Search

Your search keyword '"Tritto F."' showing total 24 results
Start Over Author "Tritto F."
24 results on '"Tritto F."'

1. Cardiac surgery practice during the COVID-19 outbreak: A multicentre national survey

Author

Rubino, A. S., De Santo, L. S., Pisano, Adelaide, Mauro, M. D., Benussi, S., Borghetti, V., Castiglioni, A., Chiariello, L., Colli, A., De Bellis, Andrea, De Filippo, C. M., De Paulis, R., Di Benedetto, G., Di Eusanio, M., Faggian, G., Fiorani, B., Fratto, P. A., Giuffrida, A. G., Glauber, M., Iannelli, G., Iesu, S., Livi, U., Martinelli, G., Massetti, Massimo, Mastroroberto, P., Menicanti, L., Minniti, G., Miraldi, F., Montesi, G., Musumeci, F., Nicolini, Francesco, Napoleone, C. P., Panisi, P., Pappalardo, A., Patane`, F., Ragni, T., Rinaldi, M., Tribastone, S., Triggiani, M., Tritto, F. P., Zebele, C., Parolari, A., Gerosa, G., De Feo, M., Antonino, S. R., Luca Salvatore, D. S., Antonio, P., Michele, D. M., Stefano, B., Valentino, B., Alessandro, C., Luigi, C., Andrea, C., Antonio, D. B., Carlo Maria, D. F., Ruggero, D. P., Giuseppe, D. B., Marco, D. E., Giuseppe, F., Brenno, F., Pasquale, A. F., Angelo Giuseppe, G., Mattia, Giuseppe, Gabriele, I., Severino, Iolanda, Ugolino, L., Gianluca, M., Massimo, M., Pasquale, M., Lorenzo, M., Giuseppe, M., Fabio, M., Gianfranco, M., Francesco, M., Francesco, N., Carlo Pace, N., Paolo, P., Aniello, P., Francesco, P., Temistocle, R., Mauro, R., Salvatore, T., Michele, T., Francesco Paolo, T., Carlo, Z., Alessandro, P., Gino, G., Marisa, D. F., Pisano A., De Bellis A., Massetti M. (ORCID:0000-0002-7100-8478), Nicolini F., Mattia G., Severino I., Rubino, A. S., De Santo, L. S., Pisano, Adelaide, Mauro, M. D., Benussi, S., Borghetti, V., Castiglioni, A., Chiariello, L., Colli, A., De Bellis, Andrea, De Filippo, C. M., De Paulis, R., Di Benedetto, G., Di Eusanio, M., Faggian, G., Fiorani, B., Fratto, P. A., Giuffrida, A. G., Glauber, M., Iannelli, G., Iesu, S., Livi, U., Martinelli, G., Massetti, Massimo, Mastroroberto, P., Menicanti, L., Minniti, G., Miraldi, F., Montesi, G., Musumeci, F., Nicolini, Francesco, Napoleone, C. P., Panisi, P., Pappalardo, A., Patane`, F., Ragni, T., Rinaldi, M., Tribastone, S., Triggiani, M., Tritto, F. P., Zebele, C., Parolari, A., Gerosa, G., De Feo, M., Antonino, S. R., Luca Salvatore, D. S., Antonio, P., Michele, D. M., Stefano, B., Valentino, B., Alessandro, C., Luigi, C., Andrea, C., Antonio, D. B., Carlo Maria, D. F., Ruggero, D. P., Giuseppe, D. B., Marco, D. E., Giuseppe, F., Brenno, F., Pasquale, A. F., Angelo Giuseppe, G., Mattia, Giuseppe, Gabriele, I., Severino, Iolanda, Ugolino, L., Gianluca, M., Massimo, M., Pasquale, M., Lorenzo, M., Giuseppe, M., Fabio, M., Gianfranco, M., Francesco, M., Francesco, N., Carlo Pace, N., Paolo, P., Aniello, P., Francesco, P., Temistocle, R., Mauro, R., Salvatore, T., Michele, T., Francesco Paolo, T., Carlo, Z., Alessandro, P., Gino, G., Marisa, D. F., Pisano A., De Bellis A., Massetti M. (ORCID:0000-0002-7100-8478), Nicolini F., Mattia G., and Severino I.

