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12. Treatment and outcomes of mechanical complications of acute myocardial infarction during the Covid-19 era: A comparison with the pre-Covid-19 period. A systematic review and meta-analysis

Author

Spadaccio Cristiano, Pisani Angelo, Salsano Antonio, Nenna Antonio, Fardman Alexander, D’Alessandro David, Santini Francesco, Gaudino Mario F. L., Sundt Thoralf M., and Rose David

Subjects
myocardial infarction, mechanical complications, covid-19, Medicine
Abstract

This study aims to compare treatments and outcomes of mechanical complications of acute myocardial infarction (MI) during the Covid-19 and in the pre-Covid-19 era. Electronic databases have been searched for MI mechanical complications during the Covid-19 era and in the previous period from January 1998 to January 2020 (pre-Covid-19 era), until October 2021. To perform a quantitative analysis of non-comparative series, a meta-analysis of proportion has been conducted. Early mortality after surgical treatment was 15.0% while it was significantly higher after conservative treatment (62.4%) (P = 0.026). Early mortality after surgical treatment was seemingly higher in the pre-Covid-19 era but the difference did not reach statistical significance (15.0% vs 38.9%; P = 0.13). Mortality in patients treated conservatively, or turned down for surgery, was lower during the Covid-19 pandemic (62.4% vs 97.7%; P = 0.001). The crude mean prevalence of the use rate of conservative or surgical treatment across the studies during Covid-19 and in the pre-Covid-19 era was comparable. The current increased incidence of MI mechanical complications might be a consequence of delayed presentation or restricted access to hospital facilities. Despite the general negative impact of Covid-19 on cardiac surgery volumes and outcomes and the apparent increase of the incidence of MI complications, the outcomes of their surgical and clinical treatment seem not to have been affected during the pandemic.

Published
2022
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13. Postcardiotomy Venoarterial Extracorporeal Membrane Oxygenation With and Without Intra-Aortic Balloon Pump

Author

Björnsdóttir, Björk, Biancari, Fausto, Dalén, Magnus, Dell'Aquila, Angelo M., Jónsson, Kristján, Fiore, Antonio, Mariscalco, Giovanni, El-Dean, Zein, Gatti, Giuseppe, Zipfel, Svante, Perrotti, Andrea, Bounader, Karl, Alkhamees, Khalid, Loforte, Antonio, Lechiancole, Andrea, Pol, Marek, Spadaccio, Cristiano, Pettinari, Matteo, De Keyzer, Dieter, Welp, Henryk, Speziale, Giuseppe, Lichtenberg, Artur, Ruggieri, Vito G., Yusuf, Hakeem, and Ragnarsson, Sigurdur

Published
2022
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14. Enhanced recovery protocols after surgery: A systematic review and meta‐analysis of randomized trials in cardiac surgery

Author

Spadaccio, Cristiano, primary, Salsano, Antonio, additional, Pisani, Angelo, additional, Nenna, Antonio, additional, Nappi, Francesco, additional, Osho, Asishana, additional, D’Alessandro, David, additional, Sundt, Thoralf M., additional, Crestanello, Juan, additional, Engelman, Daniel, additional, and Rose, David, additional

Published
2024
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16. Neurologic Injury in Patients Treated With Extracorporeal Membrane Oxygenation for Postcardiotomy Cardiogenic Shock

Author

Toivonen, Fanni, Biancari, Fausto, Dalén, Magnus, Dell'Aquila, Angelo M., Jónsson, Kristján, Fiore, Antonio, Mariscalco, Giovanni, El-Dean, Zein, Gatti, Giuseppe, Zipfel, Svante, Perrotti, Andrea, Bounader, Karl, Alkhamees, Khalid, Loforte, Antonio, Lechiancole, Andrea, Pol, Marek, Spadaccio, Cristiano, Pettinari, Matteo, De Keyzer, Dieter, Welp, Henryk, Lichtenberg, Artur, Saeed, Diyar, Ruggieri, Vito G., and Ragnarsson, Sigurdur

Published
2021
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17. Duration of Venoarterial Extracorporeal Membrane Oxygenation and Mortality in Postcardiotomy Cardiogenic Shock

Author

Mariscalco, Giovanni, El-Dean, Zein, Yusuff, Hakeem, Fux, Thomas, Dell'Aquila, Angelo M., Jónsson, Kristján, Ragnarsson, Sigurdur, Fiore, Antonio, Dalén, Magnus, di Perna, Dario, Gatti, Giuseppe, Juvonen, Tatu, Zipfel, Svante, Perrotti, Andrea, Bounader, Karl, Alkhamees, Khalid, Loforte, Antonio, Lechiancole, Andrea, Pol, Marek, Spadaccio, Cristiano, Pettinari, Matteo, De Keyzer, Dieter, Welp, Henryk, Maselli, Daniele, Lichtenberg, Artur, Ruggieri, Vito G., and Biancari, Fausto

Published
2021
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22. Sutureless Valves, a "Wireless" Option for Patients With Aortic Valve Disease: JACC State-of-the-Art Review.

