1
|
Salsano A, Di Mauro M, Labate L, Della Corte A, Lo Presti F, De Bonis M, Trumello C, Rinaldi M, Cura Stura E, Actis Dato G, Punta G, Nicolini F, Carino D, De Vincentiis C, Garatti A, Cappabianca G, Musazzi A, Cugola D, Merlo M, Pacini D, Folesani G, Sponga S, Vendramin I, Pilozzi Casado A, Rosato F, Mikus E, Savini C, Onorati F, Luciani GB, Scrofani R, Epifani F, Musumeci F, Lio A, Colli A, Falcetta G, Nicolardi S, Zaccaria S, Vizzardi E, Pantaleo A, Minniti G, Villa E, Dalla Tomba M, Pollari F, Barili F, Parolari A, Lorusso R, Santini F. Survival and Recurrence of Endocarditis following Mechanical vs. Biological Aortic Valve Replacement for Endocarditis in Patients Aged 40 to 65 Years: Data from the INFECT-Registry. J Clin Med 2023; 13:153. [PMID: 38202159 PMCID: PMC10779833 DOI: 10.3390/jcm13010153] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 12/21/2023] [Accepted: 12/21/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND Infective endocarditis (IE) is a serious disease, and in many cases, surgery is necessary. Whether the type of prosthesis implanted for aortic valve replacement (AVR) for IE impacts patient survival is a matter of debate. The aim of the present study is to quantify differences in long-term survival and recurrence of endocarditis AVR for IE according to prosthesis type among patients aged 40 to 65 years. METHODS This was an analysis of the INFECT-REGISTRY. Trends in proportion to the use of mechanical prostheses versus biological ones over time were tested by applying the sieve bootstrapped t-test. Confounders were adjusted using the optimal full-matching propensity score. The difference in overall survival was compared using the Cox model, whereas the differences in recurrence of endocarditis were evaluated using the Gray test. RESULTS Overall, 4365 patients were diagnosed and operated on for IE from 2000 to 2021. Of these, 549, aged between 40 and 65 years, underwent AVR. A total of 268 (48.8%) received mechanical prostheses, and 281 (51.2%) received biological ones. A significant trend in the reduction of implantation of mechanical vs. biological prostheses was observed during the study period (p < 0.0001). Long-term survival was significantly higher among patients receiving a mechanical prosthesis than those receiving a biological prosthesis (hazard ratio [HR] 0.546, 95% CI: 0.322-0.926, p = 0.025). Mechanical prostheses were associated with significantly less recurrent endocarditis after AVR than biological prostheses (HR 0.268, 95%CI: 0.077-0.933, p = 0.039). CONCLUSIONS The present analysis of the INFECT-REGISTRY shows increased survival and reduced recurrence of endocarditis after a mechanical aortic valve prosthesis implant for IE in middle-aged patients.
Collapse
Affiliation(s)
- Antonio Salsano
- Division of Cardiac Surgery, Ospedale Policlinico San Martino, 16132 Genoa, Italy;
- DISC Department, University of Genoa, 16126 Genoa, Italy
| | - Michele Di Mauro
- CARIM Maastricht University, 6229 ER Maastricht, The Netherlands;
| | - Laura Labate
- Department of Health Sciences (DISSAL), University of Genoa, 16126 Genoa, Italy;
- Infectious Diseases Unit, Ospedale Policlinico San Martino-IRCCS, 16132 Genoa, Italy
| | - Alessandro Della Corte
- Unit of Cardiac Surgery, Department of Translational Medical Sciences, Monaldi Hospital, University of Campania “L. Vanvitelli”, 80131 Naples, Italy; (A.D.C.); (F.L.P.)
| | - Federica Lo Presti
- Unit of Cardiac Surgery, Department of Translational Medical Sciences, Monaldi Hospital, University of Campania “L. Vanvitelli”, 80131 Naples, Italy; (A.D.C.); (F.L.P.)
| | - Michele De Bonis
- IRCCS Ospedale San Raffaele, Division of Cardiac Surgery, Università Vita-Salute San Raffaele, 20132 Milan, Italy; (M.D.B.)
| | - Cinzia Trumello
- IRCCS Ospedale San Raffaele, Division of Cardiac Surgery, Università Vita-Salute San Raffaele, 20132 Milan, Italy; (M.D.B.)
| | - Mauro Rinaldi
- Cardiac Surgery, Molinette Hospital, University of Turin, 10124 Turin, Italy; (M.R.)
| | - Erik Cura Stura
- Cardiac Surgery, Molinette Hospital, University of Turin, 10124 Turin, Italy; (M.R.)
| | | | - Giuseppe Punta
- Cardiac Surgery, Mauriziano Hospital, 10128 Turin, Italy; (G.A.D.); (G.P.)
| | - Francesco Nicolini
- Cardiac Surgery, Maggiore University Hospital, University of Parma, 43121 Parma, Italy; (F.N.); (D.C.)
| | - Davide Carino
- Cardiac Surgery, Maggiore University Hospital, University of Parma, 43121 Parma, Italy; (F.N.); (D.C.)
| | - Carlo De Vincentiis
- Cardiac Surgery, San Donato IRCCS Hospital, San Donato Milanese, 20097 Milan, Italy; (C.D.V.); (A.G.)
| | - Andrea Garatti
- Cardiac Surgery, San Donato IRCCS Hospital, San Donato Milanese, 20097 Milan, Italy; (C.D.V.); (A.G.)
| | | | - Andrea Musazzi
- Cardiac Surgery, University Hospital, 21100 Varese, Italy; (G.C.); (A.M.)
| | - Diego Cugola
- Cardiac Surgery, AO Papa Giovanni XXIII, 24127 Bergamo, Italy; (D.C.); (M.M.)
| | - Maurizio Merlo
- Cardiac Surgery, AO Papa Giovanni XXIII, 24127 Bergamo, Italy; (D.C.); (M.M.)
| | - Davide Pacini
- Cardiac Surgery, S. Orsola-Malpighi University Hospital, University of Bologna, 40126 Bologna, Italy; (D.P.); (G.F.)
| | - Gianluca Folesani
- Cardiac Surgery, S. Orsola-Malpighi University Hospital, University of Bologna, 40126 Bologna, Italy; (D.P.); (G.F.)
| | - Sandro Sponga
- Cardiac Surgery, S. Maria Misericordia Hospital, University of Udine, 33100 Udine, Italy (I.V.)
| | - Igor Vendramin
- Cardiac Surgery, S. Maria Misericordia Hospital, University of Udine, 33100 Udine, Italy (I.V.)
| | | | - Francesco Rosato
- Cardiac Surgery, S. Croce Hospital, 12100 Cuneo, Italy; (A.P.C.); (F.R.); (F.B.)
| | - Elisa Mikus
- GVM Care & Research, Maria Cecilia Hospital, 48033 Cotignola, Italy; (E.M.); (C.S.)
| | - Carlo Savini
- GVM Care & Research, Maria Cecilia Hospital, 48033 Cotignola, Italy; (E.M.); (C.S.)
| | - Francesco Onorati
- Cardiac Surgery, University Hospital, University of Verona, 37129 Verona, Italy; (F.O.); (G.B.L.)
| | | | - Roberto Scrofani
- Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, 20122 Milano, Italy; (R.S.); (F.E.)
| | - Francesco Epifani
- Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, 20122 Milano, Italy; (R.S.); (F.E.)
| | - Francesco Musumeci
- Cardiac Surgery, San Camillo-Forlanini Hospital, 00152 Rome, Italy; (F.M.); (A.L.)
| | - Antonio Lio
- Cardiac Surgery, San Camillo-Forlanini Hospital, 00152 Rome, Italy; (F.M.); (A.L.)
| | - Andrea Colli
- Cardiac Surgery, AO Pisana University Hospital, University of Pisa, 56126 Pisa, Italy; (A.C.); (G.F.)
| | - Giosuè Falcetta
- Cardiac Surgery, AO Pisana University Hospital, University of Pisa, 56126 Pisa, Italy; (A.C.); (G.F.)
| | | | - Salvatore Zaccaria
- Cardiac Surgery, Vito Fazzi Hospital, 73100 Lecce, Italy; (S.N.); (S.Z.)
| | | | - Antonio Pantaleo
- Department of Cardiac Surgery, Azienda ULSS2 Ca’ Foncello Hospital, 31100 Treviso, Italy; (A.P.); (G.M.)
| | - Giuseppe Minniti
- Department of Cardiac Surgery, Azienda ULSS2 Ca’ Foncello Hospital, 31100 Treviso, Italy; (A.P.); (G.M.)
| | - Emmanuel Villa
- Department of Cardiac Surgery, Poliambulanza Foundation Hospital, 25124 Brescia, Italy; (E.V.); (M.D.T.)
| | - Margherita Dalla Tomba
- Department of Cardiac Surgery, Poliambulanza Foundation Hospital, 25124 Brescia, Italy; (E.V.); (M.D.T.)
| | - Francesco Pollari
- Cardiac Surgery, Klinikum Nürnberg–Paracelsus Medical University, 90419 Nuremberg, Germany;
| | - Fabio Barili
- Cardiac Surgery, S. Croce Hospital, 12100 Cuneo, Italy; (A.P.C.); (F.R.); (F.B.)
