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Cameli M, Bombardini T, Dokollari A, Sassi CG, Losito M, Sparla S, Lisi G, Bernazzali S, Davoli G, Capannini G, Andriani S, Martinelli R, Diciolla F, Mondillo S, Maccherini M. Longitudinal Strain Stress-Echo Evaluation of Aged Marginal Donor Hearts: Feasibility in the Adonhers Project. Transplant Proc 2017; 48:399-401. [PMID: 27109965 DOI: 10.1016/j.transproceed.2015.12.036] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Accepted: 12/30/2015] [Indexed: 11/25/2022]
Abstract
BACKGROUND The Adonhers (aged donor heart rescue by stress-echo protocol) Project was created to resolve the current shortage of donor hearts. One of the great limits of stress echo is the operator dependency. Speckle-tracking echocardiography (STE), offering a quantitative objective analysis of myocardial deformation, may help to overcome this limit. This study aimed to verify feasibility of a stress-strain echo analysis in selection of aged donor hearts for heart transplant. METHODS From February 2014 to October 2015, 22 marginal candidate donors (16 men) ages 58 ± 4 years were initially enrolled. After legal declaration of brain death, all marginal donors underwent bedside echocardiography, with baseline and (when resting echocardiography was normal) dipyridamole (0.84 mg/kg in 6 minutes) stress echo. In all patients, left ventricular (LV) longitudinal myocardial deformation was obtained by STE in the 4-, 2-, and 3-chamber views, obtaining the average global longitudinal strain (GLS). GLS was assessed at baseline and at the peak of stress echo. RESULTS Baseline echocardiography showed wall motion abnormalities in 9 patients (excluded from donation). Stress echocardiography was performed in the remaining 13 patients. Results were normal in 8, who were uneventfully transplanted in marginal recipients. Stress results were abnormal in 5 (excluded from donation). STE was obtained in all cases (100% feasibility) and ΔGLS was significantly different between normal and pathological stress-echo (+13.2 ± 5.2 versus -6.1% ± 3.1%, P = .0001, respectively). CONCLUSIONS STE showed an excellent feasibility in analysis of LV myocardial longitudinal strain at baseline and at the peak of stress echo of marginal heart donors. Further experience is needed to confirm STE as a valuable additional mean to better interpret stress echo in marginal donors.
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Affiliation(s)
- M Cameli
- Department of Cardiovascular Diseases, University of Siena, Italy.
| | - T Bombardini
- Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - A Dokollari
- Department of Cardiac Surgery, University of Siena, Italy
| | - C G Sassi
- Department of Cardiac Surgery, University of Siena, Italy
| | - M Losito
- Department of Cardiovascular Diseases, University of Siena, Italy
| | - S Sparla
- Department of Cardiovascular Diseases, University of Siena, Italy
| | - G Lisi
- Department of Cardiac Surgery, University of Siena, Italy
| | - S Bernazzali
- Department of Cardiac Surgery, University of Siena, Italy
| | - G Davoli
- Department of Cardiac Surgery, University of Siena, Italy
| | - G Capannini
- Department of Cardiac Surgery, University of Siena, Italy
| | - S Andriani
- Department of Cardiac Surgery, University of Siena, Italy
| | - R Martinelli
- Department of Cardiac Surgery, University of Siena, Italy
| | - F Diciolla
- Department of Cardiac Surgery, University of Siena, Italy
| | - S Mondillo
- Department of Cardiovascular Diseases, University of Siena, Italy
| | - M Maccherini
- Department of Cardiac Surgery, University of Siena, Italy
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Cabiati M, Della Latta V, Zimbone S, Natale M, Lazzerini P, Diciolla F, Capecchi P, Laghi-Pasini F, Morales M, Del Ry S. Adenosine receptors transcriptomic profile in cardiac fibroblasts of patients with left ventricular dysfunction due to valvular disease undergoing prosthetic implantation. Vascul Pharmacol 2015. [DOI: 10.1016/j.vph.2015.11.013] [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: 10/22/2022]
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3
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Del Ry S, Della Latta V, Cabiati M, Zimbone S, Lazzerini PE, Gentile D, Sabatino L, Diciolla F, Morales MA, Laghi-Pasini F. Adenosine receptors mRNA expression in human leukocytes of patients with valvular disease. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht309.p3905] [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: 11/15/2022] Open
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4