Abstract

OBJECTIVES: Healthcare systems worldwide have been overburdened by the coronavirus disease 2019 (COVID-19) outbreak. Accordingly, hospitals had to implement strategies to profoundly reshape both non-COVID-19 medical care and surgical activities. Knowledge about the impact of the COVID-19 pandemic on cardiac surgery practice is pivotal. The goal of the present study was to describe the changes in cardiac surgery practices during the health emergency at the national level. METHODS: A 26-question web-enabled survey including all adult cardiac surgery units in Italy was conducted to assess how their clinical practice changed during the national lockdown. Data were compared to data from the corresponding period in 2019. RESULTS: All but 2 centres (94.9%) adopted specific protocols to screen patients and personnel. A significant reduction in the number of dedicated cardiac intensive care unit beds (-35.4%) and operating rooms (-29.2%), along with healthcare personnel reallocation to COVID departments (nurses-15.4%, anaesthesiologists-7.7%), was noted. Overall adult cardiac surgery volumes were dramatically reduced (1734 procedures vs 3447; P 0.001), with a significant drop in elective procedures [580 (33.4%) vs 2420 (70.2%)]. CONCLUSIONS: This national survey found major changes in cardiac surgery practice as a response to the COVID-19 pandemic. This experience should lead to the development of permanent systems-based plans to face possible future pandemics. These data may effectively help policy decision-making in prioritizing healthcare resource reallocation during the ongoing pandemic and once the healthcare emergency is over. © 2021 The Author(s). Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Published
2021

2. AS14-INFECTIONS: SEPSIS AND SEPTIC SHOCK/ANTIMICROBIAL STEWARDSHIP/TROPICAL AND PARASITE INFECTIONS/OTHER MTHFR GENE POLYMORPHISM INDUCE ENDOTHELIALMACROPHAGE HYPERINFLAMASOME ACTIVATION SYNDROME AND THROMBOSIS IN CHILDREN WITH SARSCOV 2: CASE SERIES AND LITERATURE REVIEW

Author

Mangia, Cristina, Goulart, C., Santin, C., Mozzatto, C., Acras, M., Assis, C., Martignoni, L., Lopes, C., Carneluti, A., Rutkoski, M. A., Fernandes, A. T., Maciel, K. Lamenza, Rossi, R., Tritto, F., Toledo, M., Meneses, F., and Andrade, M. C.

Published
2024
Full Text
View/download PDF

3. 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

4. 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

5. 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

6. 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

7. Antiplatelet versus oral anticoagulant therapy as antithrombotic prophylaxis after mitral valve repair

Author

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

Published
2016

8. PACEMAKER DEPENDENCY FOLLOWING CARDIAC SURGERY PROCEDURES: A COMPREHENSIVE LONG-TERM POSTOPERATIVE EVALUATION OF 1158 INHOSPITAL IMPLANTS FROM A MULTICENTER ITALIAN EXPERIENCE

Author

Lorusso, R., Barili, F., Miceli, A., Parolari, A., Daprati, A., Myasoedova, V., Alamanni, F., De Vincentiis, C., Grimaldi, F., Aimè, E., Gonzi, G. L., Gherli, T., Colli, A., Gerosa, G., De Bonis, M., Pozzoli, A., Paglino, G., Della Bella, P., Actis Dato, G., Varone, E., Parisi, F., Casabona, R., Sponga, S., Toniolo, M., Proclemer, A., Livi, U., Mariscalco, G., Scannapieco, A., Beghi, C., Scrofani, R., Foresti, D., Antona, C., Tritto, F., Gregorio, R., Miraglia, M., Piazza, L., Villa, E., Dalla Tomba, M., Pecora, D., Troise, G., Serraino, F., Renzulli, A., Rosato, F., Grasso, E., Grossi, C., Paparella, D., Amorese, L., de Luca Tupputi Schinosa, L., Coletti, G., Curnis, Antonio, Vizzardi, Enrico, and Glauber, M.

