utili, Riccardo, and Cotrufo, M.

Published
2000

29. il Trapianto di cuore

Author

MAIELLO C, L. DE SANTO, AMARELLI C, ROMANO GP, COTRUFO M, C, Maiello, DE SANTO, L., C, Amarelli, Gp, Romano, and M, Cotrufo

Published
2010

30. Private International Law before the International Court of Justice

Author

Lagarde, P, Kohler, C, Working Group of the Federal Association of German Civil Status Registrar, Kinsch, P, Neels, JL, Ubertazzi, B, Buonaiuti Marongiu, F, Queirolo, I, Schramm, D, Seatzu, F, Mari, L, Pretelli, I, Harder, S, Goldstein, G, Saumier, G, Zhang, W, Lu, S, Fan, K, Oppong, RF, El Chazli, K, Okuda, Y, Suk, KH, Grishchenkova, A, Yeo, TM, Bader, P, Kruger, T, Sural, C, Tarman, ZD, Gugu Bushati, A, Di Iorio, R, Parisot, V, Rétornaz, V, Volken, P, Bonomi A, Romano GP, UBERTAZZI, BENEDETTA CARLA ANGELA MARIA, Lagarde, P, Kohler, C, Working Group of the Federal Association of German Civil Status Registrar, Kinsch, P, Neels, JL, Ubertazzi, B, Buonaiuti Marongiu, F, Queirolo, I, Schramm, D, Seatzu, F, Mari, L, Pretelli, I, Harder, S, Goldstein, G, Saumier, G, Zhang, W, Lu, S, Fan, K, Oppong, RF, El Chazli, K, Okuda, Y, Suk, KH, Grishchenkova, A, Yeo, TM, Bader, P, Kruger, T, Sural, C, Tarman, ZD, Gugu Bushati, A, Di Iorio, R, Parisot, V, Rétornaz, V, Volken, P, Bonomi A, Romano GP, and UBERTAZZI, BENEDETTA CARLA ANGELA MARIA

Abstract

Il saggio analizza il rapporto tra la Corte Internazionale di Giustizia (ICJ) e il diritto internazionale privato. Questa analisi è necessaria perché il rapporto tra il diritto internazionale privato e la Corte Internazionale di Giustizia è generalmente considerato solo in relazione a casi specifici mentre uno studio più completo non è stato ancora effettuato. L'interconnessione tra il diritto internazionale privato e la giurisprudenza della Corte di giustizia dell'Unione europea e della Corte europea dei diritti dell'uomo invece è già stata esaminata da varie monografie., The paper analyses the relationship between the International Court of Justice (ICJ) and private international law. This analysis is necessary because the relationship between private international law and the ICJ is typically only considered with regard to specific cases and a more comprehensive study has not yet been undertaken, whereas the interconnection between private international law and the European Union Court of Justice case-law or the case-law of the European Court of Human Rights has already been examined by various monographic studies.

Published
2014

33. Measuring the Effectiveness of the EU Civil Justice Framework: Theoretical and Methodological Challenges

Author

Paul Reid Beaumont, Mihail Danov, Bonomi, A, and Romano, GP

Subjects
Conflict of laws, Jurisdiction, Administration of justice, Political science, Law, Member state, Context (language use), Enforcement, Economic Justice, Family law
Abstract

A number of harmonised private international law instruments appear to be the foundation of the whole EU civil justice framework, which primarily aims to provide effective remedies for litigants in cross-border cases. Given the level of diversity across the EU, a major feature of the EU legal landscape is the triangular relationship between the allocation of jurisdiction and identification of applicable law, on the one hand, and the available remedy, on the other hand. It appears that, when it comes to the administration of justice in a cross-border context within the EU, this triangular relationship encompasses the ability of the Member States’ courts to deal with cross-border disputes which may be important for the forum selection process. An EU model of administration of justice, which allows litigants to choose where to litigate, may result in some jurisdictions being promoted as dominant. This can only happen, of course, because the EU has already created free movement of judgments in large areas of commercial and family law. Once a judgment has been secured in any one EU Member State it should be enforceable in all others with little or no hindrance. However, litigants may have to consider where a judgment is to be actually enforced given that the rules on actual enforcement are not harmonised in the EU (this may be particularly significant in relation to family law disputes). The dominant jurisdictions could be attracting more cross-border cases, and thus some jurisdictions may become a venue of choice for the high value cross-border disputes. It is important to assess, on the basis of relevant empirical data, how the current EU Civil Justice framework is shaping the litigants’ strategies and whether the objectives of the EU PIL legislative instruments are effectively pursued in a cross-border context. An empirical study is underway in several Member States, with different legal traditions/heritages.