Author

Spadaccio, Cristiano, Nenna, Antonio, Pisani, Angelo, Laskawski, Grzegorz, Nappi, Francesco, Moon, Marc R., Biancari, Fausto, Jassar, Arminder S., Greason, Kevin L., Shrestha, Malakh L., Bonaros, Nikolaos, and Rose, David

Subjects
*HEART valve prosthesis implantation, *AORTIC valve diseases, *AORTIC valve insufficiency, *AORTIC valve transplantation, *AORTIC stenosis, *PATIENT decision making, AORTIC valve surgery
Abstract

Transcatheter technologies triggered the recent revision of the guidelines that progressively widened the indications for the treatment of aortic stenosis. On the surgical realm, a technology avoiding the need for sutures to anchor the prosthesis to the aortic annulus has been developed with the aim to reduce the duration of cardiopulmonary bypass and simplify the process of valve implantation. In addition to a transcatheter aortic valve replacement (TAVR)-like stent that exerts a radial force, these so-called "rapid deployment valves" or "sutureless valves" for aortic valve replacement also have cuffs to improve sealing and reduce the risk of paravalvular leak. Despite promising, the actual advantage of sutureless valves over traditional surgical procedures (surgical aortic valve replacement) or TAVR is still debated. This review summarizes the current comparative evidence reporting outcomes of "sutureless valves" for aortic valve replacement to TAVR and surgical aortic valve replacement in the treatment of aortic valve stenosis. • The comparative safety and efficacy of sutureless (SuAVR) vs conventional aortic valve replacement surgery is currently under investigation. • Potential candidates for SuAVR include those undergoing concomitant procedures, complex reoperations in patients with frail aortic root tissue, minimally invasive aortic valve replacement procedures, and high-risk patients for whom TAVR is not suitable. • The Heart Team should participate in shared decision making with patients in the selection of valve replacement modality for aortic stenosis. [ABSTRACT FROM AUTHOR]

Published
2024
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23. Hyperlactatemia and poor outcome After postcardiotomy veno-arterial extracorporeal membrane oxygenation: An individual patient data meta-Analysis.

Author

Biancari, Fausto, Kaserer, Alexander, Perrotti, Andrea, Ruggieri, Vito G, Cho, Sung-Min, Kang, Jin Kook, Dalén, Magnus, Welp, Henryk, Jónsson, Kristján, Ragnarsson, Sigurdur, Hernández Pérez, Francisco J, Gatti, Giuseppe, Alkhamees, Khalid, Loforte, Antonio, Lechiancole, Andrea, Rosato, Stefano, Spadaccio, Cristiano, Pettinari, Matteo, Mariscalco, Giovanni, and Mäkikallio, Timo

Subjects
WORLD Wide Web, EXTRACORPOREAL membrane oxygenation, META-analysis, DESCRIPTIVE statistics, SURGICAL complications, SYSTEMATIC reviews, MEDLINE, ODDS ratio, HYPERLACTATEMIA, ONLINE information services, CONFIDENCE intervals, CARDIAC surgery
Abstract

Introduction: Postcardiotomy veno-arterial extracorporeal membrane oxygenation (V-A-ECMO) is associated with significant mortality. Identification of patients at very high risk for death is elusive and the decision to initiate V-A-ECMO is based on clinical judgment. The prognostic impact of pre-V-A-ECMO arterial lactate level in these critically ill patients has been herein evaluated. Methods: A systematic review was conducted to identify studies on postcardiotomy VA-ECMO for the present individual patient data meta-analysis. Results: Overall, 1269 patients selected from 10 studies were included in this analysis. Arterial lactate level at V-A-ECMO initiation was increased in patients who died during the index hospitalization compared to those who survived (9.3 vs 6.6 mmol/L, p < 0.0001). Accordingly, in hospital mortality increased along quintiles of pre-V-A-ECMO arterial lactate level (quintiles: 1, 54.9%; 2, 54.9%; 3, 67.3%; 4, 74.2%; 5, 82.2%, p < 0.0001). The best cut-off for arterial lactate was 6.8 mmol/L (in-hospital mortality, 76.7% vs. 55.7%, p < 0.0001). Multivariable multilevel mixed-effect logistic regression model including arterial lactate level significantly increased the area under the receiver operating characteristics curve (0.731, 95% CI 0.702–0.760 vs 0.679, 95% CI 0.648–0.711, DeLong test p < 0.0001). Classification and regression tree analysis showed the in-hospital mortality was 85.2% in patients aged more than 70 years with pre-V-A-ECMO arterial lactate level ≥6.8 mmol/L. Conclusions: Among patients requiring postcardiotomy V-A-ECMO, hyperlactatemia was associated with a marked increase of in-hospital mortality. Arterial lactate may be useful in guiding the decision-making process and the timing of initiation of postcardiotomy V-A-ECMO. [ABSTRACT FROM AUTHOR]

Published
2024
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24. Intestinal Microbiota and Derived Metabolites in Myocardial Fibrosis and Postoperative Atrial Fibrillation.