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Maccherini M, Tsioulpas C, Bernazzali S, Diciolla F, Borrelli E. 577: Effect of Bosentan® in Candidate to Heart Transplantation with Pulmonary Hypertension Secondary to Congestive Heart Failure. J Heart Lung Transplant 2009. [DOI: 10.1016/j.healun.2008.11.584] [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: 12/01/2022] Open
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5
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Diciolla F, Scolletta S, Berti L, Maccherini M, Federici D, Bernazzali S, Lisi G, Chiavarelli M. C2 and C0 Values for Monitoring Cyclosporine Therapy in Stable Heart Transplant Recipients. Transplant Proc 2005; 37:1355-9. [PMID: 15848719 DOI: 10.1016/j.transproceed.2005.01.079] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [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: 11/30/2022]
Abstract
INTRODUCTION We sought to evaluate the behavior of C2 values and their correlation with acute rejection episodes and cyclosporine (CyA) side effects in heart transplant patients whose immunosuppressive therapy, was monitored with C0 trough levels. METHODS Sixty stable patients who had received heart transplants from 3 months to 60 months prior were randomly observed from September 2001 to June 2004. Four area under the concentration-time curves (AUC) were performed on each patient, a total of 240 AUC curves. RESULTS Regarding the variability of CyA absorption, two groups of patients were distinguished: group A, "constant absorbers," namely, low variability (<15%) of CyA absorption; group B, "inconstant absorbers" patients with higher (>15%) variability of absorption. Group B patients showed more acute rejection episodes (41%) than group A (19%). CyA side effects were more serious in patients with higher variability of absorption: systemic hypertension, neurological disorders, hyperlipidemia, and gum hyperplasia; Group B patients who developed CyA side effects showed higher maximum and mean C2 levels (P < .05) than group A patients. No differences were found with regard to renal dysfunction between the two groups: all patients showed a mean increase of serum creatinine by at least 50% compared to the baseline value. CONCLUSION Higher C2 levels were not sufficient to predict acute rejection compared to lower but constants, C2 levels. Patients with inconstant absorption were more often overexposed to CyA than underexposed, developing more side effects than patients with lower variability of absorption. Monitoring CyA therapy with C0 and C2 may prevent over- or underexposure to the drug.
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Affiliation(s)
- F Diciolla
- Department of Cardiothoracic Surgery, University of Siena, Siena, Italy.
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6
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Basile A, Bernazzali S, Diciolla F, Lenzini F, Lisi G, Maccherini M, Mangini V, Nesti E, Chiavarelli M. Risk factors for smoking abuse after heart transplantation. Transplant Proc 2004; 36:641-2. [PMID: 15110618 DOI: 10.1016/j.transproceed.2004.02.054] [Citation(s) in RCA: 22] [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: 11/27/2022]
Abstract
Patients (n = 103) were studied before heart transplantation with regard to smoking habits by means of a clinical interview, and 81 were submitted to Minnesota Multiphasic Personality Inventory (MMPI). After a mean time of 50.8 +/- 24.2 months from transplant, they were once again interviewed to ascertain their smoking habits after intervention. Nonsmokers (35 of 103) were still nonabusers. Of the remaining 68 patients who ceased smoking before heart transplant, 12 (17.6%) had returned to tobacco abuse. Dividing these 68 patients into two groups based upon the length of smoking cessation before heart transplant (less than 1 year: short term [ST] more than 1 year: long term [LT]), we noticed that the ST group showed a much greater rate of reabuse (8 of 20, 40%) than the LT group (4 of 48, 8.3%, P =.006). Analyzing six scales of MMPI, we found a statistically different score for self-control ability (scale K) in ST and LT smokers compared to nonsmokers (45.5 and 45.5 vs 51.2, P =.026), and for difficult adaptation (scale Ma) in ST compared both to LT smokers and nonsmokers (ST 57, LT 50.5, NS 47.6; P =.042 LT vs ST, P =.0005 ST vs NS). We concluded that patients who have recently decided to stop smoking and show after MMPI compilation a score of >50 for K and <50 for Ma scale have a higher risk of reabuse and need a greater effort by the transplant team to reinforce their will to stop smoking.
