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321 results on '"Troise, G."'

4. Beating Versus Arrested Heart Isolated Tricuspid Valve Surgery: Long-term Outcomes

Author

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

Abstract

Background: Isolated tricuspid valve (TV) surgery is a rare procedure generally considered at high risk for perioperative mortality and poor long-term outcomes. Surgical treatment can be performed with either an arrested heart (AH) or beating heart (BH) technique. The aim of this study was to compare the outcomes of isolated tricuspid surgery with 2 different approaches. Methods: The Surgical-Tricuspid Study is a multicenter international retrospective study enrolling adult patients who underwent isolated TV procedures (n = 406; age 56 ± 16 years; 56% female) at 13 international sites. The AH and BH strategies were performed in 253 and 153 patients, respectively. Propensity score-matched analysis was used to compare groups. Results: After matching, 129 pairs were obtained and analyzed. The 30-day mortality rate was 6.2% versus 5.0% in the AH and BH groups, respectively (P = .9). The rates of acute renal failure requiring replacement therapy (10% versus 3%; P = .02) and stroke (1.6% versus 0%; P = .08) were numerically higher in the AH group. The 6-year survival rate was 67% ± 6% versus 78% ± 5% in the AH and BH groups, respectively (P = .18), whereas freedom from cardiac death was 75% ± 5% versus 84% ± 4% (P = .21). The 6-year composite cardiac end point of cardiac death and reoperation rate was 60% ± 9% versus 86% ± 5% (P = .024) comparing AH-TV replacement and BH-TV repair groups. Conclusions: Isolated TV surgery performed with a BH strategy is a safe option and resulted in a trend of increased long-term survival and freedom from reoperation compared with the standard AH technique. Patients undergoing BH valve repair had the best long-term outcome.

Published
2022

7. OC69 SURGERY FOR BENTALL ENDOCARDITIS: SHORT AND LONG-TERM OUTCOME FROM A MULTI-CENTRE REGISTRY

Author

Sponga, S., Di Mauro, M., Pacini, D., Murara, G., Di Bartolomeo, R., Cappabianca, G., Beghi, C., Weltert, L., De Paulis, R., De Vincentiis, C., Biondi, A., Santini, F., Salsano, A., Salvador, L., Picichè, M., Mariscalco, G., Maselli, D., Rinaldi, M., Mancuso, S., Scrofani, R., Cagnoni, G., Antona, C., Dato, G.M.A., Centofani, P., De Bonis, M., Pozzoli, A., Cugola, D., Galletti, L., Villa, E., Dossena, Y., Troise, G., Barili, F., Paparella, D., Margari, V., Lorusso, R., Parolari, A., and Livi, U.

Published
2018
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8. OC71 SURGICAL TREATMENT FOR ISOLATED TRICUSPID VALVE INFECTIVE ENDOCARDITIS. 25-YEAR RESULTS

Author

Di Mauro, M., Dato, G. Actis, Barili, F., Corte, A. Della, Ratta, E. Della, Cugola, D., Galletti, L., Centofanti, P., Santini, F., Salsano, A., Rinaldi, M., Mancuso, S., Cappabianca, G., Beghi, C., De Vincentiis, C., Biondi, A., Livi, U., Sponga, S., Pacini, D., Murara, G., Di Bortalomeo, R., Scrofani, R., Cagnoni, G., Antona, C., Nicolini, F., Benassi, F., De Bonis, M., Pozzoli, A., Casali, G., Scrascia, G., Bortolotti, U., Falcetta, G., Musumeci, F., Gherli, R., Vizzardi, E., Salvador, L., Piccichè, M., Paparella, D., Margari, V., Troise, G., Villa, E., Dossena, Y., Lucarelli, C., Onorati, F., Faggian, G., Mariscalco, G., Maselli, D., Foschi, M., Parolari, A., and Lorusso, R.

Published
2018
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13. Surgical treatment of isolated tricuspid valve infective endocarditis: 25-year results from a multicenter registry