Author

Nenna, Antonio, Laudisio, Alice, Taffon, Chiara, Fogolari, Marta, Spadaccio, Cristiano, Ferrisi, Chiara, Loreni, Francesco, Giacinto, Omar, Mastroianni, Ciro, Barbato, Raffaele, Rose, David, Salsano, Antonio, Santini, Francesco, Angeletti, Silvia, Crescenzi, Anna, Antonelli Incalzi, Raffaele, Chello, Massimo, and Lusini, Mario

Subjects
MICROBIAL metabolites, TRANSFORMING growth factors-beta, RIGHT heart atrium, ATRIAL fibrillation, FIBROSIS, GUT microbiome, ENZYME-linked immunosorbent assay, GENE expression
Abstract

The high incidence of atrial fibrillation (AFib) following cardiac surgery (postoperative atrial fibrillation, POAF) relies on specific surgical features. However, in the setting of POAF, the role of the microbiome in the modulation of cardiac fibrosis is still not clear. This study aimed to analyze the effect of the microbiome and its main metabolic product (trimethylamine-N-oxide, TMAO) in the fibrosis of myocardial tissue, to investigate its role in POAF. Patients undergoing elective cardiac surgery with cardiopulmonary bypass, central atrio-caval cannulation and no history of AFib, were included. A fragment of the right atrium was analyzed for qualitative and mRNA-quantitative evaluation. A preoperative blood sample was analyzed with enzyme-linked immunosorbent assay (ELISA). A total of 100 patients have been included, with POAF occurring in 38%. Histologically, a higher degree of fibrosis, angiogenesis and inflammation has been observed in POAF. Quantitative evaluation showed increased mRNA expression of collagen-1, collagen-3, fibronectin, and transforming growth factor beta (TGFb) in the POAF group. ELISA analysis showed higher levels of TMAO, lipopolysaccharide and TGFb in POAF, with similar levels of sP-selectin and zonulin. TMAO ≥ 61.8 ng/mL (odds ratio, OR 2.88 [1.35–6.16], p = 0.006), preoperative hemoglobin < 13.1 g/dL (OR 2.37 [1.07–5.24], p = 0.033) and impaired right ventricular function (OR 2.38 [1.17–4.83], p = 0.017) were independent predictors of POAF. Also, TMAO was significantly associated with POAF by means of increased fibrosis. Gut microbiome product TMAO is crucial for myocardial fibrosis, which is a key factor for POAF. Patients in preoperative sinus rhythm who will develop POAF have increased genetic expression of pro-fibrotic genes and enhanced fibrosis in histological staining. Elevated TMAO level (≥61.8 ng/mL) is an independent risk factor for POAF. [ABSTRACT FROM AUTHOR]

Published
2024
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26. Venoarterial Extracorporeal Membrane Oxygenation After Surgical Repair of Type A Aortic Dissection

Author

Mariscalco, Giovanni, Fiore, Antonio, Ragnarsson, Sigurdur, El-Dean, Zein, Jónsson, Kristján, Dalén, Magnus, Fux, Thomas, Ruggieri, Vito G., Gatti, Giuseppe, Juvonen, Tatu, Zipfel, Svante, Dell'Aquila, Angelo M., Perrotti, Andrea, Bounader, Karl, Settembre, Nicla, Loforte, Antonio, Livi, Ugolino, Pol, Marek, Spadaccio, Cristiano, Pettinari, Matteo, Reichart, Daniel, Alkhamees, Khalid, Welp, Henryk, Maselli, Daniele, Lichtenberg, Artur, and Biancari, Fausto

Published
2020
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28. Multicenter study on postcardiotomy venoarterial extracorporeal membrane oxygenation