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Affiliation(s)
- A Basile
- UO Psicologia Azienda Ospedatiera Universitaria Senese, Siena, Italy.
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7
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Voltolini L, Luzzi L, Diciolla F, Campione A, Gotti G. Right pneumonectomy for adenocarcinoma stage IIIA-N2 in a heart transplant patient after induction chemotherapy. J Heart Lung Transplant 2004; 23:375-7. [PMID: 15019649 DOI: 10.1016/s1053-2498(03)00197-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2002] [Revised: 03/24/2003] [Accepted: 03/24/2003] [Indexed: 11/26/2022] Open
Abstract
Lung tumors are the most frequent solid tumor in the heart transplant population. Unfortunately, most of these patients are in an advanced stage of disease at the time of presentation, which carries a poor prognosis. We present a heart transplant patient with histologically proven. Stage IIIA-N2 bronchogenic adenocarcinoma who had complete lymph-node downstaging after induction chemotherapy and underwent a complete tumor resection by right pneumonectomy.
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Affiliation(s)
- L Voltolini
- Thoracic Surgery Unit, University Hospital of Siena, Siena, Italy.
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8
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Capecchi PL, Lazzerini PE, Maccherini M, Guideri F, Lisi G, Acampa M, Cuomo A, Diciolla F, Toscano M, Laghi Pasini F. Pravastatin treatment-associated reduction in plasma homocysteine in heart-transplanted patients. Transplant Proc 2002; 34:1273-4. [PMID: 12072338 DOI: 10.1016/s0041-1345(02)02768-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- P L Capecchi
- Department of Internal Medicine, Section of Clinical Immunology, University of Siena, Siena, Italy
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9
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Lazzerini PE, Capecchi PL, Maccherini M, Diciolla F, Massai MR, Guideri F, Lisi GF, Cuomo A, Acampa M, Giordano A, Toscano M, Laghi Pasini F. Early and delayed increase in plasma homocysteine levels in heart transplanted patients. Transplant Proc 2002; 34:1275-8. [PMID: 12072339 DOI: 10.1016/s0041-1345(02)02641-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- P E Lazzerini
- Department of Internal Medicine, Section of Clinical Immunology, University of Siena, 53100, Siena, Italy
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10
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Lesauskaite V, Tanganelli P, Sassi C, Neri E, Diciolla F, Ivanoviene L, Epistolato MC, Lalinga AV, Alessandrini C, Spina D. Smooth muscle cells of the media in the dilatative pathology of ascending thoracic aorta: morphology, immunoreactivity for osteopontin, matrix metalloproteinases, and their inhibitors. Hum Pathol 2001; 32:1003-11. [PMID: 11567232 DOI: 10.1053/hupa.2001.27107] [Citation(s) in RCA: 129] [Impact Index Per Article: 5.6] [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: 11/11/2022]
Abstract
The etiopathogenesis of thoracic aortic aneurysms is currently an issue of debate. The present study investigated ultrastructural, morphometric, and immunohistochemical aspects of smooth muscle cells (SMCs) in chronic aneurysm of the thoracic aorta (aneurysm group), aortic dilatation associated with valvular disease (valvular group), and dissection of the thoracic aorta (dissection group). Fragments of the ascending aorta that had been taken from the patients during coronary bypass surgery were used as controls. No significant difference was observed in the density of SMCs between the 3 pathologic groups put together and the controls. Only separate analysis of SMC density in each of the pathologic groups showed that the valvular group samples had significantly smaller amounts of SMCs in the internal layer of the media than the dissection group samples and controls. Ultrastructural analysis, in situ end labeling, propidium iodide assay, and DNA laddering did not show apoptosis of SMCs in the samples investigated. Ultrastructure of SMCs characteristic of the synthetic phenotype, together with increased expression of osteopontin in the media of pathologic thoracic aortas indicated the transition of SMCs from the contractile to the synthetic phenotype. Immunohistochemical investigation showed that medial SMCs in the samples taken from aortas of all 3 pathologic groups expressed stronger immunoreactivity for matrix metalloproteinase 1, 2, and 9 and tissue inhibitor of metalloproteinase 1 and 2 than the controls. The present study shows that during the formation of aneurysms, dissection of the thoracic aorta, or aortic dilatation associated with valvular disease, loss of SMCs was not of great importance with respect to their transition from the contractile to the synthetic type in leading to increased production of matrix metalloproteinases.
