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Giordano A, Ferraro P, Finizio F, Corcione N, Cimmino M, Biondi-Zoccai G, Denti P, Rubbio AP, Petronio AS, Bartorelli AL, Mongiardo A, Giordano S, De Felice F, Adamo M, Montorfano M, Baldi C, Tarantini G, Giannini F, Ronco F, Monteforte I, Villa E, Ferrario M, Fiocca L, Castriota F, Squeri A, Tamburino C, Bedogni F. Transcatheter Mitral Valve Repair With the MitraClip Device for Prior Mitral Valve Repair Failure: Insights From the GIOTTO-FAILS Study. J Am Heart Assoc 2024; 13:e033605. [PMID: 38742523 DOI: 10.1161/jaha.123.033605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 02/08/2024] [Indexed: 05/16/2024]
Abstract
BACKGROUND Minimally invasive mitral valve repair has a favorable risk-benefit profile in patients with significant de novo mitral regurgitation. Its role in patients with prior mitral valve repair is uncertain. We aimed to appraise the outcome of patients undergoing transcatheter edge-to-edge repair (TEER) with prior transcatheter or surgical mitral valve repair (SMVR). METHODS AND RESULTS We queried the Italian multicenter registry on TEER with MitraClip, distinguishing naïve patients from those with prior TEER or (SMVR). Inhospital and long-term clinical/echocardiographic outcomes were appraised. The primary outcome was the occurrence of death or rehospitalization for heart failure. A total of 2238 patients were included, with 2169 (96.9%) who were naïve to any mitral intervention, 29 (1.3%) with prior TEER, and 40 (1.8%) with prior SMVR. Several significant differences were found in baseline clinical and imaging features. Respectively, device success was obtained in 2120 (97.7%), 28 (96.6%), and 38 (95.0%, P=0.261) patients; procedural success in 2080 (95.9%), 25 (86.2%), and 38 (95.0%; P=0.047); and inhospital death in 61 (2.8%), 1 (3.5%), and no (P=0.558) patients. Clinical follow-up after a mean of 14 months showed similar rates of death, cardiac death, rehospitalization, rehospitalization for heart failure, and their composite (all P>0.05). Propensity score-adjusted analysis confirmed unadjusted analysis, with lower procedural success for the prior TEER group (odds ratio, 0.28 [95% CI, 0.09-0.81]; P=0.019) but similar odds ratios and hazard ratios for all other outcomes in the naïve, TEER, and SMVR groups (all P>0.05). CONCLUSIONS In carefully selected patients, TEER can be performed using the MitraClip device even after prior TEER or SMVR.
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Affiliation(s)
- Arturo Giordano
- Unità Operativa di Interventistica Cardiovascolare Pineta Grande Hospital Castel Volturno Italy
| | - Paolo Ferraro
- Unità Operativa di Emodinamica Santa Lucia Hospital San Giuseppe Vesuviano Italy
| | - Filippo Finizio
- Unità Operativa di Interventistica Cardiovascolare Pineta Grande Hospital Castel Volturno Italy
| | - Nicola Corcione
- Unità Operativa di Interventistica Cardiovascolare Pineta Grande Hospital Castel Volturno Italy
| | - Michele Cimmino
- Unità Operativa di Interventistica Cardiovascolare Pineta Grande Hospital Castel Volturno Italy
| | - Giuseppe Biondi-Zoccai
- Department of Medico-Surgical Sciences and Biotechnologies Sapienza University of Rome Latina Italy
- Mediterranea Cardiocentro Naples Italy
| | - Paolo Denti
- Department of Cardiac Surgery Vita-Salute San Raffaele University, IRCCS San Raffaele Scientific Institute Milan Italy
| | - Antonio Popolo Rubbio
- Department of Cardiology IRCCS Policlinico San Donato, San Donato Milanese Milan Italy
| | | | - Antonio L Bartorelli
- Centro Cardiologico Monzino IRCCS Milan Italy
- Department of Biomedical and Clinical Sciences University of Milan Milan Italy
| | - Annalisa Mongiardo
- Division of Cardiology, Department of Medical and Surgical Sciences "Magna Graecia" University Catanzaro Italy
| | - Salvatore Giordano
- Division of Cardiology, Department of Medical and Surgical Sciences "Magna Graecia" University Catanzaro Italy
| | - Francesco De Felice
- Division of Interventional Cardiology Azienda Ospedaliera S. Camillo Forlanini Rome Italy
| | - Marianna Adamo
- Cardiac Catheterization Laboratory and Cardiology ASST Spedali Civili di Brescia Brescia Italy