Published
2014

12. Relation of Prolonged Pacemaker Dependency After Cardiac Surgery to Mortality

Author

Giroc Investigators, Andrea Colli, Ezio Aime, Egidio Varone, Domenico Paparella, Michele De Bonis, Giuseppe Arena, Francesco Alamanni, Roberto Scrofani, Paolo Della Bella, Francesco Paolo Tritto, Emmanuel Villa, Elena Grasso, Giovanni Troise, Fabio Barili, Veronika A. Myasoedova, Caterina Simon, Elham Bidar, Kevin Vernooy, Francesco Rosato, Antonio Miceli, Enrico Vizzardi, Mattia Glauber, Domenico Pecora, Marzia Cottini, Sandro Sponga, Giovanni Mariscalco, Carlo De Vincentiis, Roberto Lorusso, Cesare Beghi, Daniele Maselli, Filiberto Serraino, Alessandro Parolari, Davide Foresti, Francesco Nicolini, Gianluca Gonzi, Lilla Amorese, Mauro Toniolo, Alessandro Proclemer, Gabriele Paglino, Guglielmo Mario Actis Dato, Maurizio Merlo, Rosario Gregorio, Michele Di Mauro, Andrea Daprati, Justine M Ravaux, Gino Gerosa, Ugolino Livi, Marco Solinas, Federica Jiritano, Lorusso, R., Ravaux, J. M., Barili, F., Bidar, E., Vernooy, K., Mauro, M. D., Miceli, A., Parolari, A., Daprati, A., Myasoedova, V., Alamanni, F., De Vincentiis, C., Aime, E., Nicolini, F., Gonzi, G., Colli, A., Gerosa, G., De Bonis, M., Paglino, G., Bella, P. D., Dato, G. A., Varone, E., Sponga, S., Toniolo, M., Proclemer, A., Livi, U., Mariscalco, G., Cottini, M., Beghi, C., Scrofani, R., Foresti, D., Tritto, F. P., Gregorio, R., Villa, E., Troise, G., Pecora, D., Serraino, F., Jiritano, F., Rosato, F., Grasso, E., Paparella, D., Amorese, L., Vizzardi, E., Solinas, M., Arena, G., Maselli, D., Simon, C., Glauber, M., Merlo, M., CTC, MUMC+: MA Med Staf Spec CTC (9), RS: Carim - V04 Surgical intervention, MUMC+: MA Med Staf Artsass CTC (9), Cardiologie, MUMC+: MA Med Staf Spec Cardiologie (9), RS: Carim - H01 Clinical atrial fibrillation, and RS: Carim - H06 Electro mechanics

Subjects
Male, Pacemaker, Artificial, 030204 cardiovascular system & hematology, Postoperative Complications, 0302 clinical medicine, Aortic valve replacement, 80 and over, Sinus rhythm, implantation, Coronary Artery Bypass, Atrioventricular Block, Permanent pacemaker, cardiac surgery, mortality, pacemaker dependency, Aged, 80 and over, Heart Valve Prosthesis Implantation, OUTCOMES, Hazard ratio, Cardiac Pacing, Artificial, Middle Aged, Cardiac surgery, Pacemaker, medicine.anatomical_structure, Artificial, Cardiology, Female, Cardiology and Cardiovascular Medicine, Aged, Bradycardia, Humans, Proportional Hazards Models, Retrospective Studies, Cardiac Surgical Procedures, Mortality, Artery, medicine.medical_specialty, aortic-valve-replacement, conduction, 03 medical and health sciences, Internal medicine, medicine, Proportional hazards model, business.industry, LONG-TERM SURVIVAL, Retrospective cohort study, medicine.disease, 030228 respiratory system, Cardiac Pacing, business, Complication
Abstract

Permanent pacemaker implantation (PPI) represents a rare complication after cardiac surgery, with no uniform agreement on timing and no information on follow-up. A multi-center retrospective study was designed to assess pacemaker dependency (PMD) and long-term mortality after cardiac surgery procedures. Between 2004 and 2016, PPI-patients from 18 centers were followed. Time-to-event data were evaluated with semiparametric regression Cox models and semiparametric Fine and Gray model for competing risk framework. Of 859 (0.90%) PPI-patients, 30% were pacemaker independent (PMI) at 6 months. PMD showed higher mortality compared with PMI (10-year survival 80.1% +/- 2.6% and 92.2% +2.4%, respectively, log-rank p-value < 0.001) with an unadjusted hazard ratio for death of 0.36 (95% CI 0.20 to 0.65, p< 0.001 favoring PMI) and an adjusted hazard ratio of 0.19 (95% CI 0.08 to 0.45, p< 0.001 with PMD as reference). Crude cumulative incidence function of restored PMI rhythm at follow-up at 6 months, 1 year and 12 years were 30.5% (95% CI 27.3% to 33.7%), 33.7% (95% CI 30.4% to 36.9%) and 37.2% (95% CI 33.8% to 40.6%) respectively. PMI was favored by preoperative sinus rhythm with normal conduction (SR) (HR 2.37, 95% CI 1.65 to 3.40, p< 0.001), whereas coronary artery bypass grafting and aortic valve replacement were independently associated with PMD (HR 0.63, 95% CI 0.45 to 0.88, p = 0.006 and HR 0.807, 95% CI 0.65 to 0.99, p = 0.047 respectively). Time-to-implantation was not associated with increased rate of PMI. Although 30% of PPI-patients are PMI after 6 months, PMD is associated with higher mortality at long term. (C) 2020 The Author(s). Published by Elsevier Inc.