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Affiliation(s)
- V Lesauskaite
- Institute of Cardiology and Department of Biochemistry, Kaunas University of Medicine, Lithuania
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11
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Maccherini M, Diciolla F, Laghi Pasini F, Lisi G, Tanganelli P, D'Ascenzo G, Mondillo S, Carone E, Oricchio L, Baraldi C, Capecchi PL, Lazzerini PE, Toscano T, Barretta A, Giunti G, Schuerfeld K, Fimiani M, Papalia U. Photopheresis immunomodulation after heart transplantation. Transplant Proc 2001; 33:1591-4. [PMID: 11267432 DOI: 10.1016/s0041-1345(00)02605-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- M Maccherini
- Institute of Thoracic and Cardiovascular Surgery, University of Siena, Siena, Italy
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12
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Basile A, Maccherini M, Diciolla F, Balistreri A, Bouklas D, Lisi G, Toscano T, Mondillo S, Biagioli B, Simeone F, Papalia U. Sexual disorders after heart transplantation. Transplant Proc 2001; 33:1917-9. [PMID: 11267569 DOI: 10.1016/s0041-1345(00)02822-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- A Basile
- U.O. Psicologia, Azienda Ospedaliera Senese, Italy
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13
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Neri E, Toscano T, Massetti M, Capannini G, Carone E, Tucci E, Diciolla F, Scolletta S, Morello R, Sassi C. Operation for acute type A aortic dissection in octogenarians: is it justified? J Thorac Cardiovasc Surg 2001; 121:259-67. [PMID: 11174731 DOI: 10.1067/mtc.2001.112205] [Citation(s) in RCA: 96] [Impact Index Per Article: 4.2] [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: 11/22/2022]
Abstract
BACKGROUND With the progressive aging of Western populations, cardiac surgeons are faced with treating an increasing number of elderly patients. Controversy exists as to whether the expenditure of health care resources on the growing elderly populations represents a cost-effective approach to resource management. The potential to avoid surgery in patients with little chance of survival and poor quality of life would spare unnecessary suffering, reduce operative mortality, and enhance the use of scarce resources. METHODS We reviewed the records of 24 consecutive patients aged 80 years or older (mean age 83 years, range 80-93 years) who underwent operations for acute type A dissection from 1985 through 1999. No patient with acute type A dissection was refused surgery because of age or concomitant disease. Seventeen patients were men. Preoperatively, none of the patients was moribund, although 66% had hemodynamic instability and 41% experienced cerebral ischemia. All patients had one or more associated pathologic conditions. Hospital mortality and morbidity models, based on our overall experience with 197 patients operated on for acute type A aortic dissection during the period of the study, were developed by means of multivariate logistic regression with preoperative and intraoperative variables used as independent predictors of outcome. RESULTS Overall hospital mortality was 83%. Intraoperative mortality was 33%. All patients who survived the operation had one or more postoperative complications. Mean hospital stay was 37 days with a total of 314 days in the intensive care unit (average 19 days, median 17 days). None of the survivors (4 patients) discharged from the hospital was able to function independently and their survival at 6 months was 0%. Statistical analysis of the overall experience with operations for type A acute aortic dissection confirmed that age in excess of 80 years is the most important independent patient risk factor associated with 30-day mortality and morbidity. CONCLUSIONS Operations for acute type A dissection performed on octogenarians involve increased hospital mortality and morbidity. Short-term survival is unfavorable and is associated with a poor quality of life. Without additional corroborative studies to endorse the present findings, the use of age as a parameter to limit access of patients to expensive medical resources remains an unsubstantiated concept. In the context of acute type A aortic dissection, however, the hypothesis that older patients should be denied such a complicated surgical intervention to conserve resources is supported by the presented data.