| | - Alessandro Parolari
- Department of Universitary Cardiac Surgery and Translational Research, IRCCS Policlinico S. Donato, University of Milan, 20122 Milan, Italy
- Department of Biomedical Sciences for Health, Università di Milano, 20122 Milan, Italy
| | - Roberto Lorusso
- Cardio-Thoracic Surgery Department, Heart & Vascular Centre, Maastricht University Medical Centre, 6229 HX Maastricht, The Netherlands;
| | - Francesco Santini
- Division of Cardiac Surgery, Ospedale Policlinico San Martino, 16132 Genoa, Italy;
- DISC Department, University of Genoa, 16126 Genoa, Italy
| |
Collapse
|
2
|
Muneretto C, Di Bacco L, Di Eusanio M, Folliguet T, Rosati F, D'Alonzo M, Cugola D, Curello S, Palacios CM, Baudo M, Pollari F, Fischlein T. Sutureless and Rapid Deployment vs. Transcatheter Valves for Aortic Stenosis in Low-Risk Patients: Mid-Term Results. J Clin Med 2023; 12:4045. [PMID: 37373738 DOI: 10.3390/jcm12124045] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 06/07/2023] [Accepted: 06/12/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Recent trials showed that TAVI is neither inferior nor superior to surgical aortic valve replacement. The aim of this study was to evaluate the outcomes of Sutureless and Rapid Deployment Valves (SuRD-AVR) when compared to TAVI in low surgical risk patients with isolated aortic stenosis. METHODS Data from five European Centers were retrospectively collected. We included 1306 consecutive patients at low surgical risk (EUROSCORE II < 4) who underwent aortic valve replacement by means of SuRD-AVR (n = 636) or TAVI (n = 670) from 2014 to 2019. A 1:1 nearest-neighbor propensity-score was performed, and two balanced groups of 346 patients each were obtained. The primary endpoints of the study were: 30-day mortality and 5-year overall survival. The secondary endpoint was 5-year survival freedom from major adverse cardiovascular and cerebrovascular events (MACCEs). RESULTS Thirty-day mortality was similar between the two groups (SuRD-AVR:1.7%, TAVI:2.0%, p = 0.779), while the TAVI group showed a significantly lower 5-year overall survival and survival freedom from MACCEs (5-year matched overall survival: SuRD-AVR: 78.5%, TAVI: 62.9%, p = 0.039; 5-year matched freedom from MACCEs: SuRD-AVR: 64.6%, TAVI: 48.7%, p = 0.004). The incidence of postoperative permanent pacemaker implantation (PPI) and paravalvular leak grade ≥ 2 (PVL) were higher in the TAVI group. Multivariate Cox Regression analysis identified PPI as an independent predictor for mortality. CONCLUSIONS TAVI patients had a significantly lower five-year survival and survival freedom from MACCEs with a higher rate of PPI and PVL ≥ 2 when compared to SuRD-AVR.
Collapse
Affiliation(s)
- Claudio Muneretto
- Division of Cardiac Surgery, University of Brescia Medical School, 250123 Brescia, Italy
| | - Lorenzo Di Bacco
- Division of Cardiac Surgery, University of Brescia Medical School, 250123 Brescia, Italy
| | | | - Thierry Folliguet
- Service de Chirurgie Thoracique et Cardio-Vasculaire, Hôpital H. Mondor, 94010 Créteil, France
| | - Fabrizio Rosati
- Division of Cardiac Surgery, University of Brescia Medical School, 250123 Brescia, Italy
| | - Michele D'Alonzo
- Division of Cardiac Surgery, University of Brescia Medical School, 250123 Brescia, Italy
| | - Diego Cugola
- Cardiac Surgery Unit, ASST Papa Giovanni XXIII, 24127 Bergamo, Italy
| | - Salvatore Curello
- Cardiac Catheterization Laboratory, Spedali Civili, 250123 Brescia, Italy
| | | | - Massimo Baudo
- Division of Cardiac Surgery, University of Brescia Medical School, 250123 Brescia, Italy
| | - Francesco Pollari
- Cardiac Surgery Department, Klinikum Nürnberg-Paracelsus Medical University, 90419 Nürnberg, Germany
| | - Theodor Fischlein
- Cardiac Surgery Department, Klinikum Nürnberg-Paracelsus Medical University, 90419 Nürnberg, Germany
| |
Collapse
|
3
|
Di Mauro M, Bonalumi G, Giambuzzi I, Dato GMA, Centofanti P, Corte AD, Ratta ED, Cugola D, Merlo M, 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, Pano M, Nicolardi S, Falcetta G, Colli A, Musumeci F, Gherli R, Vizzardi E, Salvador L, Picichè M, Paparella D, Margari V, Troise G, Villa E, Dossena Y, Lucarelli C, Onorati F, Faggian G, Mariscalco G, Maselli D, Barili F, Parolari A, Lorusso R. Similar outcome of tricuspid valve repair and replacement for isolated tricuspid infective endocarditis. J Cardiovasc Med (Hagerstown) 2022; 23:406-413. [PMID: 35645032 DOI: 10.2459/jcm.0000000000001310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AIMS To compare early and late mortality of acute isolated tricuspid valve infective endocarditis (TVIE) treated with valve repair or replacement. METHODS Patients who were surgically treated for TVIE from 1983 to 2018 were retrieved from the Italian Registry for Surgical Treatment of Valve and Prosthesis Infective Endocarditis. All the patients were followed up by means of phone interview or calling patient referral physicians or cardiologists. Kaplan-Meier method was used to assess late survival and survival free from TVIE recurrence with log-rank test for univariate comparison. The primary end points were early mortality (30 days after surgery) and long-term survival free from TVIE recurrence. RESULTS A total of 4084 patients were included in the registry. Among them, 149 patients were included in the study. Overall, 77 (51.7%) underwent TV repair and 72 (48.3%) TV replacement. Early mortality was 9% (13 patients). Expected early mortality according to EndoSCORE was 12%. The TV repair showed lower mortality and major complication rate (7% and 16%), compared with TV replacement (11% and 25%), but statistical significance was not reached. Median follow-up was 19.1 years (14.3-23.8). Late deaths were 30 and IE recurrences were 5. No difference in cardiac survival free from IE was found between the two groups after 20 years (80 ± 6% Repair Group vs 59 ± 13% Replacement Group, P = 0.3). CONCLUSIONS Overall results indicate that once surgically addressed, TVIE has a low recurrence rate and excellent survival, apparently regardless of the type of surgery used to treat it.
Collapse
Affiliation(s)
- Michele Di Mauro
- Cardio-Thoracic Surgery Department, Heart & Vascular Centre, Maastricht University Medical Centre, Maastricht, The Netherlands
| | | | | | | | | | | | | | - Diego Cugola
- Cardiac Surgery, AO Papa Giovanni XXIII, Bergamo
| | | | | | - Antonio Salsano
- Cardiac Surgery, IRCCS San Martino-IST, University Hospital, Genova
| | - Mauro Rinaldi
- Cardiac Surgery, Molinette Hospital, University of Turin, Turin
| | - Samuel Mancuso
- Cardiac Surgery, Molinette Hospital, University of Turin, Turin
| | | | | | | | - Andrea Biondi
- Cardiac Surgery, San Donato IRCCS Hospital, San Donato Milanese, Milan
| | - Ugolino Livi
- Cardiac Surgery, S. Maria Misericordia Hospital, University of Udine, Udine
| | - Sandro Sponga
- Cardiac Surgery, S. Maria Misericordia Hospital, University of Udine, Udine
| | - Davide Pacini
- Cardiac Surgery, S. Orsola-Malpighi University Hospital, University of Bologna, Bologna
| | - Giacomo Murana
- Cardiac Surgery, S. Orsola-Malpighi University Hospital, University of Bologna, Bologna
| | | | - Carlo Antona
- Cardiac Surgery, Sacco Hospital, University of Milan, Milan
| | | | - Francesco Nicolini
- Cardiac Surgery, Maggiore University Hospital, University of Parma, Parma
| | - Filippo Benassi
- Cardiac Surgery, Maggiore University Hospital, University of Parma, Parma
| | | | | | - Marco Pano
- Cardiac Surgery, Vito Fazi Hospital, Lecce
| | | | - Giosuè Falcetta
- Cardiac Surgery, AO Pisana University Hospital, University of Pisa, Pisa
| | - Andrea Colli
- Cardiac Surgery, AO Pisana University Hospital, University of Pisa, Pisa
| | | | | | | | | | | | | | | | | | | | | | - Carla Lucarelli
- Cardiac Surgery, University Hospital, University of Verona, Verona, Italy
| | - Francesco Onorati
- Cardiac Surgery, University Hospital, University of Verona, Verona, Italy
| | - Giuseppe Faggian
- Cardiac Surgery, University Hospital, University of Verona, Verona, Italy
| | | | | | | | - Alessandro Parolari
- Department of Universitary Cardiac Surgery, IRCCS Policlinico San Donato, San Donato Milanese.,Department of Biomedical Sciences for Health, Università di Milano, Milan, Italy
| | - Roberto Lorusso
- Cardio-Thoracic Surgery Department, Heart & Vascular Centre, Maastricht University Medical Centre, Maastricht, The Netherlands
| | | |
Collapse
|
4
|
Buoro S, Tombetti E, Ceriotti F, Simon C, Cugola D, Seghezzi M, Innocente F, Maestroni S, del Carmen Baigorria Vaca M, Moioli V, Previtali G, Manenti B, Adler Y, Imazio M, Brucato A. What is the normal composition of pericardial fluid? Heart 2020; 107:1584-1590. [DOI: 10.1136/heartjnl-2020-317966] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 10/04/2020] [Accepted: 10/07/2020] [Indexed: 12/21/2022] Open
Abstract
ObjectiveBiochemical and cytological pericardial fluid (PF) analysis is essentially based on the knowledge of pleural fluid composition. The aim of the present study is to identify reference intervals (RIs) for PF according to state-of-art methodological standards.MethodsWe prospectively collected and analysed the PF and venous blood of consecutive subjects undergoing elective open-heart surgery from July 2017 to October 2018. Exclusion criteria for study enrolment were evidence of pericardial diseases at preoperatory workup or at intraoperatory assessment, or any other condition that could affect PF analysis.ResultsThe final study sample included 120 patients (median age 69 years, 83 men, 69.1%). The main findings were (1) High levels of proteins, albumin and lactate dehydrogenase (LDH), but not of glucose and cholesterol (2) High cellularity, mainly represented by mesothelial cells. RIs for pericardial biochemistry were: protein content 1.7–4.6 g/dL PF/serum protein ratio 0.29–0.83, albumin 1.19–3.06 g/dL, pericardium-to-serum albumin gradient 0.18–2.37 g/dL, LDH 141–2613 U/L, PF/serum LDH ratio 0.40–2.99, glucose 80–134 mg/dL, total cholesterol 12–69 mg/dL, PF/serum cholesterol ratio 0.07–0.51. RIs for pericardial cells by optic microscopy were: 278–5608 × 106 nucleated cells/L, 40–3790 × 106 mesothelial cells/L, 35–2210 × 106 leucocytes/L, 19–1634 × 106 lymphocytes/L.ConclusionsPF is rich in nucleated cells, protein, albumin, LDH, at levels consistent with inflammatory exudates in other biological fluids. Physicians should stop to interpret PF as exudate or transudate according to tools not validated for this setting.