Published
2017

34. Private International Law before the International Court of Justice

Author

UBERTAZZI, BENEDETTA CARLA ANGELA MARIA, Lagarde, P, Kohler, C, Working Group of the Federal Association of German Civil Status Registrar, Kinsch, P, Neels, JL, Ubertazzi, B, Buonaiuti Marongiu, F, Queirolo, I, Schramm, D, Seatzu, F, Mari, L, Pretelli, I, Harder, S, Goldstein, G, Saumier, G, Zhang, W, Lu, S, Fan, K, Oppong, RF, El Chazli, K, Okuda, Y, Suk, KH, Grishchenkova, A, Yeo, TM, Bader, P, Kruger, T, Sural, C, Tarman, ZD, Gugu Bushati, A, Di Iorio, R, Parisot, V, Rétornaz, V, Volken, P, Bonomi A, and Romano GP

Subjects
diritto internazionale privato, Corte Internazionale di Giustizia, giurisdizione, legge applicabile, riconoscimento delle sentenze straniere, IUS/13 - DIRITTO INTERNAZIONALE, private international law, International Court of Justice, jurisdiction, applicable law, enforcement of foreign judgments
Abstract

Il saggio analizza il rapporto tra la Corte Internazionale di Giustizia (ICJ) e il diritto internazionale privato. Questa analisi è necessaria perché il rapporto tra il diritto internazionale privato e la Corte Internazionale di Giustizia è generalmente considerato solo in relazione a casi specifici mentre uno studio più completo non è stato ancora effettuato. L'interconnessione tra il diritto internazionale privato e la giurisprudenza della Corte di giustizia dell'Unione europea e della Corte europea dei diritti dell'uomo invece è già stata esaminata da varie monografie. The paper analyses the relationship between the International Court of Justice (ICJ) and private international law. This analysis is necessary because the relationship between private international law and the ICJ is typically only considered with regard to specific cases and a more comprehensive study has not yet been undertaken, whereas the interconnection between private international law and the European Union Court of Justice case-law or the case-law of the European Court of Human Rights has already been examined by various monographic studies.

Published
2014

36. Heart transplantation

Author

LS De Santo, B Giannolo, C Maiello, C Marra, C Amarelli, J Marmo, GP Romano, M Cotrufo, DE SANTO, Luca Salvatore, Giannolo, B, Maiello, C, Marra, C, Amarelli, C, Marmo, J, Romano, Gp, and Cotrufo, M

Published
2002

37. Infezioni polmonari micotiche e da nocardia nel paziente cardiotrapiantato: caratteristiche cliniche e trattamento

Author

M. Gambardella, MF Tripodi, R. Casillo, A. Andreana, ZAMPINO, Rosa, G. Sarnataro, E. Ragone, DURANTE MANGONI, Emanuele, P. Cione, S. Cuccurullo, C. Maiello, L. De Santo, C. Marra, C. Amarelli, GP Romano, DE FEO, Marisa, M. Cotrufo, UTILI, Riccardo, Gambardella, M, Tripodi, Mf, Casillo, R, Andreana, A, Zampino, Rosa, Sarnataro, G, Ragone, E, DURANTE MANGONI, Emanuele, Cione, P, Cuccurullo, S, Maiello, C, DE SANTO, L, Marra, C, Amarelli, C, Romano, Gp, DE FEO, Marisa, Cotrufo, M, Utili, Riccardo, Gambardella, M., Casillo, R., Andreana, A., Sarnataro, G., Ragone, E., Cione, P., Cuccurullo, S., Maiello, C., De Santo, L., Marra, C., Amarelli, C., and Cotrufo, M.

Published
2001

38. Ventricular tachyarrhythmias following coronary surgery: predisposing factors

Author

Gian Paolo Romano, Valentino Ducceschi, Antonello D'Andrea, Biagio Liccardo, Ferrara L, Berardo Sarubbi, Aldo Iacono, Maurizio Cotrufo, Lucio Santangelo, Ducceschi, V, D'Andrea, A, Liccardo, B, Sarubbi, B, Ferrara, L, Romano, Gp, Santangelo, Lucio, Iacono, A, and Cotrufo, M.