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Affiliation(s)
- E Neri
- Istituto di Chirurgia Cardiovascolare, Universita' agli Studi di Siena, Unita' Operativa di Chirurgia dell' Aorta Toracica, 53100 Siena, Italy. @unisi.it
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Neri E, Capannini G, Diciolla F, Carone E, Tripodi A, Tucci E, Sassi C. Localized dissection and delayed rupture of the abdominal aorta after extracorporeal shock wave lithotripsy. J Vasc Surg 2000; 31:1052-5. [PMID: 10805900 DOI: 10.1067/mva.2000.104592] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.2] [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: 11/22/2022]
Abstract
Extracorporeal shock wave lithotripsy (ESWL) represents the preferred treatment for most upper ureteric and renal calculi. Complication rates associated with ESWL are low, justifying the enthusiasm and acceptance of this treatment modality. As the technique has become more widely available, some deleterious effects on the kidneys and the surrounding tissues are increasingly recognized. We report on the rupture of a severely calcified abdominal aorta in a 65-year-old man who underwent 3 months of ESWL treatment earlier for renal calculi. The patient was seen with an acute recrudescence of a long-standing abdominal and left flank pain, which began immediately after the last of the three sessions of ESWL and was associated with an episode of hypotension that occurred an hour before admission. Patient history and chronologic course of events strongly suggest the role of ESWL in the genesis of abdominal aorta rupture.
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Affiliation(s)
- E Neri
- Department of Thoracic and Cardiovascular Surgery, University of Siena, Italy
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Abstract
Intramural hematoma of the aorta is a condition increasingly observed in clinical practice. Uncertainty exists whether such lesions represent a different pathology or simply the precursors of classic dissecting aneurysm. The patient was a 76-year-old woman with intramural hematoma of the ascending aorta. Clinical course, progression of the lesion to type A aortic dissection, and surgical treatment are described. Although natural history of intramural hematoma of the ascending aorta is not clearly elucidated, the case presented confirms that the evolution toward intimal flap formation is possible and that we cannot foresee the stabilization of these lesions. We stress that intramural hematoma of the ascending aorta has to be managed as an aortic type A dissection and that aggressive treatment is advisable.
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Affiliation(s)
- E Neri
- Department of Thoracic and Cardiovascular Surgery, University of Siena Hospital, Italy.
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16
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Neri E, Carone E, Capannini G, Tucci E, Diciolla F, Sassi C. Symptomatic coronary-subclavian steal syndrome: report of a case with complete occlusion of proximal left subclavian artery and anomalous origin of left vertebral artery from the aortic arch. J Thorac Cardiovasc Surg 1999; 118:565-7. [PMID: 10469979 DOI: 10.1016/s0022-5223(99)70205-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- E Neri
- Thoracic and Cardiovascular Department, University Hospital, Siena, Italy
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Abstract
BACKGROUND Femoral arteries are the preferred site of peripheral cannulation for arterial inflow in type A aortic dissection operations. The presence of aortoiliac aneurysms, severe peripheral occlusive disease, atherosclerosis of the femoral vessels, and distal extension of the aortic dissection may preclude their utilization. Axillary artery cannulation may represent a valid alternative in these circumstances. METHODS Between January 15, 1989, and August 20, 1998, in our institution, 22 of 152 operations (14.4%) for acute type A aortic dissection were performed with the use of the axillary artery for the arterial inflow. Axillary artery cannulation was undertaken in the presence of femoral arteries bilaterally compromised by dissection in 12 patients (54.5%), abdominal aorta and peripheral aneurysm in 5 patients (22.7%), severe atherosclerosis of both femoral arteries in 3 patients (13. 6%), and aortoiliac occlusive disease in 2 patients (9.1%). In all patients, distal anastomosis was performed with an open technique after deep hypothermic circulatory arrest. Retrograde cerebral perfusion was used in 9 patients (40.9%). RESULTS Axillary artery cannulation was successful in all patients. The left axillary artery was cannulated in 20 patients (90.9%), and the right axillary artery was cannulated in 2 patients (9.1%). Axillary artery cannulation followed an attempt of femoral artery cannulation in 15 patients (68. 2%). All patients survived the operation, and no patient had a cerebrovascular accident. No axillary artery thrombosis, no brachial plexus injury, and no intraoperative malperfusion were recorded in this series. Two patients (9.1%) died in the hospital of complications not related to axillary artery cannulation. CONCLUSIONS In patients with type A aortic dissection in whom femoral arteries are acutely or chronically diseased, axillary artery cannulation represents a safe and effective means of providing arterial inflow during cardiopulmonary bypass.