Collapse
|
5
|
Sponga S, Di Mauro M, Malvindi PG, Paparella D, Murana G, Pacini D, Weltert L, De Paulis R, Cappabianca G, Beghi C, De Vincentiis C, Parolari A, Messina A, Troise G, Salsano A, Santini F, Pierri MD, Di Eusanio M, Maselli D, Actis Dato G, Centofanti P, Mancuso S, Rinaldi M, Cagnoni G, Antona C, Picichè M, Salvador L, Cugola D, Galletti L, Pozzoli A, De Bonis M, Lorusso R, Bortolotti U, Livi U. Surgery for Bentall endocarditis: short- and midterm outcomes from a multicentre registry. Eur J Cardiothorac Surg 2020; 58:839-846. [DOI: 10.1093/ejcts/ezaa136] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 03/03/2020] [Accepted: 03/09/2020] [Indexed: 01/17/2023] Open
Abstract
Abstract
OBJECTIVES
Endocarditis after the Bentall procedure is a severe disease often complicated by a pseudoaneurysm or mediastinitis. Reoperation is challenging but conservative therapy is not effective. The aim of this study was to assess short- and midterm outcomes of patients reoperated on for Bentall-related endocarditis.
METHODS
Seventy-three patients with Bentall procedure-related endocarditis were recorded in the Italian registry. The mean age was 57 ± 14 years and 92% were men; preoperative comorbidities included hypertension (45%), diabetes (12%) and renal failure (11%). The logistic EuroSCORE was 25%; the EuroSCORE II was 8%.
RESULTS
Preoperatively, 12% of the patients were in septic shock; left ventricular-aortic discontinuity was present in 63% and mitral valve involvement occurred in 12%. The most common pathogens were Staphylococcus aureus (22%) and Streptococci (14%). Reoperations after a median interval of 30 months (1–221 months) included a repeat Bentall with a bioconduit (41%), a composite mechanical (33%) or biological valved conduit (19%) and a homograft (6%). In 1 patient, a heart transplant was required (1%); in 12%, a mitral valve procedure was needed. The hospital mortality rate was 15%. The postoperative course was complicated by renal failure (19%), major bleeding (14%), pulmonary failure (14%), sepsis (11%) and multiorgan failure (8%). At multivariate analysis, urgent surgery was a risk factor for early death [hazard ratio 20.5 (1.9–219)]. Survival at 5 and 8 years was 75 ± 6% and 71 ± 7%, with 3 cases of endocarditis relapse.
CONCLUSIONS
Surgery is effective in treating endocarditis following the Bentall procedure although it is associated with high perioperative mortality and morbidity rates. Endocarditis relapse seems to be uncommon.
Collapse
Affiliation(s)
- Sandro Sponga
- Cardiothoracic Department, University Hospital of Udine, DAME Udine Medical School, Udine, Italy
| | - Michele Di Mauro
- Cardiac Surgery, University “G. D’Annunzio” Chieti-Pescara, Chieti, Italy
| | - Pietro G Malvindi
- Division of Cardiac Surgery, Santa Maria Hospital, GVM Care & Research, Bari, Italy
| | - Domenico Paparella
- Division of Cardiac Surgery, Santa Maria Hospital, GVM Care & Research, Bari, Italy
| | - Giacomo Murana
- Cardiac Surgery, S. Orsola-Malpighi University Hospital, University of Bologna, Bologna, Italy
| | - Davide Pacini
- Cardiac Surgery, S. Orsola-Malpighi University Hospital, University of Bologna, Bologna, Italy
| | | | | | | | - Cesare Beghi
- Cardiac Surgery, University Hospital, Varese, Italy
| | - Carlo De Vincentiis
- Cardiac Surgery, San Donato IRCCS Hospital, San Donato Milanese, Milan, Italy
| | - Alessandro Parolari
- Cardiac Surgery, San Donato IRCCS Hospital, San Donato Milanese, Milan, Italy
| | - Antonio Messina
- Cardiac Surgery, Poliambulanza Foundation Hospital, Brescia, Italy
| | - Giovanni Troise
- Cardiac Surgery, Poliambulanza Foundation Hospital, Brescia, Italy
| | - Antonio Salsano
- Cardiac Surgery, IRCCS San Martino-IST, University Hospital, Genova, Italy
| | - Francesco Santini
- Cardiac Surgery, IRCCS San Martino-IST, University Hospital, Genova, Italy
| | - Michele D Pierri
- Cardiac Surgery, Ospedali Riuniti “Umberto I-Lancisi-Salesi”, Ancona, Italy
| | - Marco Di Eusanio
- Cardiac Surgery, Ospedali Riuniti “Umberto I-Lancisi-Salesi”, Ancona, Italy
| | | | | | | | - Samuel Mancuso
- Cardiac Surgery, Molinette Hospital, University of Turin, Turin, Italy
| | - Mauro Rinaldi
- Cardiac Surgery, Molinette Hospital, University of Turin, Turin, Italy
| | - Giuseppe Cagnoni
- Cardiac Surgery, Sacco Hospital, University of Milan, Milan, Italy
| | - Carlo Antona
- Cardiac Surgery, Sacco Hospital, University of Milan, Milan, Italy
| | | | | | - Diego Cugola
- Cardiac Surgery, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | | | - Alberto Pozzoli
- Cardiac Surgery, Vita e Salute San Raffaele University, IRCCS San Raffaele Hospital, Milan, Italy
| | - Michele De Bonis
- Cardiac Surgery, Vita e Salute San Raffaele University, IRCCS San Raffaele Hospital, Milan, Italy
| | - Roberto Lorusso
- Cardio-Thoracic Surgery Department, Heart & Vascular Centre, Cardiovascular Research Institute, Maastricht, Netherlands
| | | | - Ugolino Livi
- Cardiothoracic Department, University Hospital of Udine, DAME Udine Medical School, Udine, Italy
| | | |
Collapse
|
6
|
Di Mauro M, Foschi M, Dato GMA, Centofanti P, Barili F, Corte AD, Ratta ED, 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, Picichè 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. Surgical treatment of isolated tricuspid valve infective endocarditis: 25-year results from a multicenter registry. Int J Cardiol 2019; 292:62-67. [DOI: 10.1016/j.ijcard.2019.05.020] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 04/02/2019] [Accepted: 05/06/2019] [Indexed: 01/13/2023]
|
7
|
Buoro S, Seghezzi M, Baigorria Vaca MDC, Manenti B, Moioli V, Previtali G, Simon C, Cugola D, Brucato A, Ottomano C, Lippi G. Comparison between optical microscopy and automation for cytometric analysis of pericardial fluids in a cohort of adult subjects undergoing cardiac surgery. J Clin Pathol 2019; 72:493-500. [DOI: 10.1136/jclinpath-2019-205788] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 03/28/2019] [Accepted: 03/28/2019] [Indexed: 01/04/2023]
Abstract
AimsLimited information is available on number and type of cells present in the pericardial fluid (PF). Current evidence and has been garnered with inaccurate application of guidelines for analysis of body fluids. This study was aimed at investigating the performance of automate cytometric analysis of PF in adult subjects.MethodsSeventy-four consecutive PF samples were analysed with Sysmex XN with a module for body fluid analysis (XN-BF) and optical microscopy (OM). The study also encompassed the assessment of limit of blank, limit of detection and limit of quantitation (LoQ), imprecision, carryover and linearity of XN-BF module.ResultsXN-BF parameters were compared with OM for the following cell classes: total cells (TC), leucocytes (white blood cell [WBC]), polymorphonuclear (PMN) and mononuclear (MN) cells. The relative bias were −4.5%, 71.2%, 108.2% and −47.7%, respectively. Passing and Bablok regression yielded slope comprised between 0.06 for MN and 5.8 for PMN, and intercept between 0.7 for PMN and 220.3 for MN. LoQ was comprised between 3.8×106 and 6.0×106 cells/L for WBC and PMN. Linearity was acceptable and carryover negligible.ConclusionsPF has a specific cellular composition. Overall, automated cell counting can only be suggested for total number of cells, whereas OM seems still the most reliable option for cell differentiation.