Subjects
Male, medicine.medical_specialty, Heart disease, Ventricular tachycardia, Coronary artery disease, Cohort Studies, Postoperative Complications, Internal medicine, Odds Ratio, Medicine, Humans, Sinus rhythm, cardiovascular diseases, Derivation, Coronary Artery Bypass, Univariate analysis, business.industry, Perioperative, Middle Aged, medicine.disease, Causality, Logistic Models, Italy, Anesthesia, Ventricular fibrillation, Multivariate Analysis, Cardiology, Tachycardia, Ventricular, Female, Cardiology and Cardiovascular Medicine, business
Abstract

The perioperative factors potentially associated with post-coronary artery bypass grafting (CABG) ventricular tachyarrhythmias (VT) onset have not been deeply investigated. Monomorphic or polymorphic ventricular tachycardia and ventricular fibrillation represent the most dreadful arrhythmic events that can complicate the postoperative course of CABG. As a consequence, the aim of our paper was to identify which perioperative variables might predict post-CABG VT occurrence. One hundred and fifty-two consecutive patients who underwent CABG surgery at our Institution were included in the study. Post-CABG VT occurred in 13 out of 152 patients (8.5%, six cases of monomorphic ventricular tachycardia and seven cases of ventricular fibrillation). At univariate analysis, VT patients were significantly younger (54.8±6.6 vs. 60.1±8.8, P=0.038), exhibited a more severe coronary artery disease (CAD) (number of diseased vessels 2.92±0.3 vs. 2.45±0.7, P=0.023, and percentage of patients with three-vessel CAD 91.7% vs. 57.3%, P=0.043) and received a greater number of CABGs than those remaining in sinus rhythm (SR) (percentage of patients receiving three or more CABGs 76.9% vs. 38.8%, P=0.018) Moreover, VT patients more frequently developed intra- or postoperative myocardial infarction (total CK>1000 76.9% vs. 38%, P=0.016 and MB-CK>normal range 72.7% vs. 30.7%, P=0.014), electrolyte derangement (84.6% vs. 45.6%, P=0.017) and a severe haemodynamic impairment (need for IABP 23% vs. 2.9%, P=0.009). At multivariate analysis, total CK>1000, postoperative electrolyte imbalance, the need for three or more CABGs and of IABP all were independent correlates for VT. In conclusion, post-CABG VT seem to be related to the preexistence of a severe underlying coronary artery disease along with perioperative triggering factors such as acute ischemia, electrolytic disorders and a sudden haemodynamic impairment.

Published
2000

39. Perioperative correlates of malignant ventricular tachyarrhythmias complicating coronary surgery

Author

Ferrara L, Alfonso Alfieri, Antonello D'Andrea, Valentino Ducceschi, Lucio Santangelo, Gian Paolo Romano, Maurizio Cotrufo, Aldo Iacono, Berardo Sarubbi, Biagio Liccardo, Ducceschi, V, D'Andrea, A, Liccardo, B, Sarubbi, B, Ferrara, L, Alfieri, A, Romano, Gp, Santangelo, Lucio, Iacono, A, and Cotrufo, M.

Subjects
Male, medicine.medical_specialty, Coronary Disease, Ventricular tachycardia, Severity of Illness Index, Perioperative Care, Coronary artery disease, Postoperative Complications, Risk Factors, Internal medicine, Odds Ratio, Medicine, Humans, Sinus rhythm, cardiovascular diseases, Coronary Artery Bypass, Univariate analysis, business.industry, Perioperative, Middle Aged, medicine.disease, Signal-averaged electrocardiogram, Cardiac surgery, Logistic Models, Anesthesia, Ventricular fibrillation, Multivariate Analysis, Ventricular Fibrillation, Cardiology, Tachycardia, Ventricular, Female, Cardiology and Cardiovascular Medicine, business
Abstract

Sustained ventricular tachyarrhythmias (VT), such as monomorphic or polymorphic ventricular tachycardia, and ventricular fibrillation, represent the most serious arrhythmic events that can complicate the postoperative course of coronary artery bypass grafting (CABG). The perioperative factors potentially associated with post-CABG sustained VT onset have not been thoroughly investigated. As a consequence, the aim of our study was to identify which perioperative variables might predict post-CABG VT occurrence. One hundred and fifty-two consecutive patients who underwent CABG surgery at our Institute were included in the study. Post-CABG VT occurred in 13 out of 152 patients (8.5%, six cases of monomorphic ventricular tachycardia and seven cases of ventricular fibrillation). Univariate analysis revealed that VT patients were significantly younger (54.8 +/- 6.6 vs 60.1 +/- 8.8, P = 0.038), exhibited more severe coronary artery disease (CAD) (no. of diseased vessels, 2.92 +/- 0.3 vs 2.45 +/- 0.7, P = 0.023; and percentage of patients with three-vessel CAD, 91.7 vs 57.3%, P = 0.043), and received a greater number of CABGs than those remaining in sinus rhythm (SR) (percentage of patients receiving three or more CABGs, 76.9 vs 38.8%, P = 0.018) Moreover, VT patients more frequently developed intra- or postoperative myocardial infarction (total CK > 1,000, 76.9 vs 38%, P = 0.016; and MB-CK > normal range, 72.7 vs 30.7%, P = 0.014), electrolyte derangement (84.6 vs 45.6%, P = 0.017), and a severe hemodynamic impairment (need for intra-aortic balloon pump (IABP), 23 vs 2.9%, P = 0.009). On multivariate analysis, total CK > 1,000, postoperative electrolyte imbalance, the need for three or more CABGs, and for IABP all were independent correlates for VT. In conclusion, post-CABG VT seem to be related to the preexistence of a severe underlying coronary artery disease along with perioperative triggering factors, such as acute ischemia, electrolytic disorders, and sudden hemodynamic impairment.