- Department of Medical and Surgical Specialties, Radiological Sciences Public Health University of Brescia Brescia Italy
| | - Matteo Montorfano
- Interventional Cardiology Unit IRCCS San Raffaele Scientific Institute, Vita Salute San Raffaele University Milan Italy
- Thoracic-Vascular Department San Raffaele University Hospital Milan Italy
| | - Cesare Baldi
- Heart Department University Hospital 'Scuola Medica Salernitana' Salerno Italy
| | - Giuseppe Tarantini
- Department of Cardiac, Thoracic and Vascular Science, Interventional Cardiology Unit University of Padua Padua Italy
| | - Francesco Giannini
- Division of Cardiology IRCCS Ospedale Galeazzi-Sant'Ambrogio Milan Italy
| | - Federico Ronco
- Interventional Cardiology, Department of Cardio-Thoracic and Vascular Sciences Ospedale dell'Angelo, AULSS3 Serenissima Venezia Italy
| | - Ida Monteforte
- Divisione di Cardiologia A.O. dei Colli, Ospedale Monaldi Naples Italy
| | - Emmanuel Villa
- Cardiac Surgery Unit and Valve Center Poliambulanza Foundation Hospital Brescia Italy
| | - Maurizio Ferrario
- Division of Cardiology Fondazione IRCCS Policlinico S. Matteo Pavia Italy
| | - Luigi Fiocca
- Cardiovascular Department Papa Giovanni XXIII Hospital Bergamo Italy
| | - Fausto Castriota
- Interventional Cardiology Unit GVM Care & Research, Maria Cecilia Hospital Cotignola Italy
| | - Angelo Squeri
- Interventional Cardiology Unit GVM Care & Research, Maria Cecilia Hospital Cotignola Italy
| | - Corrado Tamburino
- Division of Cardiology, Centro Alte Specialità e Trapianti (CAST) Azienda Ospedaliero-Universitaria Policlinico-Vittorio Emanuele, University of Catania Catania Italy
| | - Francesco Bedogni
- Department of Cardiology IRCCS Policlinico San Donato, San Donato Milanese Milan Italy
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Corcione N, Ferraro P, Finizio F, Cimmino M, Albanese M, Biondi-Zoccai G, Denti P, Rubbio AP, Bartorelli AL, Mongiardo A, Giordano S, De Felice F, Adamo M, Montorfano M, Baldi C, Tarantini G, Giannini F, Ronco F, Monteforte I, Villa E, Ferrario M, Fiocca L, Castriota F, Squeri A, Tamburino C, Bedogni F, Giordano A. Transcatheter mitral valve repair with MitraClip: comparison of NT, NTr, and XTr Devices. J Invasive Cardiol 2024. [PMID: 38598251 DOI: 10.25270/jic/24.00020] [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] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
Abstract
OBJECTIVES Transcatheter edge-to-edge repair (TEER) has become an established minimally invasive treatment for significant mitral regurgitation. Ongoing refinements and the availability of different clipping devices have expanded the indications for and effectiveness of TEER, but comprehensive comparative data on this issue are lacking. In this study, we compared NT, NTr, and XTr MitraClip devices (Abbot) for TEER. METHODS Details on patient, imaging, and procedural details, as well as short- and long-term outcomes, were sought from a national prospective clinical registry on TEER with MitraClip. The primary outcome of interest was discharge after procedural success without major clinical complications. RESULTS A total of 2236 patients were included, 1228 (54.9%) in whom NT implantation only was attempted, 233 (10.4%) in whom NTr but not XTr implantation was attempted, and 775 (34.7%) in whom XTr implantation was attempted. Clinical and imaging features differed substantially across the groups, reflecting expanding indications with NTr and XTr devices. In-hospital outcomes were largely similar among the 3 groups, including death. Long-term unadjusted estimates of effect showed significant differences in several outcomes, including death, rehospitalization, and their composite, which demonstrated that NT was associated with more unfavorable outcomes compared with the other devices (all P less than .05). However, most differences depended on baseline features, as adjusted analysis showed no significant differences for early as well as long-term outcomes, including long-term death, rehospitalization, and their composite (all P greater than .05). CONCLUSIONS New-generation MitraClip devices are associated with favorable procedural and clinical outcomes, despite being used in patients with more adverse features, when compared with patients treated with previous devices.