Collapse
|
8
|
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, 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, Livi U. OC69 SURGERY FOR BENTALL ENDOCARDITIS. J Cardiovasc Med (Hagerstown) 2018. [DOI: 10.2459/01.jcm.0000549877.33309.a0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
|
9
|
Di Mauro M, Dato GA, Barili F, Corte AD, Ratta ED, 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, Lorusso R. OC71 SURGICAL TREATMENT FOR ISOLATED TRICUSPID VALVE INFECTIVE ENDOCARDITIS. 25-YEAR RESULTS. J Cardiovasc Med (Hagerstown) 2018. [DOI: 10.2459/01.jcm.0000549876.95190.c5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
|
10
|
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, Nappi G. Surgery for prosthetic valve endocarditis: a retrospective study of a national registry. Eur J Cardiothorac Surg 2018; 52:105-111. [PMID: 28329161 DOI: 10.1093/ejcts/ezx045] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2016] [Accepted: 01/21/2017] [Indexed: 12/13/2022] Open
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.
Collapse
Affiliation(s)
- Alessandro Della Corte
- Italian Group for Research on Surgical Outcomes (GIROC), Italian Society of Cardiac Surgery (SICCH), Rome, Italy
| | - Michele Di Mauro
- Italian Group for Research on Surgical Outcomes (GIROC), Italian Society of Cardiac Surgery (SICCH), Rome, Italy
| | - Guglielmo Actis Dato
- Italian Group for Research on Surgical Outcomes (GIROC), Italian Society of Cardiac Surgery (SICCH), Rome, Italy
| | - Fabio Barili
- Italian Group for Research on Surgical Outcomes (GIROC), Italian Society of Cardiac Surgery (SICCH), Rome, Italy
| | - Diego Cugola
- Italian Group for Research on Surgical Outcomes (GIROC), Italian Society of Cardiac Surgery (SICCH), Rome, Italy
| | - Sandro Gelsomino
- Italian Group for Research on Surgical Outcomes (GIROC), Italian Society of Cardiac Surgery (SICCH), Rome, Italy
| | - Pasquale Santè
- Italian Group for Research on Surgical Outcomes (GIROC), Italian Society of Cardiac Surgery (SICCH), Rome, Italy
| | - Antonio Carozza
- Italian Group for Research on Surgical Outcomes (GIROC), Italian Society of Cardiac Surgery (SICCH), Rome, Italy
| | - Ester Della Ratta
- Italian Group for Research on Surgical Outcomes (GIROC), Italian Society of Cardiac Surgery (SICCH), Rome, Italy
| | - Lorenzo Galletti
- Italian Group for Research on Surgical Outcomes (GIROC), Italian Society of Cardiac Surgery (SICCH), Rome, Italy
| | - Roger Devotini
- Italian Group for Research on Surgical Outcomes (GIROC), Italian Society of Cardiac Surgery (SICCH), Rome, Italy
| | - Riccardo Casabona
- Italian Group for Research on Surgical Outcomes (GIROC), Italian Society of Cardiac Surgery (SICCH), Rome, Italy
| | - Francesco Santini
- Italian Group for Research on Surgical Outcomes (GIROC), Italian Society of Cardiac Surgery (SICCH), Rome, Italy
| | - Antonio Salsano
- Italian Group for Research on Surgical Outcomes (GIROC), Italian Society of Cardiac Surgery (SICCH), Rome, Italy
| | - Roberto Scrofani
- Italian Group for Research on Surgical Outcomes (GIROC), Italian Society of Cardiac Surgery (SICCH), Rome, Italy
| | - Carlo Antona
- Italian Group for Research on Surgical Outcomes (GIROC), Italian Society of Cardiac Surgery (SICCH), Rome, Italy
| | - Carlo De Vincentiis
- Italian Group for Research on Surgical Outcomes (GIROC), Italian Society of Cardiac Surgery (SICCH), Rome, Italy
| | - Andrea Biondi
- Italian Group for Research on Surgical Outcomes (GIROC), Italian Society of Cardiac Surgery (SICCH), Rome, Italy
| | - Cesare Beghi
- Italian Group for Research on Surgical Outcomes (GIROC), Italian Society of Cardiac Surgery (SICCH), Rome, Italy
| | - Giangiuseppe Cappabianca
- Italian Group for Research on Surgical Outcomes (GIROC), Italian Society of Cardiac Surgery (SICCH), Rome, Italy
| | - Michele De Bonis
- Italian Group for Research on Surgical Outcomes (GIROC), Italian Society of Cardiac Surgery (SICCH), Rome, Italy
| | - Alberto Pozzoli
- Italian Group for Research on Surgical Outcomes (GIROC), Italian Society of Cardiac Surgery (SICCH), Rome, Italy
| | - Francesco Nicolini
- Italian Group for Research on Surgical Outcomes (GIROC), Italian Society of Cardiac Surgery (SICCH), Rome, Italy
| | - Filippo Benassi
- Italian Group for Research on Surgical Outcomes (GIROC), Italian Society of Cardiac Surgery (SICCH), Rome, Italy
| | - Davide Pacini
- Italian Group for Research on Surgical Outcomes (GIROC), Italian Society of Cardiac Surgery (SICCH), Rome, Italy
| | - Roberto Di Bartolomeo
- Italian Group for Research on Surgical Outcomes (GIROC), Italian Society of Cardiac Surgery (SICCH), Rome, Italy
| | - Andrea De Martino
- Italian Group for Research on Surgical Outcomes (GIROC), Italian Society of Cardiac Surgery (SICCH), Rome, Italy
| | - Uberto Bortolotti
- Italian Group for Research on Surgical Outcomes (GIROC), Italian Society of Cardiac Surgery (SICCH), Rome, Italy
| | - Roberto Lorusso
- Italian Group for Research on Surgical Outcomes (GIROC), Italian Society of Cardiac Surgery (SICCH), Rome, Italy
| | - Enrico Vizzardi
- Italian Group for Research on Surgical Outcomes (GIROC), Italian Society of Cardiac Surgery (SICCH), Rome, Italy
| | - Gabriele Di Giammarco
- Italian Group for Research on Surgical Outcomes (GIROC), Italian Society of Cardiac Surgery (SICCH), Rome, Italy
| | - Daniele Marinelli
- Italian Group for Research on Surgical Outcomes (GIROC), Italian Society of Cardiac Surgery (SICCH), Rome, Italy
| | - Emmanuel Villa
- Italian Group for Research on Surgical Outcomes (GIROC), Italian Society of Cardiac Surgery (SICCH), Rome, Italy
| | - Giovanni Troise
- Italian Group for Research on Surgical Outcomes (GIROC), Italian Society of Cardiac Surgery (SICCH), Rome, Italy
| | - Domenico Paparella
- Italian Group for Research on Surgical Outcomes (GIROC), Italian Society of Cardiac Surgery (SICCH), Rome, Italy
| | - Vito Margari
- Italian Group for Research on Surgical Outcomes (GIROC), Italian Society of Cardiac Surgery (SICCH), Rome, Italy
| | - Francesco Tritto
- Italian Group for Research on Surgical Outcomes (GIROC), Italian Society of Cardiac Surgery (SICCH), Rome, Italy
| | - Girolamo Damiani
- Italian Group for Research on Surgical Outcomes (GIROC), Italian Society of Cardiac Surgery (SICCH), Rome, Italy
| | - Giuseppe Scrascia
- Italian Group for Research on Surgical Outcomes (GIROC), Italian Society of Cardiac Surgery (SICCH), Rome, Italy
| | - Salvatore Zaccaria
- Italian Group for Research on Surgical Outcomes (GIROC), Italian Society of Cardiac Surgery (SICCH), Rome, Italy
| | - Attilio Renzulli
- Italian Group for Research on Surgical Outcomes (GIROC), Italian Society of Cardiac Surgery (SICCH), Rome, Italy
| | - Giuseppe Serraino
- Italian Group for Research on Surgical Outcomes (GIROC), Italian Society of Cardiac Surgery (SICCH), Rome, Italy
| | - Giovanni Mariscalco
- Italian Group for Research on Surgical Outcomes (GIROC), Italian Society of Cardiac Surgery (SICCH), Rome, Italy
| | - Daniele Maselli
- Italian Group for Research on Surgical Outcomes (GIROC), Italian Society of Cardiac Surgery (SICCH), Rome, Italy
| | - Alessandro Parolari
- Italian Group for Research on Surgical Outcomes (GIROC), Italian Society of Cardiac Surgery (SICCH), Rome, Italy
| | - Giannantonio Nappi
- Italian Group for Research on Surgical Outcomes (GIROC), Italian Society of Cardiac Surgery (SICCH), Rome, Italy
| |
Collapse
|
11
|
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, Nappi G. 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]. Int J Cardiol 2018; 258:337. [PMID: 29398138 DOI: 10.1016/j.ijcard.2018.01.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Michele Di Mauro
- Cardiac Surgery, University "G. D'Annunzio" Chieti-Pescara, Chieti, Italy.
