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Schmiady MO, Jashari R, Lenherr R, Regenscheit S, Hitendu D, Wendt M, Schiess S, Schweiger M, Hofmann M, Sromicki J, Flammer A, Wilhelm MJ, Cesnjevar R, Carrel T, Vogt PR, Mestres CA. How to counteract the lack of donor tissue in cardiac surgery? Initial experiences with a newly established homograft procurement program. Cell Tissue Bank 2024; 25:1-10. [PMID: 37097383 PMCID: PMC10126547 DOI: 10.1007/s10561-023-10087-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 03/28/2023] [Indexed: 04/26/2023]
Abstract
Homograft heart valves may have significant advantages and are preferred for the repair of congenital valve malformations, especially in young women of childbearing age, athletes and in patients with active endocarditis. A growing problem, however, is the mismatch between tissue donation and the increasing demand. The aim of this paper is to describe the initiation process of a homograft procurement program to attenuate the shortage of organs. A comprehensive description of the infrastructure and procedural steps required to initiate a cardiac and vascular tissue donation program combined with a prospective follow-up of all homografts explanted at our institution. Between January 2020 and May 2022, 28 hearts and 12 pulmonary bifurcations were harvested at our institution and delivered to the European homograft bank. Twenty-seven valves (19 pulmonary valves, 8 aortic valves) were processed and allocated for implantation. The reasons for discarding a graft were either contamination (n = 14), or morphology (n = 13) or leaflet damage (n = 2). Five homografts (3 PV, 2 AV) have been cryopreserved and stored while awaiting allocation. One pulmonary homograft with a leaflet cut was retrieved by bicuspidization technique and awaits allocation, as a highly requested small diameter graft. The implementation of a tissue donation program in cooperation with a homograft bank can be achieved with reasonable additional efforts at a transplant center with an in-house cardiac surgery department. Challenging situations with a potential risk of tissue injury during procurement include re-operation, harvesting by a non-specialist surgeon and prior central cannulation for mechanical circulatory support.
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Affiliation(s)
- Martin O Schmiady
- Clinic for Cardiac Surgery, University Heart Center, University Hospital Zurich, Rämistrasse 100, CH-8091, Zurich, Switzerland.
- Department of Congenital Cardiovascular Surgery, University Children's Hospital Zurich, Zurich, Switzerland.
- Children's Research Center, University Children's Hospital Zurich, University Zurich, Zurich, Switzerland.
| | - Ramadan Jashari
- European Homograft Bank (EHB), University Hospital St. Luc, Brussels, Belgium
| | - Renato Lenherr
- Donor Care Association, University Hospital Zurich, Zurich, Switzerland
| | | | - Dave Hitendu
- Department of Congenital Cardiovascular Surgery, University Children's Hospital Zurich, Zurich, Switzerland
- Children's Research Center, University Children's Hospital Zurich, University Zurich, Zurich, Switzerland
| | - Martin Wendt
- Department of Surgery and Transplantation, Swiss HPB Centre, University Hospital Zurich, Zurich, Switzerland
| | - Stefanie Schiess
- Department of Surgery and Transplantation, Swiss HPB Centre, University Hospital Zurich, Zurich, Switzerland
| | - Martin Schweiger
- Department of Congenital Cardiovascular Surgery, University Children's Hospital Zurich, Zurich, Switzerland
- Children's Research Center, University Children's Hospital Zurich, University Zurich, Zurich, Switzerland
| | - Michael Hofmann