Author

Di Mauro, M, Foschi, M, Dato, G, Centofanti, P, Barili, F, Corte, A, Ratta, E, Cugola, D, Galletti, L, Santini, F, Salsano, A, Rinaldi, M, Mancuso, S, Cappabianca, G, Beghi, C, De Vincentiis, C, Biondi, A, Livi, U, Sponga, S, Pacini, D, Murana, G, Scrofani, R, Antona, C, Cagnoni, G, Nicolini, F, Benassi, F, De Bonis, M, Pozzoli, A, Casali, G, Scrascia, G, Falcetta, G, Bortolotti, U, Musumeci, F, Gherli, R, Vizzardi, E, Salvador, L, Piciche, M, Paparella, D, Margari, V, Troise, G, Villa, E, Dossena, Y, Lucarelli, C, Onorati, F, Faggian, G, Mariscalco, G, Maselli, D, Parolari, A, Lorusso, R, Di Mauro M., Foschi M., Dato G. M. A., Centofanti P., Barili F., Corte A. D., Ratta E. D., Cugola D., Galletti L., Santini F., Salsano A., Rinaldi M., Mancuso S., Cappabianca G., Beghi C., De Vincentiis C., Biondi A., Livi U., Sponga S., Pacini D., Murana G., Scrofani R., Antona C., Cagnoni G., Nicolini F., Benassi F., De Bonis M., Pozzoli A., Casali G., Scrascia G., Falcetta G., Bortolotti U., Musumeci F., Gherli R., Vizzardi E., Salvador L., Piciche M., Paparella D., Margari V., Troise G., Villa E., Dossena Y., Lucarelli C., Onorati F., Faggian G., Mariscalco G., Maselli D., Parolari A., Lorusso R., Di Mauro, M, Foschi, M, Dato, G, Centofanti, P, Barili, F, Corte, A, Ratta, E, Cugola, D, Galletti, L, Santini, F, Salsano, A, Rinaldi, M, Mancuso, S, Cappabianca, G, Beghi, C, De Vincentiis, C, Biondi, A, Livi, U, Sponga, S, Pacini, D, Murana, G, Scrofani, R, Antona, C, Cagnoni, G, Nicolini, F, Benassi, F, De Bonis, M, Pozzoli, A, Casali, G, Scrascia, G, Falcetta, G, Bortolotti, U, Musumeci, F, Gherli, R, Vizzardi, E, Salvador, L, Piciche, M, Paparella, D, Margari, V, Troise, G, Villa, E, Dossena, Y, Lucarelli, C, Onorati, F, Faggian, G, Mariscalco, G, Maselli, D, Parolari, A, Lorusso, R, Di Mauro M., Foschi M., Dato G. M. A., Centofanti P., Barili F., Corte A. D., Ratta E. D., Cugola D., Galletti L., Santini F., Salsano A., Rinaldi M., Mancuso S., Cappabianca G., Beghi C., De Vincentiis C., Biondi A., Livi U., Sponga S., Pacini D., Murana G., Scrofani R., Antona C., Cagnoni G., Nicolini F., Benassi F., De Bonis M., Pozzoli A., Casali G., Scrascia G., Falcetta G., Bortolotti U., Musumeci F., Gherli R., Vizzardi E., Salvador L., Piciche M., Paparella D., Margari V., Troise G., Villa E., Dossena Y., Lucarelli C., Onorati F., Faggian G., Mariscalco G., Maselli D., Parolari A., and Lorusso R.

Abstract

Background: To assess early and late mortality in patients with isolated acute tricuspid valve infective endocarditis (TVIE) using data from a multicenter registry. Methods: From 1983 to 2018, isolated acute TVIE was surgically treated in 157 (3.8%) patients [mean age 47 ± 16 years (range 15–86 years), 25% females]. Of these, 142 (90%) had native tricuspid regurgitation, 7 (5%) native tricuspid valve (TV) steno-regurgitation, and 8 (5%) prosthetic TVIE. Intravenous drug use (IVDU) was recorded in 38% of patients, infection involved cardiac implantable electronic device leads in 21%, and vascular catheters for dialysis in 1%; in the remaining cases, the cause was unknown. The primary endpoint was in-hospital outcome, long-term freedom from recurrence and overall survival. Results: Overall, 77 (49%) patients underwent TV repair, 72 (46%) TV replacement, and 8 (5%) prosthetic TV replacement. Early mortality was 11% (n = 17). Expected early mortality according to EndoSCORE was 12%, with age (odds ratio 1.06) and redo (odds ratio 6.64) as risk factors. Late deaths occurred in 31 patients and TVIE recurrences in 4. Survival rates at 10, 20, and 25 years were 66%, 60%, and 44%, respectively. Risk factors were age [hazard ratio (HR) 1.06], mycotic TVIE (HR 4.2), IVDU (HR 4.90), infected prosthesis replacement (HR 4.4), and presence of cardiac implantable electronic device leads (HR 3.0). No significant difference was found in valve repair vs. replacement and in IVDUs vs. non-IVDUs. Conclusions: Patients with isolated acute TVIE undergoing surgical treatment show acceptable early and late outcomes. TVIE recurrence was low, and repair of the affected valve does not seem to confer any advantage either at early or long term up to 25 years.