| | | | - Fabio Barili
- Cardiac Surgery, S. Croce Hospital, Cuneo, Italy
| | - Sandro Gelsomino
- Cardio-Thoracic Surgery Department, Heart & Vascular Centre, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Pasquale Santè
- Cardiothoracic Sciences, Second University of Naples, Naples, Italy
| | | | - Antonio Carrozza
- Cardiothoracic Sciences, Second University of Naples, Naples, Italy
| | | | - Diego Cugola
- Cardiac Surgery, AO, Papa Giovanni XXIII, Bergamo, Italy
| | | | | | | | - Francesco Santini
- Cardiac Surgery, IRCCS San Martino-IST, University Hospital, Genova, Italy
| | - Antonio Salsano
- Cardiac Surgery, IRCCS San Martino-IST, University Hospital, Genova, Italy
| | - Roberto Scrofani
- Cardiac Surgery, Sacco Hospital, University of Milan, Milan, Italy
| | - Carlo Antona
- Cardiac Surgery, Sacco Hospital, University of Milan, Milan, Italy
| | - Luca Botta
- Cardiac Surgery, Niguarda Hospital, Milan, Italy
| | | | - Samuel Mancuso
- Cardiac Surgery, Molinette Hospital, University of Turin, Turin, Italy
| | - Mauro Rinaldi
- Cardiac Surgery, Molinette Hospital, University of Turin, Turin, Italy
| | - Carlo De Vincentiis
- Cardiac Surgery, San Donato IRCCS Hospital, San Donato Milanese, Milan, Italy
| | - Andrea Biondi
- Cardiac Surgery, San Donato IRCCS Hospital, San Donato Milanese, Milan, Italy
| | - Cesare Beghi
- Cardiac Surgery, University Hospital, Varese, Italy
| | | | | | - Gino Gerosa
- Cardiac Surgery, University Hospital, Padua, Italy
| | | | | | - Francesco Nicolini
- Cardiac Surgery, Maggiore University Hospital, University of Parma, Italy
| | - Filippo Benassi
- Cardiac Surgery, Maggiore University Hospital, University of Parma, Italy
| | | | - Elena Grasso
- Cardiac Surgery, S. Croce Hospital, Cuneo, Italy
| | - Ugolino Livi
- Cardiac Surgery, S. Maria Misericordia Hospital, University of Udine, Udine, Italy
| | - Sandro Sponga
- Cardiac Surgery, S. Maria Misericordia Hospital, University of Udine, Udine, Italy
| | - Davide Pacini
- Cardiac Surgery, S. Orsola-Malpighi University Hospital, University of Bologna, Bologna, Italy
| | - Roberto Di Bartolomeo
- Cardiac Surgery, S. Orsola-Malpighi University Hospital, University of Bologna, Bologna, Italy
| | - Andrea DeMartino
- Cardiac Surgery, AO Pisana University Hospital, University of Pisa, Pisa, Italy
| | - Uberto Bortolotti
- Cardiac Surgery, AO Pisana University Hospital, University of Pisa, Pisa, Italy
| | - Francesco Onorati
- Cardiac Surgery, University Hospital, University of Verona, Verona, Italy
| | - Giuseppe Faggian
- Cardiac Surgery, University Hospital, University of Verona, Verona, Italy
| | - Roberto Lorusso
- Cardio-Thoracic Surgery Department, Heart & Vascular Centre, Maastricht University Medical Centre, Maastricht, The Netherlands
| | | | | | - Daniele Marinelli
- Cardiac Surgery, University "G. D'Annunzio" Chieti-Pescara, Chieti, Italy
| | | | | | - Marco Picichè
- Cardiac Surgery, San Camillo-Forlanini Hospital, Rome, Italy
| | | | - Domenico Paparella
- Cardiac Surgery, University Hospital, University "Aldo Moro", Bari, Italy
| | - Vito Margari
- Cardiac Surgery, University Hospital, University "Aldo Moro", Bari, Italy
| | - Francesco Tritto
- Cardiac Surgery, S. Anna e S. Sebastiano Hospital, Caserta, Italy
| | - Girolamo Damiani
- Cardiac Surgery, S. Anna e S. Sebastiano Hospital, Caserta, Italy
| | | | | | - Attilio Renzulli
- Cardiac Surgery, University Hospital, University "Magna Grecia", Catanzaro, Italy
| | - Giuseppe Serraino
- Cardiac Surgery, University Hospital, University "Magna Grecia", Catanzaro, Italy
| | | | | | | | - Alessandro Parolari
- Cardiac Surgery, San Donato IRCCS Hospital, San Donato Milanese, Milan, Italy
| | | | | |
Collapse
|
12
|
Fino C, Iacovoni A, Pibarot P, Pepper JR, Ferrero P, Merlo M, Galletti L, Caputo M, Ferrazzi P, Anagnostopoulos C, Cugola D, Senni M, Bellavia D, Magne J. Exercise Hemodynamic and Functional Capacity After Mitral Valve Replacement in Patients With Ischemic Mitral Regurgitation. Circ Heart Fail 2018; 11:e004056. [DOI: 10.1161/circheartfailure.117.004056] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Accepted: 11/30/2017] [Indexed: 01/06/2023]
Abstract
Background
In patients with ischemic mitral regurgitation requiring mitral valve replacement (MVR), the choice of the prosthesis type is crucial. The exercise hemodynamic and functional capacity performance in patients with contemporary prostheses have never been investigated. To compare exercise hemodynamic and functional capacity between biological (MVRb) and mechanical (MVRm) prostheses.
Methods and Results
We analyzed 86 consecutive patients with ischemic mitral regurgitation who underwent MVRb (n=41) or MVRm (n=45) and coronary artery bypass grafting. All patients underwent preoperative resting echocardiography and 6-minute walking test. At follow-up, exercise stress echocardiography was performed, and the 6-minute walking test was repeated. Resting and exercise indexed effective orifice areas of MVRm were larger when compared with MVRb (resting: 1.30±0.2 versus 1.19±0.3 cm
2
/m
2
;
P
=0.03; exercise: 1.57±0.2 versus 1.18±0.3 cm
2
/m
2
;
P
=0.0001). The MVRm had lower exercise systolic pulmonary arterial pressure at follow-up compared with MVRb (41±5 versus 59±7 mm Hg;
P
=0.0001). Six-minute walking test distance was improved in the MVRm (pre-operative: 242±43, post-operative: 290±50 m;
P
=0.001), whereas it remained similar in the MVRb (pre-operative: 250±40, post-operative: 220±44 m;
P
=0.13). In multivariable analysis, type of prosthesis, exercise indexed effective orifice area, and systolic pulmonary arterial pressure were joint predictors of change in 6-minute walking test (ie, difference between baseline and follow-up).
Conclusions
In patients with ischemic mitral regurgitation, bioprostheses are associated with worse hemodynamic performance and reduced functional capacity, when compared with MVRm. Randomized studies with longer follow-up including quality of life and survival data are required to confirm these results.
Collapse
Affiliation(s)
- Carlo Fino
- >From the Cardiovascular Department, Ospedale Papa Giovanni XXIII, Bergamo, Italy (C.F., A.I., P.F., M.M., L.G., P.F., D.C., M.S.); Hypertrofic Cardiomyopathy Centre, Policlinico di Monza, Monza, Italy (P.F.); Québec Heart & Lung Institute, Department of Medicine, Laval University, Quebec City, QC, Canada (P.P.); Department of Cardiothoracic Surgery, Royal Brompton and Harefield Hospital, London, United Kingdom (J.R.P.); Bristol Royal Infirmary, University of Bristol, United Kingdom (M.C.)
| | - Attilio Iacovoni
- >From the Cardiovascular Department, Ospedale Papa Giovanni XXIII, Bergamo, Italy (C.F., A.I., P.F., M.M., L.G., P.F., D.C., M.S.); Hypertrofic Cardiomyopathy Centre, Policlinico di Monza, Monza, Italy (P.F.); Québec Heart & Lung Institute, Department of Medicine, Laval University, Quebec City, QC, Canada (P.P.); Department of Cardiothoracic Surgery, Royal Brompton and Harefield Hospital, London, United Kingdom (J.R.P.); Bristol Royal Infirmary, University of Bristol, United Kingdom (M.C.)
| | - Philippe Pibarot
- >From the Cardiovascular Department, Ospedale Papa Giovanni XXIII, Bergamo, Italy (C.F., A.I., P.F., M.M., L.G., P.F., D.C., M.S.); Hypertrofic Cardiomyopathy Centre, Policlinico di Monza, Monza, Italy (P.F.); Québec Heart & Lung Institute, Department of Medicine, Laval University, Quebec City, QC, Canada (P.P.); Department of Cardiothoracic Surgery, Royal Brompton and Harefield Hospital, London, United Kingdom (J.R.P.); Bristol Royal Infirmary, University of Bristol, United Kingdom (M.C.)
| | - John R. Pepper
- >From the Cardiovascular Department, Ospedale Papa Giovanni XXIII, Bergamo, Italy (C.F., A.I., P.F., M.M., L.G., P.F., D.C., M.S.); Hypertrofic Cardiomyopathy Centre, Policlinico di Monza, Monza, Italy (P.F.); Québec Heart & Lung Institute, Department of Medicine, Laval University, Quebec City, QC, Canada (P.P.); Department of Cardiothoracic Surgery, Royal Brompton and Harefield Hospital, London, United Kingdom (J.R.P.); Bristol Royal Infirmary, University of Bristol, United Kingdom (M.C.)