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Affiliation(s)
- E Neri
- Istituto di Chirurgia Cardiovascolar Universitá agli Studi di Siena, Italy
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18
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Affiliation(s)
- E Neri
- Thoracic and Cardiovascular Department, University Hospital, Siena, Italy
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Giunti G, Schürfeld K, Maccherini M, Tanganelli P, Rubegni P, Alfani D, D'Ascenzo G, Diciolla F, Bernazzali S, Fimiani M, Toscano M, Sani G. Photopheresis for recurrent acute rejection in cardiac transplantation. Transplant Proc 1999; 31:128-9. [PMID: 10083041 DOI: 10.1016/s0041-1345(98)01471-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- G Giunti
- Istituto di Chirurgia Toracica e Cardiovascolare Tecnologie Biomediche Cardiochirurgia, Università degli Studi di Siena, Italy
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20
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Schürfeld K, Giunti G, Maccherini M, Rubegni P, D'Ascenzo G, Diciolla F, Tanganelli P, Bernazzali S, Bizzarri F, Fimiani M, Alfani D, Toscano M, Sani G. Photopheresis after cardiac transplantation induces apoptosis. Transplant Proc 1999; 31:125-7. [PMID: 10083040 DOI: 10.1016/s0041-1345(98)01470-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- K Schürfeld
- Istituto di Anatomia e Istologia Patologica, Università degli Studi di Siena, Italy
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Diciolla F, Sassi C, Neri E, Carone E, Capannini G, Giunti G, Guerrieri W, Bernazzali S, Maccherini M, Sani G, Toscano M. Abdominal aortic aneurysms in heart transplanted patients. J Mal Vasc 1998; 23:358-60. [PMID: 9894190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
OBJECTIVE In the AA's opinion, the dilatation of the abdominal aorta is not a contraindication to heart transplantation. METHODS AND MATERIALS From July 1994 to February 1998, 3 out of 80 heart transplanted patients, required a replacement of their abdominal aorta because of an infrarenal aortic aneurysm. The first patient (62 years old) did not have an aneurysm by time of heart transplantation: his aneurysm (5.1 cm wide) was resected 2 years later. The other two patients (m, 44 years old; m, 60 years old) had a dilatation of 3.1 and 3.5 cm of the abdominal aorta by time of cardiac transplantation: 15 months later, the aneurysms measured 5.8 and 7 cm, respectively, and had been resected. Two resections were performed through a retroperitoneal approach. RESULTS All 3 patients had uneventful postoperative course. CONCLUSION Before heart transplantation the aorta must be screened for dilatation or aneurysm, which can be enlarged by operation. Such lesions can be operated on, with low risks, and should not be a contraindication to heart transplantation.
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Affiliation(s)
- F Diciolla
- Institute of Thoracic and Cardiovascular Surgery, University of Siena, Italy
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Maccherini M, Bernazzali S, Diciolla F, Giunti G, Bizzarri F, Lisi GF, Davoli G, Biagioli B, Giomarelli PP, Simeone F, Caciorgna M, Marchetti L, Pula G, Sani G, Toscano M. Neoral versus Sandimmun: clinical impact and modification of immunosuppressive therapy in cardiac transplantation. Transplant Proc 1998; 30:1904-5. [PMID: 9723327 DOI: 10.1016/s0041-1345(98)00476-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- M Maccherini
- Institute of Thoracic and Cardiovascular Surgery, University of Siena, Hospital Le Scotte, Italy
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