Published
2000

40. Treatment of recurrent postoperative mediastinitis with granulated sugar

Author

M, De Feo, R, Gregorio, A, Renzulli, G, Ismeno, G P, Romano, M, Cotrufo, DE FEO, Marisa, Gregorio, R, Renzulli, A, Ismeno, G, Romano, Gp, and Cotrufo, M.

Subjects
Male, Mediastinitis, Debridement, Dietary Sucrose, Recurrence, Humans, Surgical Wound Infection, Female, Middle Aged, Therapeutic Irrigation, Bandages, Aged
Abstract

The authors report their experience with granulated sugar as dressing technique in the treatment of postoperative mediastinitis refractory to a closed irrigation system.Between January 1990 and January 1998, mediastinitis developed in 61 (0,93%) of 6521 patients who had undergone open heart surgery. Diagnosis of sternal infections was based on wound tenderness, drainage, cellulitis, fever associated with sternal instability. All of them were initially treated with surgical debridement and closed chest irrigation. Nine patients with postcardiotomy mediastinitis refractory to closed chest irrigation underwent open dressing with granulated sugar. All of them were febrile with leukocytosis and positive wound cultures.Bacteria isolated were staphylococcus aureus in 6 cases, staphylococcus epidermidis in 2 and pseudomonas in 1. Redebridement was performed in all cases and the wound was filled with granulated sugar four times a day. Fever ceased within 4.3+/-1.3 days from the beginning of treatment and WBC became normal after 6.6+/-1.6 days. Three patients had hyperbaric therapy as associated treatment. Complete wound healing was achieved in 58.8+/-32.9 days (three patients underwent successful pectoralis muscle flaps).Sugar treatment is a reasonable and effective option in patients with mediastinitis refractory to closed irrigation treatment. It may be used either as primary treatment or as a bridge to pectoralis muscle flaps.

Published
2000

41. Determinants and prognostic value of ischemic necrosis in early biopsies following heart transplant

Author

Ciro Maiello, Salvatore Esposito, B. Giannolo, Luca Salvatore De Santo, Attilio Renzulli, J Marmo, Maurizio Cotrufo, Gianpaolo Romano, Alessandro Della Corte, C. Marra, Cristiano Amarelli, L. Agozzino, Esposito, S, Maiello, C, Renzulli, A, Agozzino, Lucio, DE SANTO, Luca Salvatore, Romano, Gp, DELLA CORTE, Alessandro, Amarelli, C, Marra, C, Giannolo, B, Marmo, J, and Cotrufo, M.

Subjects
Adult, Graft Rejection, Male, medicine.medical_specialty, Adolescent, medicine.medical_treatment, Myocardial Ischemia, Disease-Free Survival, Necrosis, Postoperative Complications, medicine, Humans, Viaspan, Hospital Mortality, Survival analysis, Aged, Retrospective Studies, Heart transplantation, business.industry, Incidence (epidemiology), Immunosuppression, Retrospective cohort study, Middle Aged, Vascular surgery, Prognosis, Survival Analysis, Cardiac surgery, Surgery, Italy, Heart Transplantation, Female, Cardiology and Cardiovascular Medicine, business
Abstract

To evaluate the impact of early ischemic necrosis (IN) on the early and late outcome of heart transplantation, we reviewed our 11-year experience. Between January 1988 and June 1999, 207 heart transplants were performed in 205 patients (174 male and 31 female). Criteria for donor and recipient selection, and protocols for postoperative immunosuppression and rejection monitoring have remained unchanged over this period. Three different cardioplegic solutions were employed in graft preservation: St. Thomas Hospital solution in the earliest 31 cases (15%), University of Wisconsin solution in 96 cases (46.4%), and Celsior solution in the last 80 cases (38.6%). All patients who underwent at least one endomyocardial biopsy (176 patients) were divided into two groups according to the findings of IN within the early 3 postoperative months (group A, 49 patients with IN; group B, 127 patients without IN). The following variables were estimated in each group: donor and recipient age, ischemic time, type of cardioplegia, late mortality for cardiac causes, incidence of grade >2 rejection within the first 6 postoperative months, late incidence of grade >2 rejection, late incidence of NYHA class >II. No significant difference was found in any parameter between the two groups, except for the type of cardioplegic solution. A significantly higher incidence of ischemic necrosis in hearts preserved with St. Thomas solution was found (P < 0.001). Although pathology findings show that extracellular solutions carried a higher risk of early IN, no associated significant impairment in terms of late survival and event-free rate was observed in recipients with early IN.