- Clinic for Cardiac Surgery, University Heart Center, University Hospital Zurich, Rämistrasse 100, CH-8091, Zurich, Switzerland
| | - Juri Sromicki
- Clinic for Cardiac Surgery, University Heart Center, University Hospital Zurich, Rämistrasse 100, CH-8091, Zurich, Switzerland
| | - Andreas Flammer
- Clinic for Cardiology, University Heart Centre, University Hospital Zurich, Zurich, Switzerland
| | - Markus J Wilhelm
- Clinic for Cardiac Surgery, University Heart Center, University Hospital Zurich, Rämistrasse 100, CH-8091, Zurich, Switzerland
| | - Robert Cesnjevar
- Department of Congenital Cardiovascular Surgery, University Children's Hospital Zurich, Zurich, Switzerland
- Children's Research Center, University Children's Hospital Zurich, University Zurich, Zurich, Switzerland
| | - Thierry Carrel
- Clinic for Cardiac Surgery, University Heart Center, University Hospital Zurich, Rämistrasse 100, CH-8091, Zurich, Switzerland
| | - Paul R Vogt
- Clinic for Cardiac Surgery, University Heart Center, University Hospital Zurich, Rämistrasse 100, CH-8091, Zurich, Switzerland
| | - Carlos A Mestres
- Clinic for Cardiac Surgery, University Heart Center, University Hospital Zurich, Rämistrasse 100, CH-8091, Zurich, Switzerland
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Vida VL, Guariento A, Milanesi O, Gregori D, Stellin G, Zucchetta F, Zanotto L, Padalino MA, Castaldi B, Bosiznik S, Crepaz R, Stuefer J, de Maria Garcia Gonzales F, Castaneda AR, Crupi G, Agnoletti G, Bondanza S, Marasini M, Zannini L, Butera G, Frigiola A, Varrica A, Chiappa E, Pilati M, Carotti A, Matteo T, Prandstraller D, Gargiulo G, Giovanna Russo M, Santoro G, Caianiello G, Spadoni I, Murzi B, Arcieri L, Pozzi M, Porcedda G, Berggren H, Carrel T, Kadner A, Çiçek S, Zorman Y, Fragata J, Gordo A, Hazekamp M, Sojak V, Hraska V, Asfour B, Maruszewski B, Kozlowski M, Metras D, Pretre R, Rubay J, Sairanen H, Sarris G, Schreiber C, Ono M, Meyns B, Van den Bossche K, Tlaskal T, Lo Rito M, Joon Yoo S, Van Arsdell GS, Calderone C, Iwamoto Y, Leon-Wyss J, Di Filippo S, Leconte C, Mulder BJM, Ebels T, Arrigoni S, Valsangiacomo E, Hitendu D, Konstantinov IE, Gamillscheg A, Gabriela D, Herberg U, Dulac Y, Edmerger J, Zarate Fuentes A, Miguel Gil Jaurena J, Bo I, Ghez O, Rigby ML, Bacha EA, Kalfa D, Speggiorin S, Bu’Lock F, Al-Ahmadi M, Di Salvo G, Surmacz R, Yemets IM, Mykychak YB, Lugones I, Cameron DE, Vricella LA, Troconis CJ, Thiene G, Angelini A, Zanotto L. The natural history and surgical outcome of patients with scimitar syndrome: a multi-centre European study. Eur Heart J 2017; 39:1002-1011. [DOI: 10.1093/eurheartj/ehx526] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Accepted: 08/16/2017] [Indexed: 12/29/2022] Open
Affiliation(s)
- Vladimiro L Vida
- Pediatric and Congenital Cardiac Surgery Unit, Department of Thoracic, Cardiac and Vascular Sciences, University of Padua, Via Giustiniani 2, Padua, Italy
- Pediatric Cardiology Unit, Department of Child and Woman’s Health, University of Padua, Via Giustiniani 3, Padua, Italy
| | - Alvise Guariento
- Pediatric and Congenital Cardiac Surgery Unit, Department of Thoracic, Cardiac and Vascular Sciences, University of Padua, Via Giustiniani 2, Padua, Italy
| | - Ornella Milanesi
- Pediatric Cardiology Unit, Department of Child and Woman’s Health, University of Padua, Via Giustiniani 3, Padua, Italy
| | - Dario Gregori
- Unit of Biostatistics, Epidemiology and Public Health Unit, Department of Thoracic, Cardiac and Vascular Sciences, University of Padua, via Loredan 18, Padua, Italy
| | - Giovanni Stellin
- Pediatric and Congenital Cardiac Surgery Unit, Department of Thoracic, Cardiac and Vascular Sciences, University of Padua, Via Giustiniani 2, Padua, Italy