Published
2019

14. 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

15. Surgical aortic valve replacement with new-generation bioprostheses: Sutureless versus rapid-deployment

Author

D'Onofrio, Ginevra Federica, Salizzoni, S., Filippini, C., Tessari, C., Bagozzi, L., Messina, A., Troise, Giovanni, Tomba, M. D., Rambaldini, M., Dalen, M., Alamanni, F., Massetti, Massimo, Mignosa, C., Russo, C., Salvador, L., Di Bartolomeo, R., Maselli, Daniele, De Paulis, R., Alfieri, O., De Filippo, C. M., Portoghese, M., Bortolotti, U., Rinaldi, M., Gerosa, G., D'Onofrio A., Troise G., Massetti M. (ORCID:0000-0002-7100-8478), Maselli D., D'Onofrio, Ginevra Federica, Salizzoni, S., Filippini, C., Tessari, C., Bagozzi, L., Messina, A., Troise, Giovanni, Tomba, M. D., Rambaldini, M., Dalen, M., Alamanni, F., Massetti, Massimo, Mignosa, C., Russo, C., Salvador, L., Di Bartolomeo, R., Maselli, Daniele, De Paulis, R., Alfieri, O., De Filippo, C. M., Portoghese, M., Bortolotti, U., Rinaldi, M., Gerosa, G., D'Onofrio A., Troise G., Massetti M. (ORCID:0000-0002-7100-8478), and Maselli D.

Abstract

Objectives: The aim of this retrospective multicenter study was to compare early clinical and hemodynamic outcomes of Perceval-S sutureless (Livanova, London, United Kingdom) and Intuity rapid-deployment (Edwards Lifesciences, Irvine, Calif) bioprostheses. Methods: Data from patients who underwent isolated or combined aortic valve replacement with Perceval-S and with Intuity bioprostheses at 18 cardiac surgical institutions were analyzed. Propensity matching was performed to identify similar patient cohorts. Results: We included 911 patients from March 2011 until May 2017. Perceval-S and Intuity valves were implanted in 349 (38.3%) and in 562 (61.7%) patients, respectively. Propensity score identified 117 matched pairs. In the matched cohort, device success was 99.1% and 100% in Perceval-S and Intuity group, respectively (P = 1.000). Thirty-day Valve Academic Research Consortium mortality occurred in 2 (1.7%) and 4 (3.4%) patients in the Perceval-S and in Intuity group, respectively (P = .6834). The rate of postoperative new permanent pacemaker implantation was 6% (7 patients) and 6.8% (8 patients) in the Perceval-S and in Intuity group, respectively (P = .7896). Perceval-S valve implantation requires significantly shorter aortic crossclamp and cardiopulmonary bypass times than Intuity valve implantation (aortic crossclamp time for isolated, 52 ± 14 minutes vs 62 ± 24 minutes; P < .0001). Peak transaortic gradients were 22.4 ± 8.1 mm Hg and 19.6 ± 6.7 mm Hg (P = .0144), whereas mean gradients were 11.8 ± 4.7 mm Hg and 10.5 ± 3.9 mm Hg (P = .0388) in the Perceval-S and Intuity groups, respectively. Conclusions: Sutureless Perceval-S and rapid-deployment Intuity bioprostheses provide good and similar early clinical and hemodynamic outcomes. Perceval-S valve implantation requires shorter crossclamp and cardiopulmonary bypass times, whereas Intuity valve implantation provides lower transaortic peak and mean gradients.

Published
2020

16. Evidence and controversy on the indications for prophylactic surgery of thoracic aneurysms: Beyond the 'magic numbers' of the aortic diameter

Author

Berretta P., Cefarelli M., Montalto A., Savini C., Miceli A., Rubino A. S., Troise G., Patane L., Di Eusanio M., Berretta P., Cefarelli M., Montalto A., Savini C., Miceli A., Rubino A.S., Troise G., Patane L., and Di Eusanio M.

Subjects
Risk, Aortic aneurysm, Aortic Aneurysm, Thoracic, Aneurysm, Dissecting, Aortic Rupture, parasitic diseases, cardiovascular system, Aortic dissection, Hemodynamic, Thoracic aorta, complex mixtures, digestive system diseases, Human
Abstract

Thoracic aortic aneurysm (TAA) is a silent disease that can become rapidly lethal once dissection or rupture occurs. To prevent aortic catastrophe, prophylactic aortic replacement is the mainstay of therapy in patients with TAA. Currently, surgical indications for TAA repair are predominantly based on the aortic size. However, the effectiveness of the diameter criterion to predict aortic rupture and dissection has been largely questioned over the last years. Growing evidence suggests that aortic size alone May not be sufficient to predict the risk in all TAAs. In this setting, other predictors such as genetic, environmental, biochemical and hemodynamic factors have been proposed. The aim of this paper is to review and discuss on current evidence, controversies and future directions for the treatment of patients with TAA.

Published
2018

17. 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

18. 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

19. ANMCO/GISE/SICCH Inter-Society Consensus Document: Antithrombotic therapy in patients undergoing surgery and/or interventional procedures for valvular heart diseases. How to treat complications

Author

Patane, L., Di Lenarda, A., Aspromonte, N., Bianca, I., Capranzano, P., Di Eusanio, M., Di Fusco, S., Di Tano, G., Gabrielli, D., Garatti, A., Geraci, G., Gerometta, P., Miceli, A., Montalto, A., Musumeci, F., Musumeci, G., Nardi, F., Parolari, A., Pino, P.G., Rubino, A.S., Savini, C., Troise, G., Tarantini, G., Urbinati, S., Varbella, F., and Gulizia, M.M.