Author

Pälve, Kristiina, Anttila, Vesa, Fux, Thomas, Amr, Gilles, Kalampokas, Nikolaos, Lichtenberg, Artur, Jeppsson, Anders, Gabrielli, Marco, Reichart, Daniel, Chocron, Sidney, Fiorentino, Mariafrancesca, Livi, Ugolino, Netuka, Ivan, De Keyzer, Dieter, Mogianos, Krister, El Dean, Zein, Dell’Aquila, Angelo M., Settembre, Nicla, Rosato, Stefano, Biancari, Fausto, Dalén, Magnus, Fiore, Antonio, Ruggieri, Vito G., Saeed, Diyar, Jónsson, Kristján, Gatti, Giuseppe, Zipfel, Svante, Perrotti, Andrea, Bounader, Karl, Loforte, Antonio, Lechiancole, Andrea, Pol, Marek, Spadaccio, Cristiano, Pettinari, Matteo, Ragnarsson, Sigurdur, Alkhamees, Khalid, Mariscalco, Giovanni, and Welp, Henryk

Published
2020
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31. Inter-institutional analysis of the outcome after postcardiotomy veno-arterial extracorporeal membrane oxygenation

Author

Biancari, Fausto, primary, Mäkikallio, Timo, additional, Loforte, Antonio, additional, Kaserer, Alexander, additional, Ruggieri, Vito G, additional, Cho, Sung-Min, additional, Kang, Jin Kook, additional, Dalén, Magnus, additional, Welp, Henryk, additional, Jónsson, Kristján, additional, Ragnarsson, Sigurdur, additional, Hernández Pérez, Francisco J, additional, Gatti, Giuseppe, additional, Alkhamees, Khalid, additional, Fiore, Antonio, additional, Lechiancole, Andrea, additional, Rosato, Stefano, additional, Spadaccio, Cristiano, additional, Pettinari, Matteo, additional, Perrotti, Andrea, additional, Sahli, Sebastian D, additional, L’Acqua, Camilla, additional, Arafat, Amr A, additional, Albabtain, Monirah A, additional, AlBarak, Mohammed M, additional, Laimoud, Mohamed, additional, Djordjevic, Ilija, additional, Krasivskyi, Ihor, additional, Samalavicius, Robertas, additional, Jankuviene, Agne, additional, Alonso-Fernandez-Gatta, Marta, additional, Wilhelm, Markus J, additional, Juvonen, Tatu, additional, and Mariscalco, Giovanni, additional

Published
2023
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36. The Impact of Normothermic Regional Perfusion during DCD Recovery on Lung Allograft Function: A Pre-Clinical Study

Author

Ribeiro, Rafaela V.P., primary, Reynolds, Frank A., additional, Sarrafian, Tiffany L., additional, Spadaccio, Cristiano, additional, Colby, Clint, additional, Richman, Adam, additional, Brazzell, Jennifer L., additional, Ergi, Defne Gunes, additional, Altarabsheh, Salah, additional, Daxon, Benjamin T., additional, Cypel, Marcelo, additional, and Saddoughi, Sahar A., additional

Published
2023
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43. Inter-institutional analysis of the outcome after postcardiotomy veno-arterial extracorporeal membrane oxygenation.

Author

Biancari, Fausto, Mäkikallio, Timo, Loforte, Antonio, Kaserer, Alexander, Ruggieri, Vito G, Cho, Sung-Min, Kang, Jin Kook, Dalén, Magnus, Welp, Henryk, Jónsson, Kristján, Ragnarsson, Sigurdur, Hernández Pérez, Francisco J, Gatti, Giuseppe, Alkhamees, Khalid, Fiore, Antonio, Lechiancole, Andrea, Rosato, Stefano, Spadaccio, Cristiano, Pettinari, Matteo, and Perrotti, Andrea

Published
2024
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47. Hyperlactatemia and poor outcome After postcardiotomy veno-arterial extracorporeal membrane oxygenation: An individual patient data meta-Analysis

Author

Biancari, Fausto, primary, Kaserer, Alexander, additional, Perrotti, Andrea, additional, Ruggieri, Vito G, additional, Cho, Sung-Min, additional, Kang, Jin Kook, additional, Dalén, Magnus, additional, Welp, Henryk, additional, Jónsson, Kristján, additional, Ragnarsson, Sigurdur, additional, Hernández Pérez, Francisco J, additional, Gatti, Giuseppe, additional, Alkhamees, Khalid, additional, Loforte, Antonio, additional, Lechiancole, Andrea, additional, Rosato, Stefano, additional, Spadaccio, Cristiano, additional, Pettinari, Matteo, additional, Mariscalco, Giovanni, additional, Mäkikallio, Timo, additional, Sahli, Sebastian D, additional, L’Acqua, Camilla, additional, Arafat, Amr A, additional, Albabtain, Monirah A, additional, AlBarak, Mohammed M, additional, Laimoud, Mohamed, additional, Djordjevic, Ilija, additional, Krasivskyi, Ihor, additional, Samalavicius, Robertas, additional, Puodziukaite, Lina, additional, Alonso-Fernandez-Gatta, Marta, additional, Spahn, Donat R, additional, and Fiore, Antonio, additional

Published
2023
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