| | - Fabio Zucchetta
- Pediatric and Congenital Cardiac Surgery Unit, Department of Thoracic, Cardiac and Vascular Sciences, University of Padua, Padua, Italy
- Cardiac surgery unit
| | - Lorenza Zanotto
- Pediatric and Congenital Cardiac Surgery Unit, Department of Thoracic, Cardiac and Vascular Sciences, University of Padua, Padua, Italy
- Cardiac surgery unit
| | - Massimo A Padalino
- Pediatric and Congenital Cardiac Surgery Unit, Department of Thoracic, Cardiac and Vascular Sciences, University of Padua, Padua, Italy
- Cardiac surgery unit
| | - Biagio Castaldi
- Pediatric Cardiology Unit, Department of Child and Woman’s Health, University of Padua, Padua, Italy
- Cardiology unit
| | - Sasa Bosiznik
- Pediatric Cardiology Unit, Department of Child and Woman’s Health, University of Padua, Padua, Italy
- Cardiology unit
| | - Roberto Crepaz
- Pediatric and Congenital Cardiology Unit, Hospital of Bolzano, Bolzano, Italy
- Cardiac surgery unit
| | - Joseph Stuefer
- Pediatric and Congenital Cardiology Unit, Hospital of Bolzano, Bolzano, Italy
- Cardiac surgery unit
| | | | - Aldo R Castaneda
- Pediatric Cardiology and Cardiac Surgery Unit of Guatemala, UNICARP, Guatemala City, Guatemala
- Cardiac surgery unit
| | - Giancarlo Crupi
- Centre for the Diagnosis and Treatment of Congenital Heart Defects, Ospedali Riuniti di, Bergamo, Italy
- Cardiac surgery unit
| | - Gabriella Agnoletti
- Pediatric Cardiology Unit, Città della Salute e della Scienza, Department of Public Health and Pediatrics, University di Torino, Torino, Italy
- Cardiology unit
| | - Sara Bondanza
- Pediatric Cardiac Surgery Unit, Department of Pediatric Cardiology and Cardiovascular Surgery, Istituto Giannina Gaslini- IRCS, Genoa, Italy
- Cardiology unit
| | - Maurizio Marasini
- Pediatric Cardiac Surgery Unit, Department of Pediatric Cardiology and Cardiovascular Surgery, Istituto Giannina Gaslini- IRCS, Genoa, Italy
- Cardiology unit
| | - Lucio Zannini
- Pediatric Cardiac Surgery Unit, Department of Pediatric Cardiology and Cardiovascular Surgery, Istituto Giannina Gaslini- IRCS, Genoa, Italy
- Cardiac surgery unit
| | - Gianfranco Butera
- Department of Paediatric Cardiology and Cardiac Surgery and Adult Congenital Heart Disease, IRCCS Policlinico San Donato Milanese, Italy
- Cardiology unit
| | - Alessandro Frigiola
- Department of Paediatric Cardiology and Cardiac Surgery and Adult Congenital Heart Disease, IRCCS Policlinico San Donato Milanese, Italy
- Cardiac surgery unit
| | - Alessandro Varrica
- Department of Paediatric Cardiology and Cardiac Surgery and Adult Congenital Heart Disease, IRCCS Policlinico San Donato Milanese, Italy
- Cardiac surgery unit
| | - Enrico Chiappa
- Division of Pediatric Cardiology, Azienda Ospedaliero-Universitaria Meyer, Firenze, Italy
- Cardiology unit
| | - Mara Pilati
- Department of Pediatric Cardiology and Cardiac surgery, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
- Cardiology unit
| | - Adriano Carotti
- Department of Pediatric Cardiology and Cardiac surgery, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
- Cardiac surgery unit
| | - Trezzi Matteo
- Department of Pediatric Cardiology and Cardiac surgery, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
- Cardiac surgery unit
| | - Daniela Prandstraller
- Department of Pediatric Cardiology and Pediatric and Adult Cardiac Surgery, University di Bologna, Bologna, Italy
- Cardiology unit
| | - Gaetano Gargiulo
- Department of Pediatric Cardiology and Pediatric and Adult Cardiac Surgery, University di Bologna, Bologna, Italy
- Cardiac surgery unit