Subjects
Settore MED/23 - Chirurgia Cardiaca, Blood coagulation, Cardiac catheterization, Cardiac surgical procedures, Heart valve prosthesis, Platelet aggregation inhibitors, Anticoagulants, Consensus, Female, Fibrinolytic Agents, Heart Valve Diseases, Heart Valve Prosthesis Implantation, Humans, Postoperative Complications, Pregnancy, Pregnancy Complications, Cardiovascular, Thromboembolism, Practice Guidelines as Topic
Published
2019

22. Aortic Valve Replacement in Elderly Patients with Small Aortic Annulus: Results with Three Different Bioprostheses

Author

Chiariello, G. A., Bruno, P., Villa, E., Pasquini, Annalisa, Pavone, Natalia, Cammertoni, F., Mazza, A., Colizzi, Christian, Nesta, Marialisa, Iafrancesco, M., Perri, Gianluigi, Messina, A., Troise, Giovanni, Massetti, Massimo, Pasquini A., Pavone N., Colizzi C., Nesta M., Perri G., Troise G., Massetti M. (ORCID:0000-0002-7100-8478), Chiariello, G. A., Bruno, P., Villa, E., Pasquini, Annalisa, Pavone, Natalia, Cammertoni, F., Mazza, A., Colizzi, Christian, Nesta, Marialisa, Iafrancesco, M., Perri, Gianluigi, Messina, A., Troise, Giovanni, Massetti, Massimo, Pasquini A., Pavone N., Colizzi C., Nesta M., Perri G., Troise G., and Massetti M. (ORCID:0000-0002-7100-8478)

Abstract

Objectives Aortic valve replacement (AVR) in patients with small aortic annulus (diameter ≤21 mm) is considered a challenging scenario because of technical aspects and the high risk of patient-prosthesis mismatch (PPM). The choice of the appropriate prosthesis is crucial, and at the moment, an ideal device has yet to be identified. We compare clinical and hemodynamic results after AVR with three bioprostheses with different design and characteristics. Methods We retrospectively evaluated 76 consecutive patients from two cardiac surgery centers who underwent AVR (Trifecta = 24; Edwards INTUITY Elite valve system = 26, and Perceval = 26) for severe aortic stenosis between 2013 and 2017. Patients selected were older than 75 years and with an annulus diameter ≤21 mm at preoperative echocardiogram. Reinterventions and combined procedures were excluded. Minimally invasive AVR was performed in 44 (57.8%) patients. Telephonic interview was obtained at 2.9 ± 0.5 years and echocardiographic follow-up at 2.2 ± 0.8 years. Results Clinical outcome was similar in the three groups. At follow-up, Trifecta patients presented significantly higher peak and mean transprosthetic pressure gradients (P = 0.04 and 0.01). Effective orifice area and left ventricular mass regression were comparable, although an advantage was observed in Perceval patients without reaching the statistical significance. Incidence of moderate (P = 0.2) and severe PPM (P = 0.7) was comparable. Conclusions Despite higher postoperative pressure gradients observed with the Trifecta valve, all three prostheses (Trifecta, Edwards INTUITY Elite, and Perceval) have proven to be reliable when implanted in small aortic annuli, with good clinical outcome and favorable left ventricular mass regression.

Published
2019

23. OC69 SURGERY FOR BENTALL ENDOCARDITIS

Author

Sponga, S., Di Mauro, M., Pacini, D., Murara, G., Di Bartolomeo, R., Cappabianca, G., Beghi, C., Weltert, L., De Paulis, R., De Vincentiis, C., Biondi, A., Santini, F., Salsano, A., Salvador, L., Picichè, M., Mariscalco, G., Maselli, D., Rinaldi, M., Mancuso, S., Scrofani, R., Cagnoni, G., Antona, C., Dato, G. M. A., Centofani, P., De Bonis, M., Pozzoli, A., Cugola, D., Galletti, L., Villa, E., Dossena, Y., Troise, G., Barili, F., Paparella, D., Margari, V., Lorusso, R., Parolari, A., and Livi, U.

Published
2018

26. 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

27. Experimental test and numerical shape optimization of a point pivoted absorber for wave energy conversion

Author

Coiro, D., Troise, G., Giuseppe Calise, Bizzarrini, N., Coiro, D., Troise, G., Calise, G., and Bizzarrini, N.