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Affiliation(s)
- Nicola Corcione
- Unità Operativa di Interventistica Cardiovascolare, Pineta Grande Hospital, Castel Volturno, Italy
| | - Paolo Ferraro
- Unità Operativa di Emodinamica, Santa Lucia Hospital, San Giuseppe Vesuviano, Italy
| | - Filippo Finizio
- Unità Operativa di Interventistica Cardiovascolare, Pineta Grande Hospital, Castel Volturno, Italy
| | - Michele Cimmino
- Unità Operativa di Interventistica Cardiovascolare, Pineta Grande Hospital, Castel Volturno, Italy
| | - Michele Albanese
- Unità Operativa di Interventistica Cardiovascolare, Pineta Grande Hospital, Castel Volturno, Italy
| | - Giuseppe Biondi-Zoccai
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy; Cardiology Unit, Santa Maria Goretti Hospital, Latina, Italy.
| | - Paolo Denti
- Department of Cardiac Surgery, Vita-Salute San Raffaele University, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Antonio Popolo Rubbio
- Department of Cardiology, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | - Antonio L Bartorelli
- Centro Cardiologico Monzino, IRCCS, Milan, Italy, and Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Annalisa Mongiardo
- Division of Cardiology, Department of Medical and Surgical Sciences, "Magna Graecia" University
| | - Salvatore Giordano
- Division of Cardiology, Department of Medical and Surgical Sciences, "Magna Graecia" University
| | - Francesco De Felice
- Division of Interventional Cardiology, Azienda Ospedaliera S. Camillo Forlanini, Rome, Italy
| | - Marianna Adamo
- Cardiac Catheterization Laboratory and Cardiology, ASST Spedali Civili di Brescia, and Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health University of Brescia, both in Brescia, Italy
| | - Matteo Montorfano
- Interventional Cardiology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy
| | - Cesare Baldi
- Heart Department, University Hospital 'Scuola Medica Salernitana', Salerno, Italy
| | - Giuseppe Tarantini
- Department of Cardiac, Thoracic and Vascular Science, Interventional Cardiology Unit, University of Padua, Padua, Italy
| | - Francesco Giannini
- Division of Cardiology, IRCCS Ospedale Galeazzi - Sant'Ambrogio, Milan, Italy
| | - Federico Ronco
- Interventional Cardiology, Department of Cardio-Thoracic and Vascular Sciences, Ospedale dell'Angelo, AULSS3 Serenissima, Mestre, Venezia, Italy
| | - Ida Monteforte
- Divisione di Cardiologia, A.O. dei Colli, Ospedale Monaldi, Napoli
| | - Emmanuel Villa
- Cardiac Surgery Unit and Valve Center, Poliambulanza Foundation Hospital, Brescia, Italy
| | - Maurizio Ferrario
- Division of Cardiology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy
| | - Luigi Fiocca
- Cardiovascular Department, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Fausto Castriota
- Interventional Cardiology Unit, GVM Care and Research, Maria Cecilia Hospital, Cotignola, Italy
| | - Angelo Squeri
- Interventional Cardiology Unit, GVM Care and Research, Maria Cecilia Hospital, Cotignola, Italy
| | - Corrado Tamburino
- Division of Cardiology, Centro Alte Specialità e Trapianti (CAST), Azienda Ospedaliero-Universitaria Policlinico-Vittorio Emanuele, University of Catania, Catania, Italy
| | - Francesco Bedogni
- Department of Cardiology, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | - Arturo Giordano
- Unità Operativa di Interventistica Cardiovascolare, Pineta Grande Hospital, Castel Volturno, Italy
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Giordano A, Pepe M, Biondi-Zoccai G, Corcione N, Finizio F, Ferraro P, Denti P, Popolo Rubbio A, Petronio S, Bartorelli AL, Nestola PL, Mongiardo A, DE Felice F, Adamo M, Montorfano M, Baldi C, Tarantini G, Giannini F, Ronco F, Monteforte I, Villa E, Ferrario Ormezzano M, Fiocca L, Castriota F, Bedogni F, Tamburino C. Impact of coronary artery disease on outcome after transcatheter edge-to-edge mitral valve repair with the MitraClip system. Panminerva Med 2023; 65:443-453. [PMID: 37259492 DOI: 10.23736/s0031-0808.23.04827-9] [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] [Indexed: 06/02/2023]
Abstract