Published
2021
Full Text
View/download PDF

13. Cardiac surgery practice during the COVID-19 outbreak: a regionwide survey

Author

Gabriele Iannelli, Marisa De Feo, Francesco Paolo Tritto, Severino Iesu, Antonino S. Rubino, Carlo Zebele, Denise Galbiati, Brenno Fiorani, Antonio De Bellis, Luigi Chiariello, Giuseppe Di Benedetto, Michele Torella, Luca Salvatore De Santo, De Santo, L. S., Rubino, A. S., Torella, M., Galbiati, D., Iannelli, G., Iesu, S., Tritto, F. P., Fiorani, B., Chiariello, L., De Bellis, A., Di Benedetto, G., Zebele, C., and De Feo, M.

Subjects
Pulmonary and Respiratory Medicine, Prioritization, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Waiting list, COVID-19 pandemic, 030204 cardiovascular system & hematology, law.invention, 03 medical and health sciences, 0302 clinical medicine, Healthcare resource, law, Health care, Pandemic, Medicine, business.industry, Outbreak, Cardiac surgery, Intensive care unit, 030228 respiratory system, Emergency medicine, Original Article, Observational study, business, Relocation
Abstract

Background: Health systems worldwide have been overburdened by the "COVID-19 surge". Consequently, strategies to remodulate non-COVID medical and surgical care had to be developed. Knowledge of the impact of COVID surge on cardiac surgery practice is mainstem. Present study aims to evaluate the regional practice pattern during lockdown in Campania. Methods: A multicenter regional observational 26-question survey was conducted, including all adult cardiac surgery units in Campania, Italy, to assess how surgical practice has changed during COVID-19 national lockdown. Results: All centers adopted specific protocols for screening patients and personnel. A significant reduction in the number of dedicated intensive care unit (ICU) beds (-30.0%±38.1%, range: 0-100%) and cardiac operating rooms (-22.2%±26.4%, range: 0-50%) along with personnel relocation to other departments was disclosed (anesthesiologists -5.8%±11.1%, range: 0-33.3%; perfusionists -5.6%±16.7%, range: 0-50%; nurses -4.8%±13.2%, range: 0-40%; cardiologists -3.2%±9.5%, range: 0-28.6%). Cardiac surgeons were never reallocated to other services. Globally, we witnessed dramatically lower adult cardiac surgery case volumes (335 vs. 667 procedures, P