| | - Paolo Ferrero
- >From the Cardiovascular Department, Ospedale Papa Giovanni XXIII, Bergamo, Italy (C.F., A.I., P.F., M.M., L.G., P.F., D.C., M.S.); Hypertrofic Cardiomyopathy Centre, Policlinico di Monza, Monza, Italy (P.F.); Québec Heart & Lung Institute, Department of Medicine, Laval University, Quebec City, QC, Canada (P.P.); Department of Cardiothoracic Surgery, Royal Brompton and Harefield Hospital, London, United Kingdom (J.R.P.); Bristol Royal Infirmary, University of Bristol, United Kingdom (M.C.)
| | - Maurizio Merlo
- >From the Cardiovascular Department, Ospedale Papa Giovanni XXIII, Bergamo, Italy (C.F., A.I., P.F., M.M., L.G., P.F., D.C., M.S.); Hypertrofic Cardiomyopathy Centre, Policlinico di Monza, Monza, Italy (P.F.); Québec Heart & Lung Institute, Department of Medicine, Laval University, Quebec City, QC, Canada (P.P.); Department of Cardiothoracic Surgery, Royal Brompton and Harefield Hospital, London, United Kingdom (J.R.P.); Bristol Royal Infirmary, University of Bristol, United Kingdom (M.C.)
| | - Lorenzo Galletti
- >From the Cardiovascular Department, Ospedale Papa Giovanni XXIII, Bergamo, Italy (C.F., A.I., P.F., M.M., L.G., P.F., D.C., M.S.); Hypertrofic Cardiomyopathy Centre, Policlinico di Monza, Monza, Italy (P.F.); Québec Heart & Lung Institute, Department of Medicine, Laval University, Quebec City, QC, Canada (P.P.); Department of Cardiothoracic Surgery, Royal Brompton and Harefield Hospital, London, United Kingdom (J.R.P.); Bristol Royal Infirmary, University of Bristol, United Kingdom (M.C.)
| | - Massimo Caputo
- >From the Cardiovascular Department, Ospedale Papa Giovanni XXIII, Bergamo, Italy (C.F., A.I., P.F., M.M., L.G., P.F., D.C., M.S.); Hypertrofic Cardiomyopathy Centre, Policlinico di Monza, Monza, Italy (P.F.); Québec Heart & Lung Institute, Department of Medicine, Laval University, Quebec City, QC, Canada (P.P.); Department of Cardiothoracic Surgery, Royal Brompton and Harefield Hospital, London, United Kingdom (J.R.P.); Bristol Royal Infirmary, University of Bristol, United Kingdom (M.C.)
| | - Paolo Ferrazzi
- >From the Cardiovascular Department, Ospedale Papa Giovanni XXIII, Bergamo, Italy (C.F., A.I., P.F., M.M., L.G., P.F., D.C., M.S.); Hypertrofic Cardiomyopathy Centre, Policlinico di Monza, Monza, Italy (P.F.); Québec Heart & Lung Institute, Department of Medicine, Laval University, Quebec City, QC, Canada (P.P.); Department of Cardiothoracic Surgery, Royal Brompton and Harefield Hospital, London, United Kingdom (J.R.P.); Bristol Royal Infirmary, University of Bristol, United Kingdom (M.C.)
| | - Constantinos Anagnostopoulos
- >From the Cardiovascular Department, Ospedale Papa Giovanni XXIII, Bergamo, Italy (C.F., A.I., P.F., M.M., L.G., P.F., D.C., M.S.); Hypertrofic Cardiomyopathy Centre, Policlinico di Monza, Monza, Italy (P.F.); Québec Heart & Lung Institute, Department of Medicine, Laval University, Quebec City, QC, Canada (P.P.); Department of Cardiothoracic Surgery, Royal Brompton and Harefield Hospital, London, United Kingdom (J.R.P.); Bristol Royal Infirmary, University of Bristol, United Kingdom (M.C.)
| | - Diego Cugola
- >From the Cardiovascular Department, Ospedale Papa Giovanni XXIII, Bergamo, Italy (C.F., A.I., P.F., M.M., L.G., P.F., D.C., M.S.); Hypertrofic Cardiomyopathy Centre, Policlinico di Monza, Monza, Italy (P.F.); Québec Heart & Lung Institute, Department of Medicine, Laval University, Quebec City, QC, Canada (P.P.); Department of Cardiothoracic Surgery, Royal Brompton and Harefield Hospital, London, United Kingdom (J.R.P.); Bristol Royal Infirmary, University of Bristol, United Kingdom (M.C.)
| | - Michele Senni
- >From the Cardiovascular Department, Ospedale Papa Giovanni XXIII, Bergamo, Italy (C.F., A.I., P.F., M.M., L.G., P.F., D.C., M.S.); Hypertrofic Cardiomyopathy Centre, Policlinico di Monza, Monza, Italy (P.F.); Québec Heart & Lung Institute, Department of Medicine, Laval University, Quebec City, QC, Canada (P.P.); Department of Cardiothoracic Surgery, Royal Brompton and Harefield Hospital, London, United Kingdom (J.R.P.); Bristol Royal Infirmary, University of Bristol, United Kingdom (M.C.)
| | - Diego Bellavia
- >From the Cardiovascular Department, Ospedale Papa Giovanni XXIII, Bergamo, Italy (C.F., A.I., P.F., M.M., L.G., P.F., D.C., M.S.); Hypertrofic Cardiomyopathy Centre, Policlinico di Monza, Monza, Italy (P.F.); Québec Heart & Lung Institute, Department of Medicine, Laval University, Quebec City, QC, Canada (P.P.); Department of Cardiothoracic Surgery, Royal Brompton and Harefield Hospital, London, United Kingdom (J.R.P.); Bristol Royal Infirmary, University of Bristol, United Kingdom (M.C.)
| | - Julien Magne
- >From the Cardiovascular Department, Ospedale Papa Giovanni XXIII, Bergamo, Italy (C.F., A.I., P.F., M.M., L.G., P.F., D.C., M.S.); Hypertrofic Cardiomyopathy Centre, Policlinico di Monza, Monza, Italy (P.F.); Québec Heart & Lung Institute, Department of Medicine, Laval University, Quebec City, QC, Canada (P.P.); Department of Cardiothoracic Surgery, Royal Brompton and Harefield Hospital, London, United Kingdom (J.R.P.); Bristol Royal Infirmary, University of Bristol, United Kingdom (M.C.)
| |
Collapse
|
13
|
D’Onofrio A, Salizzoni S, Filippini C, Agrifoglio M, Alfieri O, Chieffo A, Tarantini G, Gabbieri D, Savini C, Immè S, Ribichini F, Cugola D, Raviola E, Loi B, Pompei E, Cappai A, Cassese M, Luzi G, Aiello M, Santini F, Rinaldi M, Gerosa G. Transapical aortic valve replacement is a safe option in patients with poor left ventricular ejection fraction: results from the Italian Transcatheter Balloon-Expandable Registry (ITER)†. Eur J Cardiothorac Surg 2017; 52:874-880. [DOI: 10.1093/ejcts/ezx227] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Accepted: 05/29/2017] [Indexed: 12/13/2022] Open
|
14
|
Salizzoni S, D'Onofrio A, Agrifoglio M, Colombo A, Chieffo A, Cioni M, Besola L, Regesta T, Rapetto F, Tarantini G, Napodano M, Gabbieri D, Saia F, Tamburino C, Ribichini F, Cugola D, Aiello M, Sanna F, Iadanza A, Pompei E, Stefàno P, Cappai A, Minati A, Cassese M, Martinelli GL, Agostinelli A, Fiorilli R, Casilli F, Reale M, Bedogni F, Petronio AS, Mozzillo RA, Bonmassari R, Briguori C, Liso A, Sardella G, Bruschi G, Fiorina C, Filippini C, Moretti C, D'Amico M, La Torre M, Conrotto F, Di Bartolomeo R, Gerosa G, Rinaldi M. Early and mid-term outcomes of 1904 patients undergoing transcatheter balloon-expandable valve implantation in Italy: results from the Italian Transcatheter Balloon-Expandable Valve Implantation Registry (ITER). Eur J Cardiothorac Surg 2016; 50:1139-1148. [PMID: 27406375 DOI: 10.1093/ejcts/ezw218] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Revised: 04/08/2016] [Accepted: 04/13/2016] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES The aim of this multicentre study is to report the clinical experiences of all patients undergoing transcatheter aortic valve implantation (TAVI) with a balloon-expandable device in Italy. METHODS The Italian Transcatheter balloon-Expandable valve Registry (ITER) is a real-world registry that includes patients who have undergone TAVI with the Sapien (Edwards Lifesciences, Irvine, CA, USA) bioprosthesis in Italy since it became available in clinical practice. From 2007 to 2012, 1904 patients were enrolled to undergo TAVI in 33 Italian centres. Outcomes were classified according to the updated Valve Academic Research Consortium (VARC-2) definitions. A multivariable analysis was performed to identify independent predictors of all-cause mortality. RESULTS Mean age was 81.7 (SD:6.2) years, and 1147 (60.2%) patients were female. Mean Logistic EuroSCORE was 21.1% (SD:13.7). Transfemoral, transapical, transaortic and transaxillary TAVI was performed in 1252 (65.8%), 630 (33.1%), 18 (0.9%) and 4 (0.2%) patients, respectively. Operative mortality was 7.2% (137 patients). The VARC-2 outcomes were as follows: device success, 88.1%; disabling stroke, 1.0%; life-threatening and major bleeding 9.8 and 10.5%, respectively; major vascular complication, 9.7%; acute kidney injury, 8.2%; acute myocardial infarction ≤72 h, 1.5%. Perioperative pacemaker implantation was necessary in 116 (6.1%) patients. At discharge, the mean transprosthetic gradient was 10.7 (SD:4.5) mmHg. Incidence of postoperative mild, moderate or severe paravalvular leak was, respectively, 32.1, 5.0 and 0.4%. A total of 444/1767 (25.1%) deaths after hospital discharge were reported: of these, 168 (37.8%) were classified as cardiac death. Preoperative independent predictors of all-cause mortality were male gender (HR: 1.395; 95% CI:1.052-1.849); overweight, BMI 25-30 kg/m2 (HR: 0.775; 95% CI: 0.616-0.974); serum creatinine level (every 1 mg/dl increase; HR: 1.314; 95% CI:1.167-1.480); haemoglobin level (every 1 g/dl increase; HR: 0.905; 95% CI:0.833-0.984); critical preoperative state (HR: 2.282; 95% CI: 1.384-3.761); neurological dysfunction (HR: 1.552; 95% CI:1.060-2.272); atrial fibrillation (HR: 1.556; 95% CI:1.213-1.995); pacemaker rhythm (HR: 1.948; 95% CI:1.310-2.896); NYHA Class III or IV (HR: 1.800; 95% CI:1.205-2.689 or HR: 2.331; 95% CI:1.392-3.903, respectively). CONCLUSIONS TAVI with a balloon-expandable device in the 'real world' shows good mid-term outcomes in terms of survival, technical success, valve-related adverse events and haemodynamic performance.