Subjects
Energy from wave, Finite element method, Marine engineering, Buoy, Point pivoted absorber, wave energy conversion, point pivoted absorber, buoy, energy from waves, Matemàtiques i estadística::Anàlisi numèrica::Mètodes en elements finits [Àrees temàtiques de la UPC], Wave energy conversion
Abstract

This paper presents a numerical study on an innovative system for converting energy from waves. It consists of a point pivoted body which oscillates in presence of waves. The system uses a linear electrical generator which converts floating movements of the buoyant body into electrical power. The buoyant body floats, describing an arc, by means of two hinges. A suitable Power Take-off Device (PTO) is placed between buoy support arms and the fixed structure and has the function to convert the mechanical power of the linear oscillating motion of the connecting piston into electrical power. A design assumption is made on the PTO control system: PTO reaction force is assumed to be linearly dependent on piston oscillation velocity with a given force-speed gain. This coefficient is strictly connected to electrical generator characteristics and its value has an effect on power conversion efficiency . A scaled model of this system has also been tested in the wave/towing tank facility of Department of industrial Engineering (DII) of University of Naples “Federico II”. A variety of numerical analyses, such as potential flow simulations and Unsteady Reynolds Averaged Navier-Stokes (URANS) simulations, have been performed to predict the system performances. Numerical and experimental analyses have included the performances of the baseline geometry, both in free response and under wave excitation, in order to characterize the response of the system, and results have been used to understand which parameters affect more the power production. Finally a numerical optimization procedure has been carried out to optimize the shape of the converter with the final objective of increasing the generated power, eventually imposing a constraint on the amount of immersed volume. In this way, a modified configuration has been predicted with higher power output and the same value of submerged volume, but with different shape.

Published
2015

28. 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

31. The Italian study of the Mitroflow postoperative results (ISTHMUS): a 20-year, multicenter evaluation of Mitroflow pericardial bioprosthesis

Author

ISTHMUS Investigators, Lorusso, R, Gelsomino, S, De Cicco, G, Vizzardi, E, Faggiano, P, Carella, R, Billè, G, Teodori, G, Caimmi, P, Dato, GA, Casabona, R, Welter, L, De Paulis, R, Calafiore, AM, Di Mauro, M, Di Credico, G, Leva, C, Messina, A, Villa, E, Troise, G, Borghetti, V, Pardini, A, Medici, D, Sala, A, Citterio, E, Barbone, A, Vitali, E, Tarelli, G, FORMICA, FRANCESCO, PAOLINI, GIOVANNI, Isthmus, I, Lorusso, R, Gelsomino, S, De Cicco, G, Vizzardi, E, Faggiano, P, Carella, R, Billè, G, Teodori, G, Caimmi, P, Dato, G, Casabona, R, Welter, L, De Paulis, R, Calafiore, A, Di Mauro, M, Di Credico, G, Leva, C, Messina, A, Villa, E, Troise, G, Borghetti, V, Pardini, A, Medici, D, Sala, A, Citterio, E, Barbone, A, Vitali, E, Tarelli, G, Formica, F, and Paolini, G

Subjects
Pulmonary and Respiratory Medicine, Male, Reoperation, medicine.medical_specialty, Pediatrics, medicine.medical_treatment, Aortic Valve Insufficiency, Prosthesis Design, Prosthesis, Interquartile range, medicine, Postoperative results, Endocarditis, Humans, Mitroflow, biologica valve, aortic valve, Coronary Artery Bypass, Aged, Aged, 80 and over, Bioprosthesis, Heart Valve Prosthesis Implantation, business.industry, General Medicine, Aortic Valve Stenosis, medicine.disease, Surgery, Prosthesis Failure, MED/23 - CHIRURGIA CARDIACA, medicine.anatomical_structure, Treatment Outcome, Embolism, Italy, Cardiothoracic surgery, Concomitant, Aortic Valve, Heart Valve Prosthesis, Female, Cardiology and Cardiovascular Medicine, business, Epidemiologic Methods, Pericardium, Artery
Abstract

Objective: A multicentre experience with the Mitroflow pericardial bioprosthesis has been evaluated longitudinally over a 20-year period. Methods: From 1988 through 2008, 1591 patients (mean age, 75.3 ± 6.8 years, and 60.1% female) from 12 centres had a Mitroflow in the aortic position. Concomitant coronary artery bypass was performed in 41.9% (n = 666) of patients, urgency/emergency surgery in 9.5% (n = 152) and replacement of degenerated prosthesis in 2.3% (n = 36). Follow-up (7.447 patient-years) was 99.2% complete. Median follow-up was 61.9 months (interquartile range (IQR) 30.8-90.9 months). The study was carried out following American Association for Thoracic Surgery/Society for Thoracic Surgeons/European Association for Cardio-Thoracic Surgery (AATS/STS/EACTS) Guidelines for reporting valve morbidity and mortality. Results: The early (30-day) mortality was 6.5% (n = 104). Actuarial survival rates at 10, 15 and 18 years were 53%, 34% and 27%, respectively (2.2 patient/year). Re-operation was required in 96 patients (5.9%), of whom 59 patients (3.7%) for structural valve degeneration. Actuarial freedom from prosthetic valve degeneration at 18 years was 65.5% (78% in patients >70 years) with a linearised rate of 1.4 patient/year (0.8 patient/year in patients >70 years). At 18 years, freedom from embolism was 82% (0.9 patient/year), freedom from valve endocarditis was 89% (0.6 patient/year) and freedom from bleeding episodes was 95% (0.2 patient/year), respectively. Conclusions: This independent multicentre study indicates that the Mitroflow pericardial bioprosthesis provides favourable long-term postoperative results with a low rate of valve-related events and need of re-intervention, particularly in patients older than 70 years.