Published
2021
Full Text
View/download PDF

14. 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

15. Antiplatelet versus oral anticoagulant therapy as antithrombotic prophylaxis after mitral valve repair

Author

Domenico Paparella, Michele Di Mauro, Keren Bitton Worms, Gil Bolotin, Claudio Russo, Salvatore Trunfio, Roberto Scrofani, Carlo Antona, Guglielmo Actis Dato, Riccardo Casabona, Andrea Colli, Gino Gerosa, Attilio Renzulli, Filiberto Serraino, Giuseppe Scrascia, Salvatore Zaccaria, Michele De Bonis, Maurizio Taramasso, Luis Delgado, Francesco Tritto, Joseph Marmo, Alessandro Parolari, Veronika Myaseodova, Emmanuel Villa, Giovanni Troise, Francesco Nicolini, Tiziano Gherli, Richard Whitlock, Manuela Conte, Fabio Barili, Sandro Gelsomino, Roberto Lorusso, Edoardo Sciatti, Daniele Marinelli, Gabriele Di Giammarco, Antonio Maria Calafiore, Azmat Sheikh, Juan Jaime Alfonso, Mattia Glauber, Antonio Miceli, Crescenzia Rotunno, Ziv Beckerman, Luigi Martinelli, Marco Lanfranconi, Davide Foresti, Egidio Varone, Giuseppe Punta, Ottavio Alfieri, Elisabetta Lapenna, Gennaro Ismeno, Achille Pulcino, Francesco Alamanni, Margherita Dalla Tomba, Giuseppe Coletti, Enrico Vizzardi, Antonio Lio, Marco Solinas, Massimiliano Foschi, Nutrition, obésité et risque thrombotique ( NORT ), Institut National de la Recherche Agronomique ( INRA ) -Aix Marseille Université ( AMU ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Centre de Recherche en Cancérologie de Lyon ( CRCL ), Université Claude Bernard Lyon 1 ( UCBL ), Université de Lyon-Université de Lyon-Centre Léon Bérard [Lyon]-Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre National de la Recherche Scientifique ( CNRS ), Hospices Civils de Lyon ( HCL ), RS: CARIM - R2.12 - Surgical intervention, CTC, MUMC+: MA Med Staf Spec CTC (9), Nutrition, obésité et risque thrombotique (NORT), Aix Marseille Université (AMU)-Institut National de la Recherche Agronomique (INRA)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de Recherche en Cancérologie de Lyon (UNICANCER/CRCL), Centre Léon Bérard [Lyon]-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hospices Civils de Lyon (HCL), Centre de Recherche en Cancérologie de Lyon (CRCL), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Centre Léon Bérard [Lyon]-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Institut National de la Recherche Agronomique (INRA)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Paparella, D, Di Mauro, M, Bitton Worms, K, Bolotin, G, Russo, C, Trunfio, S, Scrofani, R, Antona, C, Actis Dato, G, Casabona, R, Colli, A, Gerosa, G, Renzulli, A, Serraino, F, Scrascia, G, Zaccaria, S, De Bonis, M, Taramasso, M, Delgado, L, Tritto, F, Marmo, J, Parolari, A, Myaseodova, V, Villa, E, Troise, G, Nicolini, F, Gherli, T, Whitlock, R, Conte, M, Barili, F, Gelsomino, S, Lorusso, R, Sciatti, E, Marinelli, D, Di Giammarco, G, Calafiore, Am, Sheikh, A, Alfonso, Jj, Glauber, M, Miceli, A, and Giroc, Investigators

Subjects
Male, Vitamin K, Databases, Factual, analysis, medicine.medical_treatment, Administration, Oral, 030204 cardiovascular system & hematology, antiplatelet, [ SDV.CAN ] Life Sciences [q-bio]/Cancer, Cohort Studies, surgery, Postoperative Complications, 0302 clinical medicine, Antithrombotic, anticoagulation, Ultrasonography, Heart Valve Prosthesis Implantation, Incidence, Age Factors, Mitral Valve Insufficiency, Atrial fibrillation, Middle Aged, Vitamin K antagonist, stroke, 3. Good health, Survival Rate, Treatment Outcome, Italy, Platelet aggregation inhibitor, Female, Cardiology and Cardiovascular Medicine, Mitral valve regurgitation, Cohort study, Pulmonary and Respiratory Medicine, Adult, Risk, medicine.medical_specialty, Canada, Patients, complications, medicine.drug_class, Injections, Subcutaneous, Hemorrhage, [SDV.CAN]Life Sciences [q-bio]/Cancer, Risk Assessment, Statistics, Nonparametric, methods, 03 medical and health sciences, mitral valve repair, Sex Factors, Predictive Value of Tests, Thromboembolism, medicine, Humans, bleeding, Surgery, Retrospective Studies, Aged, Mitral valve repair, therapy, business.industry, Anticoagulants, Retrospective cohort study, medicine.disease, mortality, ROC Curve, 030228 respiratory system, Multivariate Analysis, business, Platelet Aggregation Inhibitors, Follow-Up Studies
Abstract

International audience; OBJECTIVE: To verify the rate of thromboembolic and hemorrhagic complications during the first 6 months after mitral valve repair and to assess whether the type of antithrombotic therapy influenced clinical outcome. METHODS: Retrospective data were retrieved from 19 centers. Inclusion criteria were isolated mitral valve repair with ring implantation. Exclusion criteria were ongoing or past atrial fibrillation and any combined intraoperative surgical procedures. The study cohort consisted of 1882 patients (aged 58 +/- 15 years; 36% women), and included 1517 treated with an oral anticoagulant (VKA group) and 365 with antiplatelet drugs (APLT group). Primary efficacy outcome was the incidence of arterial thromboembolic events within 6 months and primary safety outcome was the incidence of major bleeding within 6 months. Propensity matching was performed to obtain 2 comparable cohorts (858 vs 286). RESULTS: No differences were detected for arterial embolic complications in matched cohort (1.6% VKA vs 2.1% APLT; P = .50). Conversely, patients in the APLT group showed lower incidence of major bleeding complications (3.9% vs 0.7%; P = .01). Six-month mortality rate was significantly higher in the VKA group (2.7% vs 0.3%; P = .02). Multivariable analysis in the matched cohort found VKA as independent predictor of major bleeding complications and mortality at 6 months. CONCLUSIONS: Vitamin K antagonist therapy was not superior to antiplatelet therapy to prevent thromboembolic complications after mitral valve repair. Our data suggest that oral anticoagulation may carry a higher bleeding risk compared with antiplatelet therapy, although these results should be confirmed in an adequately powered randomized controlled trial

Published
2016
Full Text
View/download PDF

16. 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].