42. Biomimetic Wings for Micro Air Vehicles.

Author

Moscato G and Romano GP

Abstract

In this work, micro air vehicles (MAVs) equipped with bio-inspired wings are investigated experimentally in wind tunnel. The starting point is that insects such as dragonflies, butterflies and locusts have wings with rigid tubular elements (corrugation) connected by flexible parts (profiling). So far, it is important to understand the specific aerodynamic effects of corrugation and profiling as applied to conventional wings for the optimization of low-Reynolds-number aerodynamics. The present study, in comparison to previous investigations on the topic, considers whole MAVs rather than isolated wings. A planform with a low aperture-to-chord ratio is employed in order to investigate the interaction between large tip vortices and the flow over the wing surface at large angles of incidence. Comparisons are made by measuring global aerodynamic loads using force balance, specifically drag and lift, and detailed local velocity fields over wing surfaces, by means of particle image velocimetry (PIV). This type of combined global-local investigation allows describing and relating overall MAV performance to detailed high-resolution flow fields. The results indicate that the combination of wing corrugation and profiling gives effective enhancements in performance, around 50%, in comparison to the classical flat-plate configuration. These results are particularly relevant in the framework of low-aspect-ratio MAVs, undergoing beneficial interactions between tip vortices and large-scale separation.

Published
2024
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43. The Fluid-Dynamics of Endo Vascular Aneurysm Sealing (EVAS) System failure.

Author

Battista F, Ficarelli R, Perrotta A, Gualtieri P, Casciola CM, Romano GP, and Taurino M

Subjects
Blood Vessel Prosthesis, Humans, Hydrodynamics, Prosthesis Design, Stents, Aortic Aneurysm, Abdominal diagnostic imaging, Aortic Aneurysm, Abdominal surgery, Blood Vessel Prosthesis Implantation adverse effects, Endovascular Procedures adverse effects
Abstract

Purpose: The main objective of this work is to investigate hemodynamics phenomena occurring in EVAS (Endo Vascular Aneurysm Sealing), to understand if and how they could lead to type 1a endoleaks and following re-intervention. To this aim, methods based on computational fluid mechanics are implemented as a tool for checking the behavior of a specific EVAS configuration, starting from the post-operative conditions. Pressure and velocity fields are detailed and compared, for two configurations of the Nellix, one as attained after correct implantation and the other in pathological conditions, as a consequence of migration or dislocation of endobags., Methods: The computational fluid dynamics (CFD) approach is used to simulate the behavior of blood within a segment of the aorta, before and after the abdominal bifurcation. The adopted procedure allows reconstructing the detailed vascular geometry from high-resolution computerized tomography (CT scan) and generating the mesh on which the equations of fluid mechanics are discretized and solved, in order to derive pressure and velocity field during heartbeats., Results: The main results are obtained in terms of local velocity fields and wall pressures. Within the endobags, velocities are usually quite regular during the whole cardiac cycle for the post-implanted condition, whereas they are more irregular for the migrated case. The largest differences among the two cases are observed in the shape and location of the recirculation region in the rear part of the aorta and the region between the endobags, with the formation of a gap due to the migration of one or both of the two. In this gap, the pressure fields are highly different among the two conditions, showing pressure peaks and pressure gradients at least four times larger for the migrated case in comparison to the post-implanted condition., Conclusions: In this paper, the migration of one or both endobags is supposed to be related to the existing differential pressures acting in the gap formed between the two, which could go on pushing the two branches one away from the other, thus causing aneurysm re-activation and endoleaks. Regions of flow recirculation and low-pressure drops are revealed only in case of endobag migration and in presence of an aneurysm. These regions are supposed to lead to possible plaque formation and atherosclerosis.

Published
2021
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44. Soluble sST2 biomarker analysis for fibrosis development in atrial fibrillation. A case control study.