BACKGROUND The clinical impact of coronary artery disease (CAD) on the prognosis of patients undergoing MitraClip implantation is still unclear. METHODS One thousand nine hundred fifty-three patients undergoing MitraClip implantation included in the multicenter GIOTTO Registry were stratified according to CAD. Endpoints were all-cause death, cardiac death, and re-hospitalization for heart failure at follow-up (median 15.8 months). RESULTS Although younger, CAD patients were more symptomatic, had worse cardiovascular risk profile, higher burden of comorbidities, more frequently affected by functional MR, with higher left ventricle (LV) diameters and lower ejection fraction (EF). At follow-up, CAD patients showed higher rates of all-cause death (25.4% vs. 19.6%; P=0.002), cardiovascular death (14.0% vs. 10.1%; P=0.007) and re-hospitalization for heart failure (13.9% vs. 10.2%; P=0.011). Dividing the population according to mitral regurgitation (MR) etiology (functional vs. non-functional MR), no differences were observed between CAD and no-CAD patients. At multivariate logistic regression, NYHA III/IV class, prior heart failure hospitalization, severe chronic kidney disease, atrial fibrillation, LV end-diastolic diameter and LVEF<30% but not CAD resulted independent predictors of all-cause death. The same finding was confirmed even after propensity score adjustment. CONCLUSIONS CAD did not show a relevant impact on mid-term prognosis per se, but seemed to identify a more complex and diseased cohort of patients with worse clinical and functional status.
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Affiliation(s)
- Arturo Giordano
- Unit of Invasive Cardiology, Pineta Grande Hospital, Castel Volturno, Caserta, Italy
| | - Martino Pepe
- Section of Cardiovascular Diseases, Department of Emergency and Organ Transplantation (DETO), University of Bari, Bari, Italy -
| | - Giuseppe Biondi-Zoccai
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University, Latina, Italy
- Mediterranea Cardiocentro, Naples, Italy
| | - Nicola Corcione
- Unit of Invasive Cardiology, Pineta Grande Hospital, Castel Volturno, Caserta, Italy
| | - Filippo Finizio
- Unit of Invasive Cardiology, Pineta Grande Hospital, Castel Volturno, Caserta, Italy
| | - Paolo Ferraro
- Department of Invasive Cardiology, Casa di Salute Santa Lucia, San Giuseppe Vesuviano, Naples, Italy
| | - Paolo Denti
- Department of Cardiac Surgery, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Antonio Popolo Rubbio
- Department of Cardiology, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | - Sonia Petronio
- Cardiac Catheterization Laboratory, Department of Cardiothoracic and Vascular, University Hospital of Pisa, Pisa, Italy
| | - Antonio L Bartorelli
- Centro Cardiologico Monzino, IRCCS, Milan, Italy
- Luigi Sacco Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Palma L Nestola
- Section of Cardiovascular Diseases, Department of Emergency and Organ Transplantation (DETO), University of Bari, Bari, Italy
| | | | - Francesco DE Felice
- Unit of Interventional Cardiology, S. Camillo Forlanini Hospital, Rome, Italy
| | - Marianna Adamo
- Cardiac Catheterization Laboratory, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, ASST Spedali Civili di Brescia, University of Brescia, Brescia, Italy
| | - Matteo Montorfano
- Cardio-Thoracic-Vascular Department, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Cesare Baldi
- Department of Interventional Cardiology, San Giovanni e Ruggi University Hospital, Salerno, Italy
| | - Giuseppe Tarantini
- Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | | | - Federico Ronco
- Department of Interventional Cardiology, Dell'Angelo Hospital, Mestre, Venice, Italy
| | - Ida Monteforte
- Unit of Interventional Cardiology, AORN dei Colli, Naples, Italy
| | - Emmanuel Villa
- Cardiac Surgery and Transcatheter Valve Therapy Group, Poliambulanza Foundation Hospital, Brescia, Italy
| | | | - Luigi Fiocca
- Unit of Interventional Cardiology, Cardiovascular Department, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Fausto Castriota