Published
2011

32. 1-year outcomes after transfemoral transcatheter or surgical aortic valve replacement: Results from the Italian OBSERVANT study

Author

Tamburino, C, Barbanti, M, D'Errigo, P, Ranucci, M, Onorati, F, Covello, R, Santini, F, Rosato, S, Santoro, G, Fusco, D, Grossi, C, Seccareccia, F, Marra, S, D'Amico, M, Gaita, F, Moretti, C, De Benedictis, M, Aranzulla, T, Pistis, G, Reale, M, Bedogni, F, Brambilla, N, Ferrario, M, Ferrero, L, Vicinelli, P, Colombo, A, Chieffo, A, Ferrari, A, Inglese, L, Casilli, F, Ettori, F, Frontini, M, Antona, C, Piccaluga, E, Klugmann, S, De Marco, F, Tespili, M, Saino, A, Leonzi, O, Rizzi, A, Grisolia, E, Franceschini Grisolia, E, Isabella, G, Fraccaro, C, Bernardi, G, Bisceglia, T, Armellini, I, Vischi, M, Parodi, E, Vignali, L, Ardissimo, D, Marzocchi, A, Marrozzini, C, Cremonesi, A, Colombo, F, Giannini, C, Pierli, C, Iadanza, A, Meucci, F, Berti, S, Mariani, M, Tomai, F, Ghini, A, Violini, R, Confessore, P, Crea, F, Giubilato, S, Sardella, G, Mancone, M, Ribichini, F, Vassanelli, C, Dandale, R, Giudice, P, Vigorito, F, Liso, A, Specchia, L, Indolfi, C, Spaccarotella, C, Stabile, A, Gandolfo, C, Ussia, G, Comoglio, C, Dyrda, O, Rinaldi, M, Salizzoni, S, Micalizzi, E, Di Gregorio, O, Scoti, P, Costa, R, Casabona, R, Del Ponte, S, Panisi, P, Spira, G, Troise, G, Messina, A, Viganò, M, Aiello, M, Alfieri, O, Denti, P, Menicanti, L, Agnelli, B, Donatelli, F, Muneretto, C, Rambaldini, M, Gamba, A, Tasca, G, Ferrazzi, P, Terzi, A, Gelpi, G, Martinelli, L, Bruschi, G, Graffigna, A, Mazzucco, A, Pappalardo, A, Gatti, G, Livi, U, Pompei, E, Coppola, R, Gucciardo, M, Albertini, A, Caprili, L, Ghidoni, I, Gabbieri, D, La Marra, M, Aquino, T, Gherli, T, Policlinico, S, Di Bartolomeo, R, Savini, C, Popoff, G, Innocenti, D, Bortolotti, U, Pratali, S, Stefano, P, Blanzola, C, Glauber, M, Cerillo, A, Chiaramonti, F, Pardini, A, Fioriello, F, Torracca, L, Rescigno, G, De Paulis, R, Nardella, S, Musumeci, F, Luzi, G, Possati, G, Bonalumi, G, Covino, E, Pollari, F, Sinatra, R, Roscitano, A, Chiariello, L, Nardi, P, Lonobile, T, Baldascino, F, Di Benedetto, G, Mastrogiovanni, G, Piazza, L, Marmo, J, Vosa, C, De Amicis, V, Speziale, G, Visicchio, G, Spirito, R, Gregorini, R, Villani, M, Pano, M, Bortone, A, De Luca Tupputi Schinosa, L, De Cillis, E, Gaeta, R, Di Natale, M, Cassese, M, Antonazzo, A, Argano, V, Santaniello, E, Patanè, L, Gentile, M, Tribastone, S, Follis, F, Montalbano, G, Pilato, M, Stringi, V, Patanè, F, Salamone, G, Ruvolo, G, Pisano, C, Mignosa, C, Bivona, A, Cirio, E, Lixi, G, Maraschini, A, Badoni, G, Onorato, F, De Palma, R, Scandotto, S, Orlando, A, Copello, F, Borgia, P, Marchetta, F, and Porcu, R

Subjects
aortic stenosis, implantation, intermediate risk, transcatheter aortic valve, Settore MED/23 - Chirurgia Cardiaca
Published
2015

34. 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

41. The risk of coronary artery disease after heart transplantation is increased in patients receiving low-dose cyclosporine, regardless of blood cyclosporine levels