Author

Marino L, Romano GP, Santulli M, Bertazzoni G, and Suppa M

Subjects
Aged, Aged, 80 and over, Biomarkers, Case-Control Studies, Female, Fibrosis, Humans, Male, Stroke Volume, Ventricular Function, Left, Atrial Fibrillation blood, Atrial Fibrillation pathology, Interleukin-1 Receptor-Like 1 Protein blood
Abstract

Abstract: Objectives. Atrial fibrillation (AF) is a clinically relevant supra-ventricular arrhythmia which represents an independent risk factor for development of heart failure and ischemic stroke. The present study aims at the investigation of the possible clinical role of the soluble sST2 biomarker to evaluate the fibrosis in a group of patients with first diagnosed or permanent AF. The possible association with the left atrium size is also studied. Materials and Methods. The serum concentrations of the biomarker have been measured in a group of 58 patients (mean age 83.6 ± 6.0 years) and 40 individuals, assumed healthy and without AF, constituted the control group. The analysis is carried out by means of a high-sensitivity enzyme-linked immunosorbent assay. Results. The mean concentration of sST2 is 26.1 (22.7-30.5) ng/mL in the AF group, while in the control is 17.3 (15.7-18.9) ng/mL. Remarkable differences have been obtained for the two subsets with first diagnosed (23 (21.2-24) ng/mL) and permanent AF (30.5 (28.6-32) ng/mL). The analysis has been completed with a trans thoracic echocardiographic exam to evaluate the left atrium size and the left ventricular ejection fraction. Conclusions. The sST2 serum concentrations are found to be higher in the permanent AF with respect to the cases where the AF is of new onset or follow a paroxysmal pattern. The results support the adoption of the marker to evaluate the degree of fibrosis related to the left atrium of fibrillating patients. A positive association has been proved between the left atrium size and the sST2 concentrations.

Published
2021
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45. Experimental investigations on the fluid-mechanics of an electrospun heart valve by means of particle image velocimetry.

Author

Del Gaudio C, Gasbarroni PL, and Romano GP

Subjects
Extracellular Matrix, Humans, Prosthesis Design, Rheology, Tissue Engineering, Tissue Scaffolds, Aortic Valve anatomy & histology, Heart Valve Prosthesis
Abstract

End-stage failing heart valves are currently replaced by mechanical or biological prostheses. Both types positively contribute to restore the physiological function of native valves, but a number of drawbacks limits the expected performances. In order to improve the outcome, tissue engineering can offer an alternative approach to design and fabricate innovative heart valves capable to support the requested function and to promote the formation of a novel, viable and correctly operating physiological structure. This potential result is particularly critical if referred to the aortic valve, being the one mainly exposed to structural and functional degeneration. In this regard, the here proposed study presents the fabrication and in vitro characterization of a bioresorbable electrospun heart valve prosthesis using the particle image velocimetry technique either in physiological and pathological fluid dynamic conditions. The scaffold was designed to reproduce the aortic valve geometry, also mimicking the fibrous structure of the natural extracellular matrix. To evaluate its performances for possible implantation, the flow fields downstream the valve were accurately investigated and compared. The experimental results showed a correct functionality of the device, supported by the formation of vortex structures at the edge of the three cusps, with Reynolds stress values below the threshold for the risk of hemolysis (which can be comprised in the range 400-4000N/m(2) depending on the exposure period), and a good structural resistance to the mechanical loads generated by the driving pressure difference., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Published
2016
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46. Treatment of recurrent postoperative mediastinitis with granulated sugar.

Author

De Feo M, Gregorio R, Renzulli A, Ismeno G, Romano GP, and Cotrufo M

Subjects
Aged, Debridement, Female, Humans, Male, Middle Aged, Recurrence, Therapeutic Irrigation, Bandages, Dietary Sucrose therapeutic use, Mediastinitis therapy, Surgical Wound Infection therapy
Abstract

Background: The authors report their experience with granulated sugar as dressing technique in the treatment of postoperative mediastinitis refractory to a closed irrigation system., Methods: Between January 1990 and January 1998, mediastinitis developed in 61 (0,93%) of 6521 patients who had undergone open heart surgery. Diagnosis of sternal infections was based on wound tenderness, drainage, cellulitis, fever associated with sternal instability. All of them were initially treated with surgical debridement and closed chest irrigation. Nine patients with postcardiotomy mediastinitis refractory to closed chest irrigation underwent open dressing with granulated sugar. All of them were febrile with leukocytosis and positive wound cultures., Results: Bacteria isolated were staphylococcus aureus in 6 cases, staphylococcus epidermidis in 2 and pseudomonas in 1. Redebridement was performed in all cases and the wound was filled with granulated sugar four times a day. Fever ceased within 4.3+/-1.3 days from the beginning of treatment and WBC became normal after 6.6+/-1.6 days. Three patients had hyperbaric therapy as associated treatment. Complete wound healing was achieved in 58.8+/-32.9 days (three patients underwent successful pectoralis muscle flaps)., Conclusions: Sugar treatment is a reasonable and effective option in patients with mediastinitis refractory to closed irrigation treatment. It may be used either as primary treatment or as a bridge to pectoralis muscle flaps.