Author

Di Mauro M, Dato GMA, Barili F, Gelsomino S, Santè P, Corte AD, Carrozza A, Ratta ED, 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, Picichè 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

Published
2018
Full Text
View/download PDF

17. A predictive model for early mortality after surgical treatment of heart valve or prosthesis infective endocarditis. The EndoSCORE.

Author

Di Mauro M, Dato GMA, Barili F, Gelsomino S, Santè P, Corte AD, Carrozza A, Ratta ED, 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, De Martino A, Bortolotti U, Onorati F, Faggian G, Lorusso R, Vizzardi E, Di Giammarco G, Marinelli D, Villa E, Troise G, Picichè 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

Subjects
Adult, Aged, Aged, 80 and over, Cardiac Surgical Procedures trends, Female, Humans, Logistic Models, Male, Middle Aged, Predictive Value of Tests, Retrospective Studies, Treatment Outcome, Cardiac Surgical Procedures mortality, Endocarditis diagnosis, Endocarditis mortality, Heart Valve Prosthesis microbiology, Prosthesis-Related Infections diagnosis, Prosthesis-Related Infections mortality
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 2mg/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"., (Copyright © 2017. Published by Elsevier B.V.)

Published
2017
Full Text
View/download PDF

18. 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
Full Text
View/download PDF

19. Antiplatelet versus oral anticoagulant therapy as antithrombotic prophylaxis after mitral valve repair.

Author

Paparella D, Di Mauro M, Bitton Worms K, Bolotin G, Russo C, Trunfio S, Scrofani R, Antona C, Actis Dato G, Casabona R, Colli A, Gerosa G, Renzulli A, Serraino F, Scrascia G, Zaccaria S, De Bonis M, Taramasso M, Delgado L, Tritto F, Marmo J, Parolari A, Myaseodova V, Villa E, Troise G, Nicolini F, Gherli T, Whitlock R, Conte M, Barili F, Gelsomino S, Lorusso R, Sciatti E, Marinelli D, Di Giammarco G, Calafiore AM, Sheikh A, Alfonso JJ, Glauber M, and Miceli A

Subjects
Administration, Oral, Adult, Age Factors, Aged, Anticoagulants adverse effects, Cohort Studies, Databases, Factual, Female, Follow-Up Studies, Heart Valve Prosthesis Implantation methods, Hemorrhage chemically induced, Humans, Injections, Subcutaneous, Male, Middle Aged, Mitral Valve Insufficiency diagnostic imaging, Multivariate Analysis, Platelet Aggregation Inhibitors adverse effects, Postoperative Complications drug therapy, Postoperative Complications prevention & control, Predictive Value of Tests, ROC Curve, Retrospective Studies, Risk Assessment, Sex Factors, Statistics, Nonparametric, Survival Rate, Thromboembolism drug therapy, Treatment Outcome, Ultrasonography, Vitamin K administration & dosage, Vitamin K antagonists & inhibitors, Anticoagulants administration & dosage, Heart Valve Prosthesis Implantation adverse effects, Hemorrhage prevention & control, Mitral Valve Insufficiency surgery, Platelet Aggregation Inhibitors administration & dosage, Thromboembolism prevention & control
Abstract