| | - Maria Giovanna Russo
- Paediatric Cardiology and Pediatric Cardiac Surgery, IInd University of Naples, Naples, Italy
- Cardiology unit
| | - Giuseppe Santoro
- Paediatric Cardiology and Pediatric Cardiac Surgery, IInd University of Naples, Naples, Italy
- Cardiology unit
| | - Giuseppe Caianiello
- Paediatric Cardiology and Pediatric Cardiac Surgery, IInd University of Naples, Naples, Italy
- Cardiac surgery unit
| | - Isabella Spadoni
- Pediatric and Adult Congenital Cardiology and Cardiac Surgery units, Heart Hospital, G. Monasterio Foundation, Massa, Italy
- Cardiology unit
| | - Bruno Murzi
- Pediatric and Adult Congenital Cardiology and Cardiac Surgery units, Heart Hospital, G. Monasterio Foundation, Massa, Italy
- Cardiac surgery unit
| | - Luigi Arcieri
- Pediatric and Adult Congenital Cardiology and Cardiac Surgery units, Heart Hospital, G. Monasterio Foundation, Massa, Italy
- Cardiac surgery unit
| | - Marco Pozzi
- Department of Pediatric and Congenital Cardiac Surgery and Cardiology, Ospedali Riuniti di Ancona, Ancona, Italy
- Cardiac surgery unit
| | - Giulio Porcedda
- Pediatric Cardiology Unit, Ospedale Santa Chiara di Trento, Trento, Italy
- Cardiology unit
| | - Hakan Berggren
- Department of Molecular and Clinical Medicine, Children’s Heart Center, The Queen Silvia’s Children’s Hospital, Göteborg, Sweden
- Cardiac surgery unit
| | - Thierry Carrel
- Deprtment for Cardiovascular Surgery, University of Bern, Bern, Switzerland
- Cardiac surgery unit
| | - Alexander Kadner
- Deprtment for Cardiovascular Surgery, University of Bern, Bern, Switzerland
- Cardiac surgery unit
| | - Sertaç Çiçek
- Center for Heart and Vascular Care, Section of Cardiovascular Surgery and Cardiac Anesthesia, Anadolu Medical Center Hospital, Turkey
- Cardiac surgery unit
| | - Yilmaz Zorman
- Center for Heart and Vascular Care, Section of Cardiovascular Surgery and Cardiac Anesthesia, Anadolu Medical Center Hospital, Turkey
- Cardiac surgery unit
| | - José Fragata
- Department of Cardiothoracic Surgery, Hospital de Santa Marta and Nova Medical School, Lisbon, Portugal
- Cardiac surgery unit
| | - Andreia Gordo
- Department of Cardiothoracic Surgery, Hospital de Santa Marta and Nova Medical School, Lisbon, Portugal
- Cardiac surgery unit
| | - Mark Hazekamp
- Department of Cardiothoracic Surgery, Leiden University Medical Center, Leiden, Netherlands
- Cardiac surgery unit
| | - Vladimir Sojak
- Department of Cardiothoracic Surgery, Leiden University Medical Center, Leiden, Netherlands
- Cardiac surgery unit
| | - Viktor Hraska
- Department of Pediatric Cardio-Thoracic Surgery, Deutsches Kinderherzzentrum, Sankt Augustin, Germany
- Cardiac surgery unit
| | - Boulos Asfour
- Department of Pediatric Cardio-Thoracic Surgery, Deutsches Kinderherzzentrum, Sankt Augustin, Germany
- Cardiac surgery unit
| | - Bohdan Maruszewski
- Department for Pediatric Cardiothoracic Surgery, The Children’s Memorial Health Institute, Warsaw, Poland
- Cardiac surgery unit
| | - Michal Kozlowski
- Department for Pediatric Cardiothoracic Surgery, The Children’s Memorial Health Institute, Warsaw, Poland
- Cardiac surgery unit
| | - Dominique Metras
- Service of Cardiothoracic Surgery, Children’s Hospital, Hopital de la Timone, Marseille, France
- Cardiac surgery unit
| | - Rene Pretre
- Department of Cardiovascular Surgery, University Hospital of Lausanne CHUV, Lausanne, Switzerland
- Cardiac surgery unit
| | - Jean Rubay
- Pediatric and Congenital Cardiac Surgery and Pediatrics, Cliniques universitaires Saint-Luc UCL, Bruxelles, Belgium
- Cardiac surgery unit
| | - Heikki Sairanen
- Department of Surgery and Cardiology, Hospital for Children and Adolescents, Helsinki University Central Hospital, Helsinki, Finland