Published
2000

47. Ventricular tachyarrhythmias following coronary surgery: predisposing factors.

Author

Ducceschi V, D'Andrea A, Liccardo B, Sarubbi B, Ferrara L, Romano GP, Santangelo L, Iacono A, and Cotrufo M

Subjects
Causality, Cohort Studies, Female, Humans, Italy epidemiology, Logistic Models, Male, Middle Aged, Multivariate Analysis, Odds Ratio, Postoperative Complications epidemiology, Tachycardia, Ventricular epidemiology, Tachycardia, Ventricular etiology, Coronary Artery Bypass, Postoperative Complications prevention & control, Tachycardia, Ventricular prevention & control
Abstract

The perioperative factors potentially associated with post-coronary artery bypass grafting (CABG) ventricular tachyarrhythmias (VT) onset have not been deeply investigated. Monomorphic or polymorphic ventricular tachycardia and ventricular fibrillation represent the most dreadful arrhythmic events that can complicate the postoperative course of CABG. As a consequence, the aim of our paper was to identify which perioperative variables might predict post-CABG VT occurrence. One hundred and fifty-two consecutive patients who underwent CABG surgery at our Institution were included in the study. Post-CABG VT occurred in 13 out of 152 patients (8.5%, six cases of monomorphic ventricular tachycardia and seven cases of ventricular fibrillation). At univariate analysis, VT patients were significantly younger (54.8+/-6.6 vs. 60.1+/-8.8, P=0.038), exhibited a more severe coronary artery disease (CAD) (number of diseased vessels 2.92+/-0.3 vs. 2.45+/-0.7, P=0.023, and percentage of patients with three-vessel CAD 91.7% vs. 57.3%, P=0.043) and received a greater number of CABGs than those remaining in sinus rhythm (SR) (percentage of patients receiving three or more CABGs 76. 9% vs. 38.8%, P1000 76.9% vs. 38%, Pnormal range 72.7% vs. 30.7%, P=0.014), electrolyte derangement (84.6% vs. 45.6%, P=0.017) and a severe haemodynamic impairment (need for IABP 23% vs. 2.9%, P1000, postoperative electrolyte imbalance, the need for three or more CABGs and of IABP all were independent correlates for VT. In conclusion, post-CABG VT seem to be related to the preexistence of a severe underlying coronary artery disease along with perioperative triggering factors such as acute ischemia, electrolytic disorders and a sudden haemodynamic impairment.

Published
2000
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48. Are blood and valve cultures predictive for long-term outcome following surgery for infective endocarditis?

Author

Renzulli A, Carozza A, Marra C, Romano GP, Ismeno G, De Feo M, Della Corte A, and Cotrufo M

Subjects
Adolescent, Adult, Aged, Child, Endocarditis, Bacterial mortality, Female, Heart Valves microbiology, Hospital Mortality, Humans, Male, Middle Aged, Predictive Value of Tests, Endocarditis, Bacterial microbiology, Endocarditis, Bacterial surgery
Abstract

Objective: To evaluate whether perioperative bacteria identification in blood and/or in valve cultures can predict early and late outcome of surgery for infective endocarditis, a retrospective study was performed., Methods: Between January 1978 and December 1998, 232 patients, 79 (34.1%) female and 153 (65.9%) male with mean age of 44. 95+/-1.03 years (range 8-79) underwent surgery for infective endocarditis on a native (162 cases) or prosthetic (70 cases) valve. Patients were divided into three groups according to the perioperative x of microbiological tests: Group A: patients with preoperative positive blood cultures (83 cases); Group B: patients with positive valve cultures (35 cases); Group C: patients with negative blood and valve cultures (114 cases). Categorical values were compared by chi(2) analysis, whereas continuous data were compared by ANOVA and Bonferroni correction for post hoc comparisons. Analysis of late survival and complications was performed with Kaplan-Meier and Log Rank test. Late mortality, reoperation, perivalvular leak, recurrence of infection were considered as treatment failure. All data were presented as mean+/-standard error., Results: Hospital mortality was 10.8% (9/83) in Group A, 8.6% (3/35) in Group B, and 14.9% (17/114) in Group C (P=0.52; not significant (NS)). Ten-year survival was 62.7+/-8% in Group A, 43.9+/-19% in Group B and 62.7+/-7% in Group C (P=0.38; NS). Ten-year freedom from reoperation was 85.2+/-6% in Group A, 37.9+/-20% in Group B and 80+/-6% in Group C (P=0.0034). Ten-year freedom from treatment failure was 56.3+/-8% in Group A, 31.6+/-16% in Group B and 55. 3+/-7% in Group C (P=0.46; NS)., Conclusions: Positive blood and tissue cultures are not predictive for hospital mortality and late treatment failure in patients with infective endocarditis. Positive valve cultures, a common finding in patients with staphylococcal endocarditis, are predictive for a higher risk of reoperation.

Published
2000
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49. Determinants and prognostic value of ischemic necrosis in early biopsies following heart transplant.