Collapse
Affiliation(s)
| | - Augusto D'Onofrio
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy
| | - Marco Agrifoglio
- Centro Cardiologico Monzino-Department of Clinical Sciences and Community, University of Milan, Milan, Italy
| | - Antonio Colombo
- Ospedale San Raffaele, Milano, Italy.,Casa di Cura Columbus, Milano, Italy
| | | | | | - Laura Besola
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy
| | - Tommaso Regesta
- Divisione di Cardiochirurgia, IRCCS San Martino-IST, Genova, Italy
| | - Filippo Rapetto
- Divisione di Cardiochirurgia, IRCCS San Martino-IST, Genova, Italy
| | - Giuseppe Tarantini
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy
| | - Massimo Napodano
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy
| | | | - Francesco Saia
- Cardio-Thoraco-Vascular Department, University Hospital Policlinico S. Orsola - Malpighi, Bologna, Italy
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Claudio Moretti
- Department of Surgical Sciences, University of Turin, Turin, Italy
| | | | | | | | - Roberto Di Bartolomeo
- Cardio-Thoraco-Vascular Department, University Hospital Policlinico S. Orsola - Malpighi, Bologna, Italy
| | - Gino Gerosa
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy
| | - Mauro Rinaldi
- Department of Surgical Sciences, University of Turin, Turin, Italy
| | | |
Collapse
|
15
|
Simon C, Grazioli L, Cugola D, Macchitelli V, Innocente F, Terzi A, Merlo M, Brucato AM, Lorini LM, Galletti L. Use of "LIMON Test" in Constrictive Pericarditis: a case series. J Cardiothorac Surg 2015. [PMCID: PMC4693943 DOI: 10.1186/1749-8090-10-s1-a37] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
|
16
|
Imazio M, Brucato A, Ferrazzi P, Pullara A, Adler Y, Barosi A, Caforio AL, Cemin R, Chirillo F, Comoglio C, Cugola D, Cumetti D, Dyrda O, Ferrua S, Finkelstein Y, Flocco R, Gandino A, Hoit B, Innocente F, Maestroni S, Musumeci F, Oh J, Pergolini A, Polizzi V, Ristic A, Simon C, Spodick DH, Tarzia V, Trimboli S, Valenti A, Belli R, Gaita F. Colchicine for prevention of postpericardiotomy syndrome and postoperative atrial fibrillation: the COPPS-2 randomized clinical trial. JAMA 2014; 312:1016-23. [PMID: 25172965 DOI: 10.1001/jama.2014.11026] [Citation(s) in RCA: 222] [Impact Index Per Article: 22.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Postpericardiotomy syndrome, postoperative atrial fibrillation (AF), and postoperative effusions may be responsible for increased morbidity and health care costs after cardiac surgery. Postoperative use of colchicine prevented these complications in a single trial. OBJECTIVE To determine the efficacy and safety of perioperative use of oral colchicine in reducing postpericardiotomy syndrome, postoperative AF, and postoperative pericardial or pleural effusions. DESIGN, SETTING, AND PARTICIPANTS Investigator-initiated, double-blind, placebo-controlled, randomized clinical trial among 360 consecutive candidates for cardiac surgery enrolled in 11 Italian centers between March 2012 and March 2014. At enrollment, mean age of the trial participants was 67.5 years (SD, 10.6 years), 69% were men, and 36% had planned valvular surgery. Main exclusion criteria were absence of sinus rhythm at enrollment, cardiac transplantation, and contraindications to colchicine. INTERVENTIONS Patients were randomized to receive placebo (n=180) or colchicine (0.5 mg twice daily in patients ≥70 kg or 0.5 mg once daily in patients <70 kg; n=180) starting between 48 and 72 hours before surgery and continued for 1 month after surgery. MAIN OUTCOMES AND MEASURES Occurrence of postpericardiotomy syndrome within 3 months; main secondary study end points were postoperative AF and pericardial or pleural effusion. RESULTS The primary end point of postpericardiotomy syndrome occurred in 35 patients (19.4%) assigned to colchicine and in 53 (29.4%) assigned to placebo (absolute difference, 10.0%; 95% CI, 1.1%-18.7%; number needed to treat = 10). There were no significant differences between the colchicine and placebo groups for the secondary end points of postoperative AF (colchicine, 61 patients [33.9%]; placebo, 75 patients [41.7%]; absolute difference, 7.8%; 95% CI, -2.2% to 17.6%) or postoperative pericardial/pleural effusion (colchicine, 103 patients [57.2%]; placebo, 106 patients [58.9%]; absolute difference, 1.7%; 95% CI, -8.5% to 11.7%), although there was a reduction in postoperative AF in the prespecified on-treatment analysis (placebo, 61/148 patients [41.2%]; colchicine, 38/141 patients [27.0%]; absolute difference, 14.2%; 95% CI, 3.3%-24.7%). Adverse events occurred in 21 patients (11.7%) in the placebo group vs 36 (20.0%) in the colchicine group (absolute difference, 8.3%; 95% CI; 0.76%-15.9%; number needed to harm = 12), but discontinuation rates were similar. No serious adverse events were observed. CONCLUSIONS AND RELEVANCE Among patients undergoing cardiac surgery, perioperative use of colchicine compared with placebo reduced the incidence of postpericardiotomy syndrome but not of postoperative AF or postoperative pericardial/pleural effusion. The increased risk of gastrointestinal adverse effects reduced the potential benefits of colchicine in this setting. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT01552187.