- Cardiac surgery unit
| | - George Sarris
- Athens Heart Surgery Institute and Department of Pediatric and Congenital Cardiac Surgery, Iaso Children’s Hospital, Athens, Greece
- Cardiac surgery unit
| | - Christian Schreiber
- Department of Cardiovascular Surgery, German Heart Center Munich at the Technical University, Munich, Germany
- Cardiac surgery unit
| | - Masamichi Ono
- Department of Cardiovascular Surgery, German Heart Center Munich at the Technical University, Munich, Germany
- Cardiac surgery unit
| | - Bart Meyns
- Department of Cardiac Surgery, University Hospital Leuven, Catholic University Leuven Leuven, Belgium
- Cardiac surgery unit
| | - Klaartje Van den Bossche
- Department of Cardiac Surgery, University Hospital Leuven, Catholic University Leuven Leuven, Belgium
- Cardiac surgery unit
| | - Tomas Tlaskal
- Children’s Heart Centre, University Hospital Motol, Prague, Czech Republic
- Cardiac surgery unit
| | - Mauro Lo Rito
- Department of Pediatrics, Division of Cardiology and Cardiovascular Surgery, Labatt Family Heart Centre, and Department of Diagnostic Imaging, Hospital for Sick Children, University of Toronto, Canada
- Cardiac surgery unit
| | - Shi Joon Yoo
- Department of Pediatrics, Division of Cardiology and Cardiovascular Surgery, Labatt Family Heart Centre, and Department of Diagnostic Imaging, Hospital for Sick Children, University of Toronto, Canada
- Diagnostic image unit
| | - Glen S Van Arsdell
- Department of Pediatrics, Division of Cardiology and Cardiovascular Surgery, Labatt Family Heart Centre, and Department of Diagnostic Imaging, Hospital for Sick Children, University of Toronto, Canada
- Cardiac surgery unit
| | - Christopher Calderone
- Department of Pediatrics, Division of Cardiology and Cardiovascular Surgery, Labatt Family Heart Centre, and Department of Diagnostic Imaging, Hospital for Sick Children, University of Toronto, Canada
- Cardiac surgery unit
| | - Yoichi Iwamoto
- Department of Pediatrics, Division of Cardiology and Cardiovascular Surgery, Labatt Family Heart Centre, and Department of Diagnostic Imaging, Hospital for Sick Children, University of Toronto, Canada
- Cardiology unit
| | - Juan Leon-Wyss
- Pediatric Cardiac Surgery, Centro Cardiovascular CEDIMAT, Santo Domingo, Dominican Republic
- Cardiac surgery unit
| | - Sylvie Di Filippo
- Pediatric and Congenital Cardiology Unit, Hospital Louis Pradel, University Medical Center of Lyon, France
- Cardiology unit
| | - Cecile Leconte
- Pediatric and Congenital Cardiology Unit, Hospital Louis Pradel, University Medical Center of Lyon, France
- Cardiology unit
| | - Barbara JM Mulder
- Department of Cardiology, Academic Medical Center of Amsterdam, Amsterdam, Netherlands
- Cardiology unit
| | - Tjark Ebels
- Departments of Congenital Cardiothoracic Surgery Thoraxcentrum, University Medical Center Groningen, Groningen, Netherlands
- Cardiac surgery unit
| | - Sara Arrigoni
- Departments of Congenital Cardiothoracic Surgery Thoraxcentrum, University Medical Center Groningen, Groningen, Netherlands
- Cardiac surgery unit
| | - Emanuela Valsangiacomo
- Division of Pediatric Cardiology and Congenital Cardiovascular Surgery, University Children’s Hospital, Zurich, Switzerland
- Cardiology unit
| | - Dave Hitendu
- Division of Pediatric Cardiology and Congenital Cardiovascular Surgery, University Children’s Hospital, Zurich, Switzerland
- Cardiac surgery unit
| | - Igor E Konstantinov
- Cardiac Surgery Unit, Royal Children’s Hospital, Melbourne, Australia
- Cardiac surgery unit
| | - Andreas Gamillscheg