Author

Esposito S, Maiello C, Renzulli A, Agozzino L, De Santo LS, Romano GP, Della Corte A, Amarelli C, Marra C, Giannolo B, Marmo J, and Cotrufo M

Subjects
Adolescent, Adult, Aged, Disease-Free Survival, Female, Graft Rejection epidemiology, Hospital Mortality, Humans, Italy epidemiology, Male, Middle Aged, Necrosis, Prognosis, Retrospective Studies, Survival Analysis, Graft Rejection diagnosis, Heart Transplantation mortality, Myocardial Ischemia pathology, Postoperative Complications pathology
Abstract

To evaluate the impact of early ischemic necrosis (IN) on the early and late outcome of heart transplantation, we reviewed our 11-year experience. Between January 1988 and June 1999, 207 heart transplants were performed in 205 patients (174 male and 31 female). Criteria for donor and recipient selection, and protocols for postoperative immunosuppression and rejection monitoring have remained unchanged over this period. Three different cardioplegic solutions were employed in graft preservation: St. Thomas Hospital solution in the earliest 31 cases (15%), University of Wisconsin solution in 96 cases (46.4%), and Celsior solution in the last 80 cases (38.6%). All patients who underwent at least one endomyocardial biopsy (176 patients) were divided into two groups according to the findings of IN within the early 3 postoperative months (group A, 49 patients with IN; group B, 127 patients without IN). The following variables were estimated in each group: donor and recipient age, ischemic time, type of cardioplegia, late mortality for cardiac causes, incidence of grade >2 rejection within the first 6 postoperative months, late incidence of grade >2 rejection, late incidence of NYHA class >II. No significant difference was found in any parameter between the two groups, except for the type of cardioplegic solution. A significantly higher incidence of ischemic necrosis in hearts preserved with St. Thomas solution was found (P < 0.001). Although pathology findings show that extracellular solutions carried a higher risk of early IN, no associated significant impairment in terms of late survival and event-free rate was observed in recipients with early IN.

Published
2000
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50. Perioperative correlates of malignant ventricular tachyarrhythmias complicating coronary surgery.

Author

Ducceschi V, D'Andrea A, Liccardo B, Sarubbi B, Ferrara L, Alfieri A, Romano GP, Santangelo L, Iacono A, and Cotrufo M

Subjects
Coronary Disease complications, Coronary Disease surgery, Female, Humans, Logistic Models, Male, Middle Aged, Multivariate Analysis, Odds Ratio, Perioperative Care, Risk Factors, Severity of Illness Index, Coronary Artery Bypass methods, Postoperative Complications prevention & control, Tachycardia, Ventricular prevention & control, Ventricular Fibrillation prevention & control
Abstract

Sustained ventricular tachyarrhythmias (VT), such as monomorphic or polymorphic ventricular tachycardia, and ventricular fibrillation, represent the most serious arrhythmic events that can complicate the postoperative course of coronary artery bypass grafting (CABG). The perioperative factors potentially associated with post-CABG sustained VT onset have not been thoroughly investigated. As a consequence, the aim of our study was to identify which perioperative variables might predict post-CABG VT occurrence. One hundred and fifty-two consecutive patients who underwent CABG surgery at our Institute were included in the study. Post-CABG VT occurred in 13 out of 152 patients (8.5%, six cases of monomorphic ventricular tachycardia and seven cases of ventricular fibrillation). Univariate analysis revealed that VT patients were significantly younger (54.8 +/- 6.6 vs 60.1 +/- 8.8, P = 0.038), exhibited more severe coronary artery disease (CAD) (no. of diseased vessels, 2.92 +/- 0.3 vs 2.45 +/- 0.7, P = 0.023; and percentage of patients with three-vessel CAD, 91.7 vs 57.3%, P = 0.043), and received a greater number of CABGs than those remaining in sinus rhythm (SR) (percentage of patients receiving three or more CABGs, 76.9 vs 38.8%, P = 0.018) Moreover, VT patients more frequently developed intra- or postoperative myocardial infarction (total CK > 1,000, 76.9 vs 38%, P = 0.016; and MB-CK > normal range, 72.7 vs 30.7%, P = 0.014), electrolyte derangement (84.6 vs 45.6%, P = 0.017), and a severe hemodynamic impairment (need for intra-aortic balloon pump (IABP), 23 vs 2.9%, P = 0.009). On multivariate analysis, total CK > 1,000, postoperative electrolyte imbalance, the need for three or more CABGs, and for IABP all were independent correlates for VT. In conclusion, post-CABG VT seem to be related to the preexistence of a severe underlying coronary artery disease along with perioperative triggering factors, such as acute ischemia, electrolytic disorders, and sudden hemodynamic impairment.

Published
1999
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