Collapse
Affiliation(s)
- Massimo Imazio
- Cardiology Department, Maria Vittoria Hospital, Torino, Italy2University of Torino, Torino, Italy
| | | | | | - Alberto Pullara
- University of Torino, Torino, Italy4AOU Città della Salute e della Scienza di Torino, Torino, Italy
| | - Yehuda Adler
- Chaim Sheba Medical Center, Tel Hashomer and Sacker University, Tel Aviv, Israel
| | - Alberto Barosi
- Department of Internal Medicine and Cardiac Surgery, Ospedale Niguarda, Milano, Italy
| | - Alida L Caforio
- Department of Cardiological Thoracic and Vascular Sciences, University of Padova, Padova, Italy
| | - Roberto Cemin
- Cardiology Department, Ospedale Regionale San Maurizio, Bolzano, Italy
| | - Fabio Chirillo
- Department of Cardiology and Cardiac Surgery, Ca Foncello Hospital, Treviso, Italy
| | - Chiara Comoglio
- Department of Cardiac Surgery and Rehabilitation, Villa Maria Pia Hospital, Torino, Italy
| | | | | | - Oleksandr Dyrda
- Department of Cardiac Surgery and Rehabilitation, Villa Maria Pia Hospital, Torino, Italy
| | - Stefania Ferrua
- Department of Cardiology, Ospedale degli Infermi, Rivoli, Italy
| | - Yaron Finkelstein
- Department of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | | | - Anna Gandino
- Department of Internal Medicine and Cardiac Surgery, Ospedale Niguarda, Milano, Italy
| | - Brian Hoit
- Case Western Reserve University, Cleveland, Ohio15University Hospitals Case Medical Center, Cleveland, Ohio
| | | | | | | | - Jae Oh
- Division of Cardiovascular Disease, Mayo Clinic, Rochester, Minnesota
| | - Amedeo Pergolini
- Department of Cardiac Surgery, Ospedale San Camillo, Roma, Italy
| | - Vincenzo Polizzi
- Department of Cardiac Surgery, Ospedale San Camillo, Roma, Italy
| | - Arsen Ristic
- Department of Cardiology, Belgrade University School of Medicine and Clinical Centre of Serbia, Belgrade, Serbia
| | | | | | - Vincenzo Tarzia
- Department of Cardiological Thoracic and Vascular Sciences, University of Padova, Padova, Italy
| | - Stefania Trimboli
- Department of Cardiac Surgery and Rehabilitation, Villa Maria Pia Hospital, Torino, Italy
| | | | - Riccardo Belli
- Cardiology Department, Maria Vittoria Hospital, Torino, Italy
| | - Fiorenzo Gaita
- University of Torino, Torino, Italy4AOU Città della Salute e della Scienza di Torino, Torino, Italy
| | | |
Collapse
|
17
|
Salizzoni S, D'Onofrio A, Agrifoglio M, Colombo A, Chieffo A, Tarantini G, Regesta T, Martinelli G, Gabbieri D, Saia F, Tamburino C, Ribichini FL, Cugola D, Aiello ML, Boi A, Iadanza A, Pompei E, Stefano P, Ornaghi D, Minati A, Agostinelli A, Boschetti C, Andrea A, Casilli F, Bedogni F, Rinaldi M. TCT-709 Early and Mid-term Outcomes Of 1904 Patients Undergoing Transcatheter Balloon-Expandable Valve Implantation: results the ITER Registry. J Am Coll Cardiol 2014. [DOI: 10.1016/j.jacc.2014.07.781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
18
|
Fino C, Iacovoni A, Ferrero P, Senni M, Merlo M, Cugola D, Ferrazzi P, Caputo M, Miceli A, Magne J. Restrictive mitral valve annuloplasty versus mitral valve replacement for functional ischemic mitral regurgitation: An exercise echocardiographic study. J Thorac Cardiovasc Surg 2014; 148:447-53.e2. [DOI: 10.1016/j.jtcvs.2013.05.053] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2013] [Revised: 05/16/2013] [Accepted: 05/31/2013] [Indexed: 11/29/2022]
|
19
|
Fino C, Cugola D, Merlo M, Miceli A, Senni M, Iacovoni A, Ferrero P, Magne J. 012 * MITRAL VALVE ANNULOPLASTY VERSUS MITRAL VALVE REPLACEMENT FOR ISCHAEMIC MITRAL REGURGITATION: HAEMODYNAMIC AND FUNCTIONAL CAPACITY COMPARISON. Interact Cardiovasc Thorac Surg 2013. [DOI: 10.1093/icvts/ivt372.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
20
|
Seddio F, Gorislavets N, Iacovoni A, Cugola D, Fontana A, Galletti L, Terzi A, Ferrazzi P. Is heart transplantation for complex congenital heart disease a good option? A 25-year single centre experience. Eur J Cardiothorac Surg 2012; 43:605-11; discussion 611. [PMID: 22733841 DOI: 10.1093/ejcts/ezs350] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Heart transplantation (HTx) in patients with complex congenital heart disease (CHD) is a challenge because of structural anomalies and multiple previous procedures. We analysed our results in adult and paediatric patients to evaluate outcome and assess risk factors affecting mortality. METHODS Between 1985 and 2011, among 839 patients who underwent HTx, 85 received transplantation for end-stage CHD. Patients were divided into four age subgroups: <1 year (8 patients, Group I), 1-10 years (20 patients, Group II), 11-18 years (24 patients, Group III) and >18 years (33 patients, Group IV) and into two time periods: 1985-2000 (47 patients) and 2001-2011 (38 patients). Anatomical diagnoses were single-ventricle defect in 37 patients (44%) and two-ventricle defect in 48 patients (56%). Seventy-three patients (86%) had undergone one or more cardiac surgical procedures prior to HTx (mean 2.4 ± 0.9). Twenty-two of them were suffering from Fontan failure. Mean pulmonary artery pressure was 25.2 ± 14.2 mmHg. Mean transpulmonary gradient was 9.4 ± 6.9 mmHg. RESULTS Mean follow-up after HTx was 7.8 ± 6.8 years. Survival at 1 month was 37.7% in Group I, 85.8% in Group II, 96.8% in Group II and 98.4% in Group IV and was significantly worse in younger recipients. Overall 30-day mortality was 17.6%. Currently 56 patients (65.8%) are alive. Overall survival at 1, 5, 10 and 15 years is 83-, 73-, 67- and 58%, respectively. There were 14 late deaths. Univariate analysis found that risk factors for early and late death were those related to recipient illness, such as pre-transplant creatinine, intravenous inotropic drugs, intravenous diuretics, mechanical ventilation and presence of protein-losing enteropathy (PLE). Multivariate analysis for all events (early and late deaths) identified preoperative mechanical ventilation as an independent risk factor for mortality. Number of previous procedures did not influence survival. Previous Fontan procedure did not increase mortality. We documented the reversibility of PLE in survivors. CONCLUSIONS We demonstrated that heart transplantation for patients with CHD can be performed with the expectation of excellent results. Previous procedures, including the Fontan operation, do not reduce survival. Mortality is related to preoperative patient condition. We advocate early referral of complex CHD patients for transplant assessment and for inclusion in waiting lists before the detrimental effects of end-stage failure manifest themselves.
Collapse
Affiliation(s)
- Francesco Seddio
- Paediatric Cardiovascular Surgery Unit, Bergamo Hospital, Bergamo, Italy.
| | | | | | | | | | | | | | | |
Collapse
|
21
|
D'Onofrio A, Cugola D, Bolgan I, Menicanti L, Fabbri A, Di Donato M. Surgical ventricular reconstruction with different myocardial protection strategies. A propensity matched analysis. Interact Cardiovasc Thorac Surg 2010; 10:530-4. [PMID: 20071447 DOI: 10.1510/icvts.2009.222919] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
The aim of this study is to compare outcomes of patients undergoing surgical ventricular reconstruction (SVR) with normothermic cardiopulmonary bypass (CPB) and beating heart or hypothermic CPB and cardioplegic arrest. Between 2001 and 2008, 588 patients underwent SVR. A propensity score matching was performed and 91 matched pairs were created: group 1 (G1) operated with normothermic CPB and beating-heart technique, and group 2 (G2) operated with hypothermic CPB and cardioplegic arrest. Mean age was 62+/-9 years in G1 and 63+/-10 years in G2 [not significant (NS)]. Average follow-up was 42.7+/-26 months (range 1-72). Major cardiac and cerebro-vascular events (MACCE) were assessed. Thirty-day mortality was 4% in G1 and 5% in G2 (NS). Kaplan-Meier survival at six years was 79+/-4% and 72+/-9% (NS) and freedom from MACCE was 82+/-4% and 83+/-7% in G1 and G2, respectively (NS). Left ventricular volume reduction, ejection fraction and New York Heart Association (NYHA) class improvement were significant in the overall population; no significant differences were found between groups. The following independent risk factors for cardiac death were identified: mitral valve regurgitation, surgery <3 months from myocardial infarction, NYHA class III-IV. This study showed that outcomes following SVR are not affected by myocardial protection strategies neither in cardiac function and clinical status nor in survival.
Collapse
Affiliation(s)
- Augusto D'Onofrio
- Division of Cardiac Surgery, San Bortolo Hospital, Viale Rodolfi 37, 36100 Vicenza, Italy.
| | | | | | | | | | | |
Collapse
|
22
|
Ragusa R, Faggian G, Rungatscher A, Cugola D, Marcon A, Mazzucco A. Use of gelatin powder added to rifamycin versus bone wax in sternal wound hemostasis after cardiac surgery. Interact Cardiovasc Thorac Surg 2006; 6:52-5. [PMID: 17669768 DOI: 10.1510/icvts.2005.126250] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Bone wax is the substance which has been used for hemostasis in different surgical fields for up to one hundred years and historically used in our center to prevent sternal bleeding and subsequent complications. Recently, reabsorbable gelatin powder has come into use. Up to now there are no clinical studies that compare these two substances. Between 1st January and 31st December 2004, 1249 subsequent patients have been operated on for different cardiac surgical procedures in our center, of them 557 were enrolled in a randomized perspective monocentric study. They have been divided into two similar subgroups: one treated with swine gelatin plus rifamycin (group one) and the other with bone wax (group two). The two hemostatic products have been applied just after the sternotomy and before the chest closing. Each patient was evaluated for bleeding, sternal infections and was followed-up for two months for bone and wound healing. Postoperative bleeding at the tenth hour was 315 ml+/-269 (mean+/-S.D.) in the first group and 395 ml+/-265 in the second (P<0.001). In the 10th-20th hour interval time bleeding was 120 ml+/-74 and 205 ml+/-132, respectively (P<0.001). Total bleeding was 415 ml+/-87 in group one and 580 ml+/-150 in group two (P<0.001). Chest reopening for bleeding not due to surgical problems was carried out in 14 patients (4.7%) (group one) and 19 (7.3%) (group two) (n.s.). Superficial sternal wound infection occurred in two patients (0.7%) in group one and three patients (1.1%) in group two (n.s.). There were no deep sternal wound infections. Bleeding was significantly higher in patients treated with bone wax compared to those with absorbable gelatin plus rifamycin.
Collapse
Affiliation(s)
- Renato Ragusa
- Cardiovascular Surgery Department, Verona University, Verona, Italy
| | | | | | | | | | | |
Collapse
|