- GVM Care & Research Maria Cecilia Hospital, Cotignola, Ravenna, Italy
| | - Francesco Bedogni
- Department of Cardiology, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | - Corrado Tamburino
- Division of Cardiology, G. Rodolico - San Marco Polyclinic Univeristy Hospital, University of Catania, Catania, Italy
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Moretti F, Bernelli C, Pellegrini D, Boccuzzi G, Colombo F, Sirbu V, Vassileva A, Fiocca L, Canova P, Bezerra H, Pereira GTR, Cereda A, De Luca L, Saia F, Capodanno D, Guagliumi G. Determinants and long-term outcomes of largely uncovered struts in thin-struts drug-eluting stents assessed by optical coherence tomography. Catheter Cardiovasc Interv 2022; 100 Suppl 1:S25-S35. [PMID: 36661369 DOI: 10.1002/ccd.30379] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 06/30/2022] [Accepted: 08/12/2022] [Indexed: 01/21/2023]
Abstract
BACKGROUND Uncovered struts are a determinant of stent failure. The impact of plaque composition and procedural factors on the occurrence, evolution, and outcomes of uncovered struts in a high-risk setting has not been investigated. OBJECTIVE To investigate the determinants and long-term clinical impact of largely uncovered struts (LUS) in thin-struts drug-eluting stents (DES) implanted in complex lesions by intracoronary optical coherence tomography (OCT). METHODS Ninety patients with multivessel disease undergoing staged complete revascularization were randomly assigned to bioabsorbable or durable polymer DES. OCT were serially performed during the index procedure, at 3- and 18-month follow-up, and analyzed by an independent core lab. Struts were defined uncovered by OCT if no tissue was visible above the struts. LUS were defined as ≥30% of uncovered struts at 3-month follow-up. Clinical outcomes were the occurrence of target vessel failure (TVF) and major adverse cardiac and cerebrovascular events (MACCE) at 5-year follow-up. RESULTS LUS occurred in 31 patients (34.4%) regardless of stent platform. At 5 years, no differences were observed in the rate of TVF (12.7% vs. 13.4%; p = 0.91) and MACCE (23.9% vs. 24.9%; p = 0.88) between the two groups. At multivariate logistic regression, plaque rupture, mean lumen diameter, proximal reference vessel area, and maximum stent deployment pressure were independent predictors of LUS. CONCLUSIONS LUS are a frequent finding in complex coronary lesions treated with thin-struts DES, especially in the presence of plaque rupture. However, in this study, no significant safety signal related to LUS emerged in long-term follow-up.
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Affiliation(s)
- Francesco Moretti
- Department of Cardiovascular, Ospedale Papa Giovanni XXIII, Bergamo, Italy.,Cardiology Unit, Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Chiara Bernelli
- Division of Cardiology, Ospedale Santa Corona, Pietra Ligure, Italy
| | - Dario Pellegrini
- Department of Cardiovascular, Ospedale Papa Giovanni XXIII, Bergamo, Italy
| | - Giacomo Boccuzzi
- Department of Cardiovascular, Ospedale San Giovanni Bosco, Torino, Italy
| | - Francesco Colombo
- Department of Cardiovascular, Ospedale San Giovanni Bosco, Torino, Italy
| | - Vasile Sirbu
- Department of Cardiovascular, Ospedale Papa Giovanni XXIII, Bergamo, Italy.,Interventional Cardiology, Jilin Heart Hospital, Changchun, Jilin Province, China
| | - Angelina Vassileva
- Department of Cardiovascular, Ospedale Papa Giovanni XXIII, Bergamo, Italy
| | - Luigi Fiocca
- Department of Cardiovascular, Ospedale Papa Giovanni XXIII, Bergamo, Italy
| | - Paolo Canova
- Department of Cardiovascular, Ospedale Papa Giovanni XXIII, Bergamo, Italy
| | - Hiram Bezerra
- Cardiovascular Imaging Core Laboratory, University Hospital, Case Medical Centre, Cleveland, Ohio, USA
| | - Gabriel T R Pereira
- Cardiovascular Imaging Core Laboratory, University Hospital, Case Medical Centre, Cleveland, Ohio, USA
| | - Alberto Cereda
- Division of Cardiology, ASST Santi Paolo e Carlo, Milan, Italy
| | - Leonardo De Luca
- Department of Cardiosciences, Azienda Ospedaliera San Camillo-Forlanini, Roma, Italy
| | - Francesco Saia