Author

Gamba, A, Mamprin, F, Fiocchi, R, Senni, M, Troise, G, Ferrazzi, P, Ferrara, R, Corbetta, G, Gamba A, Mamprin F, Fiocchi R, Senni M, Troise G, Ferrazzi P, Ferrara R, Corbetta G, Gamba, A, Mamprin, F, Fiocchi, R, Senni, M, Troise, G, Ferrazzi, P, Ferrara, R, Corbetta, G, Gamba A, Mamprin F, Fiocchi R, Senni M, Troise G, Ferrazzi P, Ferrara R, and Corbetta G

Abstract

Background: Coronary artery disease (CAD) of allografted hearts is the main cause of late mortality after cardiac transplant, but its etiology is still undetermined. Hypothesis: This study was undertaken to evaluate the relevance of several risk factors, including cyclosporine (CsA) dose and blood CsA levels, to the incidence of CAD.Methods: In 163 heart transplants performed between November 1985 and August 1994 at our Institution, CAD was diagnosed by coronary angiography or at postmortem examination. Patients in whom postmortem examination or coronary angiography was not performed, as well as those <15 years of age and those who died within 1 month of surgery, were excluded from the study. The following risk factors were analyzed: recipient age, gender, pretransplant diagnosis, donor age, number of human leukocyte antigen (HLA)-AB mismatches, cytomegalovirus serology, mean serum cholesterol and triglyceride levels, the number of treated acute rejections, mean weighted CsA dose (CsA dose(w)) and weighted blood CsA levels (blood CsA level(w)).Results: Coronary artery disease was diagnosed in 32 patients (19.6%). A low mean CsA dose(w) was the only significant predictor for CAD at multivariate analysis (p < 0.01); there was no correlation with blood CsA level(w). In the patients receiving a CsA dose(w) > 4 mg/kg/day, the 8.9 year probability of their remaining CAD free was 69% [confidence interval (CI) 50-87%] in comparison with 31% (CI 0-65%) in patients receiving a CsA dose(w) < 4 mg/kg/day.Conclusion: In our experience, a low CsA maintenance dose is the main risk factor for CAD, irrespective of blood CsA levels.

Published
1997

42. Medical treatment of end-stage heart failure

Author

Binetti, G, Senni, M, Colombo, F, Tasca, G, Mamprin, F, Caporale, R, Ferrazzi, P, Gamba, A, Glauber, M, Troise, G, Fiocchi, R, Binetti G, Senni M, Colombo F, Tasca G, Mamprin F, Caporale R, Ferrazzi P, Gamba A, Glauber M, Troise G, Fiocchi R, Binetti, G, Senni, M, Colombo, F, Tasca, G, Mamprin, F, Caporale, R, Ferrazzi, P, Gamba, A, Glauber, M, Troise, G, Fiocchi, R, Binetti G, Senni M, Colombo F, Tasca G, Mamprin F, Caporale R, Ferrazzi P, Gamba A, Glauber M, Troise G, and Fiocchi R

Abstract

Congestive heart failure is a lethal condition that affects an increasing number of patients. In recent years a great amount of data have accumulated on the pathophysiology and medical and surgical therapy of this condition. In spite of the advances in its management and the great number of patients affected, common errors are still made by internists and cardiologists in the use of drugs and therapeutic strategies. Digitalis has only recently been shown to affect hemodynamics, exercise capacity, and clinical symptoms, but the effects on survival still have to be demonstrated. Loop diuretics, eventually combined with thiazides and antialdosterone drugs in patients with clinical signs and symptoms of fluid retention, are the mainstays of therapy of congestive heart failure. In order to make diuretic therapy efficacious, moderate salt and water intake restriction is mandatory. Angiotensin-converting enzyme (ACE) inhibitors are now considered unavoidable drugs in the management of heart failure, and an attempt to reach the doses that have been shown to be efficacious for survival in the large trials has to be made in every patient with this condition. Other vasodilators, such as hydralazine and nitrates, which show a less pronounced effect on survival but more effective hemodynamic actions than ACE inhibitors, may be used to control mitral insufficiency or to improve hemodynamics in very sick patients. Hemodynamic instability refractory to increasing doses of vasodilators and diuretics is a severe condition that requires hospital admission to administer drugs parenterally. These patients are usually treated with the combination of catecholamines and phosphodiesterase inhibitors associated with intravenous diuretics until clinical stability is again achieved and oral therapy is resumed and restructured. The use of aggressive pharmacological therapy and phosphodiesterase inhibitors has reduced the need for assisted circulatory support in these patients. Beta-blockers hav

Published
1996

43. The Italian study on the Mitroflow postoperative results (ISTHMUS): a 20-year,multicentre evaluation of Mitroflow pericardial bioprosthesis

Author

Lorusso, R, Gelsomino, S, De Cicco, G, Vizzardi, Enrico, Faggiano, P, Carella, R, Billè, G, Teodori, G, Caimmi, P, Dato, Ga, Casabona, R, Welter, L, De Paulis, R, Calafiore, Am, Di Mauro, M, Di Credico, G, Leva, C, Messina, A, Villa, E, Troise, G, Borghetti, V, Pardini, A, Medici, D, Sala, A, Citterio, E, Barbone, A, Vitali, E, Tarelli, G, Formica, F, and Paolini, G.