Objective: To verify the rate of thromboembolic and hemorrhagic complications during the first 6 months after mitral valve repair and to assess whether the type of antithrombotic therapy influenced clinical outcome., Methods: Retrospective data were retrieved from 19 centers. Inclusion criteria were isolated mitral valve repair with ring implantation. Exclusion criteria were ongoing or past atrial fibrillation and any combined intraoperative surgical procedures. The study cohort consisted of 1882 patients (aged 58 ± 15 years; 36% women), and included 1517 treated with an oral anticoagulant (VKA group) and 365 with antiplatelet drugs (APLT group). Primary efficacy outcome was the incidence of arterial thromboembolic events within 6 months and primary safety outcome was the incidence of major bleeding within 6 months. Propensity matching was performed to obtain 2 comparable cohorts (858 vs 286)., Results: No differences were detected for arterial embolic complications in matched cohort (1.6% VKA vs 2.1% APLT; P = .50). Conversely, patients in the APLT group showed lower incidence of major bleeding complications (3.9% vs 0.7%; P = .01). Six-month mortality rate was significantly higher in the VKA group (2.7% vs 0.3%; P = .02). Multivariable analysis in the matched cohort found VKA as independent predictor of major bleeding complications and mortality at 6 months., Conclusions: Vitamin K antagonist therapy was not superior to antiplatelet therapy to prevent thromboembolic complications after mitral valve repair. Our data suggest that oral anticoagulation may carry a higher bleeding risk compared with antiplatelet therapy, although these results should be confirmed in an adequately powered randomized controlled trial., (Copyright © 2016 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.)

Published
2016
Full Text
View/download PDF

20. Protective effect of HOE642, a selective blocker of Na+-H+ exchange, against the development of rigor contracture in rat ventricular myocytes.

Author

Ruiz-Meana M, Garcia-Dorado D, Juliá M, Inserte J, Siegmund B, Ladilov Y, Piper M, Tritto FP, González MA, and Soler-Soler J

Subjects
Animals, Bicarbonates metabolism, Calcium metabolism, Energy Metabolism physiology, Heart Ventricles cytology, Heart Ventricles drug effects, Heart Ventricles enzymology, Hydrogen-Ion Concentration, In Vitro Techniques, L-Lactate Dehydrogenase metabolism, Male, Myocardium enzymology, Perfusion, Rats, Rats, Sprague-Dawley, Rigor Mortis enzymology, Sodium metabolism, Enzyme Inhibitors pharmacology, Guanidines pharmacology, Heart drug effects, Myocardial Contraction drug effects, Myocardium cytology, Rigor Mortis prevention & control, Sodium-Hydrogen Exchangers antagonists & inhibitors, Sulfones pharmacology
Abstract

The objective of this study was to investigate the effect of Na+-H+ exchange (NHE) and HCO3--Na+ symport inhibition on the development of rigor contracture. Freshly isolated adult rat cardiomyocytes were subjected to 60 min metabolic inhibition (MI) and 5 min re-energization (Rx). The effects of perfusion of HCO3- or HCO3--free buffer with or without the NHE inhibitor HOE642 (7 microM) were investigated during MI and Rx. In HCO3--free conditions, HOE642 reduced the percentage of cells developing rigor during MI from 79 +/- 1% to 40 +/- 4% (P < 0.001) without modifying the time at which rigor appeared. This resulted in a 30% reduction of hypercontracture during Rx (P < 0.01). The presence of HCO3- abolished the protective effect of HOE642 against rigor. Cells that had developed rigor underwent hypercontracture during Rx independently of treatment allocation. Ratiofluorescence measurement demonstrated that the rise in cytosolic Ca2+ (fura-2) occurred only after the onset of rigor, and was not influenced by HOE642. NHE inhibition did not modify Na+ rise (SBFI) during MI, but exaggerated the initial fall of intracellular pH (BCEFC). In conclusion, HOE642 has a protective effect against rigor during energy deprivation, but only when HCO3--dependent transporters are inhibited. This effect is independent of changes in cytosolic Na+ or Ca2+ concentrations.

Published
2000

21. Sodium/hydrogen exchanger inhibition reduces myocardial reperfusion edema after normothermic cardioplegia.

Author

Tritto FP, Inserte J, Garcia-Dorado D, Ruiz-Meana M, and Soler-Soler J

Subjects
Animals, Edema, Cardiac etiology, Edema, Cardiac physiopathology, Hemodynamics, In Vitro Techniques, L-Lactate Dehydrogenase metabolism, Myocardial Reperfusion Injury etiology, Myocardial Reperfusion Injury physiopathology, Rats, Rats, Sprague-Dawley, Ventricular Function, Left, Edema, Cardiac prevention & control, Guanidines pharmacology, Heart Arrest, Induced, Myocardial Reperfusion Injury prevention & control, Sodium-Hydrogen Exchangers antagonists & inhibitors, Sulfones pharmacology
Abstract