- Department of Cardiothoracic Vascular, University Hospital, Bologna, Italy
| | - Davide Capodanno
- Department of Cardio-Thoracic-Vascular and Transplant, A.O.U. Vittorio Emanuele-Policlinico, University of Catania, Catania, Italy
| | - Giulio Guagliumi
- Department of Cardiovascular, Ospedale Papa Giovanni XXIII, Bergamo, Italy
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Fiocca L, Rossini R, Carioli G, Carobbio A, Piazza I, Collaku E, Giubilato S, Amico F, Molfese M, De Benedictis M, Calabria P, Limbruno U, Valente S, Ferlini M, Spezzano T, Senni M, Gavazzi A. Adherence of ticagrelOr in real world patients with aCute coronary syndrome: The AD-HOC study. IJC Heart & Vasculature 2022; 42:101092. [PMID: 35873861 PMCID: PMC9301572 DOI: 10.1016/j.ijcha.2022.101092] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 06/19/2022] [Accepted: 07/13/2022] [Indexed: 10/24/2022]
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Iacovoni A, Conti N, Zucchetti O, Fiocca L, Senni M. Diastolic Ventricular Interaction in a Heart Transplant Patient With Severe Tricuspid Regurgitation. Circ Heart Fail 2022; 15:e009368. [PMID: 35189707 DOI: 10.1161/circheartfailure.121.009368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Attilio Iacovoni
- Cardiovascular Department, ASST Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Nicolina Conti
- Cardiovascular Department, ASST Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Ottavio Zucchetti
- Cardiovascular Department, ASST Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Luigi Fiocca
- Cardiovascular Department, ASST Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Michele Senni
- Cardiovascular Department, ASST Papa Giovanni XXIII Hospital, Bergamo, Italy
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Moretti F, Bernelli C, Pellegrini D, Boccuzzi G, Colombo F, Sirbu V, Vassileva A, Fiocca L, Canova P, Rodrigues Pereira GT, Cereda A, De Luca L, Kim JS, Saia F, Capodanno D, Guagliumi G. TCT-437 Determinants and Long-Term Outcomes of Largely Uncovered Struts in Thin-Strut Drug-Eluting Stents Assessed by Optical Coherence Tomography: A TRANSFORM-OCT Substudy. J Am Coll Cardiol 2021. [DOI: 10.1016/j.jacc.2021.09.1290] [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: 10/20/2022]
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Pescetelli I, Marchetti M, Gomez Rosas P, Sanga E, Russo L, Moretti F, Pellegrini D, Fiocca L, Canova PA, Vassileva A, Gamba S, Verzeroli C, Grosu A, Guagliumi G, Falanga A. A prospective evaluation of COVID-19 associated coagulopathy with acute coronary syndrome (ACS). Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1288] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Hospitalised COVID-19 pneumonia patients are characterised by the occurrence of a hypercoagulable state associated to a high risk of thromboembolic events. The main laboratory findings of this coagulopathy include D-dimer increase, mild thrombocytopenia, prolonged PT, and increase endothelial activation biomarkers (vWF, thrombomodulin). No data are available about coagulation profile in patients presenting with an acute coronary syndrome (ACS) combined with SARS-CoV-2 infection.
Purpose
In this prospective study, we aimed to evaluate the contribute of concomitant SARS-CoV-2 infection to the haemostatic system derangement (i.e., from endothelial cell activation to fibrinolytic phase) observed in patients presenting with ACS. Further, the role of haemostatic biomarkers (HB) for in-hospital mortality risk prediction was also explored.
Methods
Consecutive patients admitted to our hospital for ACS at peak intensity of local pandemia were enrolled into this study. At admission, all patients underwent routine blood examinations with blood count, serum biochemical tests and an extensive coagulation profiling. Data from coronary angiography and percutaneous coronary intervention (PCI), when performed, were collected. In-hospital major adverse cardio and cerebrovascular events –MACCEs- (total and cardiovascular death, stroke, systemic or pulmonary embolism, re-MI and bleedings) are reported.