Published
2011

44. Good survival of patients considered too-well for heart transplantation

Author

Senni, M, Ferrazzi, P, Mamprin, F, Tasca, G, Colombo, F, Fiocchi, R, Gamba, A, G lauber, M, Troise, G, Binetti, G, Senni M, Ferrazzi P, Mamprin F, Tasca G, Colombo F, Fiocchi R, Gamba A, G lauber M, Troise G, Binetti G, Senni, M, Ferrazzi, P, Mamprin, F, Tasca, G, Colombo, F, Fiocchi, R, Gamba, A, G lauber, M, Troise, G, Binetti, G, Senni M, Ferrazzi P, Mamprin F, Tasca G, Colombo F, Fiocchi R, Gamba A, G lauber M, Troise G, and Binetti G

Published
1995

45. Low dosage of cyclosporine and increased occurrence of chronic rejection in heart-transplanted patients

Author

Mamprin, F, Gamba, A, Fiocchi, R, Merlo, M, Senni, M, Troise, G, Binetti, G, Motta T, Parma, A, Ferrazzi, P, Mamprin F, Gamba A, Fiocchi R, Merlo M, Senni M, Troise G, Binetti G, Parma A, Ferrazzi P, Mamprin, F, Gamba, A, Fiocchi, R, Merlo, M, Senni, M, Troise, G, Binetti, G, Motta T, Parma, A, Ferrazzi, P, Mamprin F, Gamba A, Fiocchi R, Merlo M, Senni M, Troise G, Binetti G, Parma A, and Ferrazzi P

Published
1994

46. Trapianto cardiaco in età pediatrica: esperienza in 34 casi

Author

Gamba, A, Ferrazzi, P, Mamprin, F, Fiocchi, R, Glauber, M, Senni, M, Troise, G, Parenzan, L, Gamba A, Ferrazzi P, Mamprin F, Fiocchi R, Glauber M, Senni M, Troise G, Parenzan L, Gamba, A, Ferrazzi, P, Mamprin, F, Fiocchi, R, Glauber, M, Senni, M, Troise, G, Parenzan, L, Gamba A, Ferrazzi P, Mamprin F, Fiocchi R, Glauber M, Senni M, Troise G, and Parenzan L

Published
1994

48. Pediatric heart transplantation without chronic maintenance steroids

Author

Ferrazzi, P, Fiocchi, R, Gamba, A, Mamprin, F, Senni, M, Glauber, M, Troise, G, Parenzan, L, Ferrazzi P, Fiocchi R, Gamba A, Mamprin F, Senni M, Glauber M, Troise G, Parenzan L, Ferrazzi, P, Fiocchi, R, Gamba, A, Mamprin, F, Senni, M, Glauber, M, Troise, G, Parenzan, L, Ferrazzi P, Fiocchi R, Gamba A, Mamprin F, Senni M, Glauber M, Troise G, and Parenzan L

Abstract

From 1986 to February 1993, 40 children aged 2 months to 18 years (average age 10.4 ± 5.8 years) underwent heart transplantation. Indications for transplantation were idiopathic cardiomyopathy (52%), congenital heart disease (35%) with and without prior repair (71% and 29%, respectively), hypertrophic cardiomyopathy (5%), valvular heart disease (3%), and doxorubicin cardiomyopathy (5%). Patients were managed with cyclosporine and azathioprine. No prophylaxis with antilymphocyte globulin was used. Steroids were given to 39% of patients for refractory rejection, but weaning was always attempted and generally successful (64%). Five patients (14%) received maintenance steroids. Four patients died in the perioperative period and one died 4 months later. There have been no deaths related to rejection or infection. Average follow-up was 36 ± 19 months (range 1 to 65 months). Cumulative survival is 88% at 5 years. In patients less than 7 years of age, rejection was monitored noninvasively. In the first postoperative month, 89% of patients were treated for rejection. Freedom from serious infections was 83% at 1 month and 65% at 1 year. Cytomegalovirus infections were treated successfully with ganciclovir in 11 patients. No impairment of growth was observed in children who underwent transplantation compared with a control population. Twenty-one patients (60%) have undergone annual catheterizations and no sign of graft atherosclerosis has been observed. Seizures occurred in five patients (14%) and hypertension was treated in 10 patients (28%). No patient was disabled and no lymphoproliferative disorder was observed. When this group was compared with 87 heart transplant recipients who were more than 50 years of age and receiving no maintenance steroids, a better postoperative survival rate was found (97% vs 84%; p < 0.05). Our experience suggests that immunosuppression without maintenance steroids might improve the prospects for prolonged survival in the pediatric age group.

Published
1993

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