Objective: The hypothesis was that Na+/H+ exchange occurring during normothermic cardioplegia contributes to the development of myocardial edema during subsequent reperfusion and impairs functional recovery., Methods: Rat hearts were perfused in a Langendorff apparatus and submitted to 60 minutes of normothermic cardioplegia and 90 minutes of reperfusion. Hearts were allocated to one of four groups (n = 8): inhibition of Na+/H+ exchanger with HOE642 throughout the whole experiment (HOE group), only during cardioplegia (HOE-C) or during reperfusion (HOE-R), and a control group., Results: In HOE and HOE-C groups, myocardial water content at the end of reperfusion was lower than in the HOE-R and control groups (526 +/- 19 and 533 +/- 18 ml/100 gm dry tissue vs 632 +/- 25 and 634 +/- 17 ml/100 gm dry tissue, respectively, p = 0.001), left ventricular end-diastolic pressure increased less after reperfusion (46.6 +/- 9.7 and 63.2 +/- 10.0 mm Hg vs 75.1 +/- 4.3 mm Hg and 85.7 +/- 8.9 mm Hg, respectively, p = 0.006), and recovery of left ventricular developed pressure was better (46.7% and 45.8% vs 4.5% and 9.8%, p = 0.048). Relative to the control group, total lactate dehydrogenase release during reperfusion was reduced by 80.2%, 69.3% and 36% in HOE, HOE-C, and HOE-R groups, respectively., Conclusion: Inhibition of the Na+/H+ exchange during normothermic cardioplegia reduces myocardial edema and necrosis during subsequent reperfusion, improving functional recovery. Inhibition of Na+/H+ exchange during reperfusion only has a much smaller effect.

Published
1998
Full Text
View/download PDF

22. New surgical technique for harvesting the internal mammary artery.

Author

Nappi G, Tritto FP, Falco A, Longobardi F, and Cotrufo M

Subjects
Humans, Intraoperative Care methods, Middle Aged, Vascular Patency, Mammary Arteries transplantation, Myocardial Revascularization methods
Abstract

Inadequate flow and limited length can be reasons for not using the internal mammary artery graft for myocardial revascularization. Several methods have been described to obviate these limitations, but each has disadvantages that contraindicate their application on a routine basis. Herein we describe what to the best of our knowledge is a new surgical technique of harvesting the internal mammary artery graft wherein the endothoracic fascia is incised longitudinally along the artery. In our experience, this surgical maneuver enables an increase in hematic flow (average, 30.6%) and in length of the graft (average, 10%) with reduced risk of damaging the arterial intima. This technique also enables the surgeon to detect the presence of atheromatous plaques and of parietal hematomas of the internal mammary artery wall. Moreover, we have observed a drastic reduction in the incidence of arterial spasms after use of this technique.

Published
1994

23. The size of the pulmonary arteries and the results of the Fontan operation.

Author

Fontan F, Fernandez G, Costa F, Naftel DC, Tritto F, Blackstone EH, and Kirklin JW

Subjects
Blood Vessel Prosthesis, Child, Female, Follow-Up Studies, Heart Atria surgery, Heart Defects, Congenital mortality, Humans, Information Systems, Male, Multivariate Analysis, Pulmonary Artery surgery, Risk Factors, Time Factors, Heart Defects, Congenital surgery, Pulmonary Artery anatomy & histology, Tricuspid Valve abnormalities
Abstract

All patients (n = 334) undergoing the Fontan operation at the University of Bordeaux, France, and the University of Alabama Medical Center, Birmingham, were entered into a single data base to examine the relation, if any, between size of the pulmonary arteries and outcome. Recent follow-up was made of all patients. The time-related freedom from death or takedown of the Fontan operation was 78% at 1 month, 73% at 6 months, and 72%, 68%, 61%, and 50% at 1, 5, 10, and 15 years after the operation. The hazard function (instantaneous risk of the combined event at each moment in time after the operation) had a rapidly declining early phase that gave way at about 6 months to a late phase of hazard, which began slowly to rise about 8 years after the operation. One of the most powerful risk factors for death or takedown of the Fontan operation was the dimensions of the right and left pulmonary arteries, expressed as a McGoon ratio. By multivariate analysis, the risk of the combined event increased sharply when the McGoon ratio was less than about 1.8, and when the ratio was as low as 1.2 the probability of death or takedown within 30 days of the operation was predicted to be 55% when the right atrium was connected to the pulmonary artery and 34% when connected to the right ventricle. Other risk factors identified were age at operation, the presence of mitral atresia, the degree of main chamber hypertrophy, elevated pulmonary artery pressure, non-use of cardioplegia, global myocardial ischemic time, and attachment of the right atrium to the pulmonary artery rather than to the right ventricle.

Published
1989

Catalog

Books, media, physical & digital resources
See catalog results