- Division of Pediatric Cardiology, Department of Pediatrics, Medical University Graz, Graz, Austria
- Cardiology unit
| | - Doros Gabriela
- Third Pediatric Clinic, Department of Pediatric Cardiology, “Louis Turcanu” Emergency Children Hospital Timisoara, University of Medicine and Pharmacy “Victor Babes” Timisoara, Roman
- Cardiology unit
| | - Ulrike Herberg
- Department of Pediatric Cardiology, University of Bonn, Bonn, Germany
- Cardiology unit
| | - Yves Dulac
- Department of Paediatric Cardiology, Children's Hospital, Toulouse, France
- Cardiology unit
| | - Julio Edmerger
- Pediatric Cardiology Unit, Hospital Infantil de Mexico, Mexico City, Mexico
- Cardiology unit
| | - Alberto Zarate Fuentes
- Pediatric Cardiology Unit, Hospital Infantil de Mexico, Mexico City, Mexico
- Cardiology unit
| | - Juan Miguel Gil Jaurena
- Paediatric Cardiac Surgery Department, Gregorio Marañón Hospital, Madrid, Spain
- Cardiology unit
| | - Ilaria Bo
- Department of Pediatric Cardiology and Pediatric Cardiac Surgery, Royal Brompton Hospital, London, UK
- Cardiology unit
| | - Olivier Ghez
- Department of Pediatric Cardiology and Pediatric Cardiac Surgery, Royal Brompton Hospital, London, UK
- Cardiac surgery unit
| | - Micheal L Rigby
- Department of Pediatric Cardiology and Pediatric Cardiac Surgery, Royal Brompton Hospital, London, UK
- Cardiology unit
| | - Emile A Bacha
- Department of Pediatric and Congenital Cardiac Surgery, Morgan Stanley Children's Hospital of New York-Presbyterian, Columbia University Medical Center, NY, USA
- Cardiac surgery unit
| | - David Kalfa
- Department of Pediatric and Congenital Cardiac Surgery, Morgan Stanley Children's Hospital of New York-Presbyterian, Columbia University Medical Center, NY, USA
- Cardiac surgery unit
| | - Simone Speggiorin
- Pediatric and Congenital Cardiac Surgery Unit and Pediatric Cardiology Unit, East Midlands Congenital Heart Centre, Glenfield hospital, Leicester, UK
- Cardiac surgery unit
| | - Frances Bu’Lock
- Pediatric and Congenital Cardiac Surgery Unit and Pediatric Cardiology Unit, East Midlands Congenital Heart Centre, Glenfield hospital, Leicester, UK
- Cardiology unit
| | - Mamdouh Al-Ahmadi
- Division of Pediatric Cardiology and Cardiac Surgery, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
- Cardiac surgery unit
| | - Giovanni Di Salvo
- Division of Pediatric Cardiology and Cardiac Surgery, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
- Cardiology unit
| | - Rafal Surmacz
- Department of Pediatric Cardiology Poznan University of Medical Sciences, Poznan, Poland
- Cardiology unit
| | - Illya M Yemets
- Cardiac Surgery Department, Ukrainian Children’s Cardiac Center, Kyiv, Ukraine
- Cardiac surgery unit
| | - Yaroslav B Mykychak
- Cardiac Surgery Department, Ukrainian Children’s Cardiac Center, Kyiv, Ukraine
- Cardiac surgery unit
| | - Ignacio Lugones
- Division of Cardiovascular Surgery, Fundacion Favaloro University Hospital, Buenos Aires, Argentina
- Cardiac surgery unit
| | - Duke E Cameron
- Division of Cardiac Surgery, The Johns Hopkins Hospital, Baltimore, MD, USA
- Cardiac surgery unit
| | - Luca A Vricella
- Division of Cardiac Surgery, The Johns Hopkins Hospital, Baltimore, MD, USA
- Cardiac surgery unit
| | - Carlos J Troconis
- Pediatric Cardiac Surgery Unit, Caracas, Venezuela
- Cardiac surgery unit
| | - Gaetano Thiene
- Cardiovascular Pathology Unit, Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy
| | - Annalisa Angelini
- Cardiovascular Pathology Unit, Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy
| | - Lucia Zanotto
- Department of Statistical Sciences of the University of Padua, Padua, Italy
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