Results
A total of 99 (76M/23F) consecutive patients with a median age of 66.7 (±12.1) were enrolled. According to nasal swab, 24 patients were SARS-CoV-2 positive and 75 negative. The two groups, similar in age, sex and cardiovascular risk factors, significantly differed in presenting symptoms (p<.001) and radiological signs of pneumonia (p<.0001). At admission, there were no differences in routine laboratory values between groups. Differently, analysis of the HB showed significantly higher values of D-dimer, vWF antigen, vWF activity and vWF; RiCof, t-PA and PAI-1 and lower levels of ADAMTS-13 in the positive group. Furthermore, among ACS patients, both STEMI and NSTEMI subjects, positive for SARS-CoV-2, had significantly higher plasma values of all the HB compared to the respective negative counterparts, with SARS-CoV-2 positive STEMI subjects displaying the highest values. When performed, PCI finished more frequently with a final TIMI flow <3 (p=.004) in positive patients. The in-hospital rate of MACCEs was 24% (24/99 patients) with a higher (p<.0001) prevalence in SARS-Co-V2 positive group. Cardiovascular mortality accounted for the majority of deaths (8/10; p=.019). At multivariable analysis, we identified dyspnoea at presentation, vWF antigen and leukocyte values as independent risk factors for in-hospital death.
Conclusions
In patients presenting with ACS combined with SARS-Cov-2 infection an additional HB asset derangement with stronger endothelial cell activation occurs which negatively impact the outcome, regardless of the invasive treatment.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- I Pescetelli
- ASST Papa Giovanni XXIII Bergamo, Cardiovascular Department, Bergamo, Italy
| | - M Marchetti
- ASST Papa Giovanni XXIII Bergamo, Department of Immunohematology and Transfusion Medicine & Hemostasis and Thrombosis Center, Bergamo, Italy
| | - P Gomez Rosas
- ASST Papa Giovanni XXIII Bergamo, Department of Immunohematology and Transfusion Medicine & Hemostasis and Thrombosis Center, Bergamo, Italy
| | - E Sanga
- ASST Papa Giovanni XXIII Bergamo, Department of Immunohematology and Transfusion Medicine & Hemostasis and Thrombosis Center, Bergamo, Italy
| | - L Russo
- ASST Papa Giovanni XXIII Bergamo, Department of Immunohematology and Transfusion Medicine & Hemostasis and Thrombosis Center, Bergamo, Italy
| | - F Moretti
- ASST Papa Giovanni XXIII Bergamo, Cardiovascular Department, Bergamo, Italy
| | - D Pellegrini
- ASST Papa Giovanni XXIII Bergamo, Cardiovascular Department, Bergamo, Italy
| | - L Fiocca
- ASST Papa Giovanni XXIII Bergamo, Cardiovascular Department, Bergamo, Italy
| | - P A Canova
- ASST Papa Giovanni XXIII Bergamo, Cardiovascular Department, Bergamo, Italy
| | - A Vassileva
- ASST Papa Giovanni XXIII Bergamo, Cardiovascular Department, Bergamo, Italy
| | - S Gamba
- ASST Papa Giovanni XXIII Bergamo, Department of Immunohematology and Transfusion Medicine & Hemostasis and Thrombosis Center, Bergamo, Italy
| | - C Verzeroli
- ASST Papa Giovanni XXIII Bergamo, Department of Immunohematology and Transfusion Medicine & Hemostasis and Thrombosis Center, Bergamo, Italy
| | - A Grosu
- ASST Papa Giovanni XXIII Bergamo, Cardiovascular Department, Bergamo, Italy
| | - G Guagliumi
- ASST Papa Giovanni XXIII Bergamo, Cardiovascular Department, Bergamo, Italy
| | - A Falanga
- ASST Papa Giovanni XXIII Bergamo, Department of Immunohematology and Transfusion Medicine & Hemostasis and Thrombosis Center, Bergamo, Italy
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9
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Pellegrini D, Fiocca L, Pescetelli I, Canova P, Vassileva A, Faggi L, Senni M, Guagliumi G. Effect of Respiratory Impairment on the Outcomes of Primary Percutaneous Coronary Intervention in Patients With ST-Segment Elevation Myocardial Infarction and Coronavirus Disease-2019 (COVID-19). Circ J 2021; 85:1701-1707. [PMID: 33658444 DOI: 10.1253/circj.cj-20-1166] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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] [Indexed: 11/09/2022]
Abstract
BACKGROUND Coronavirus Disease-2019 (COVID-19) may impair outcomes of patients with ST-segment elevation myocardial infarction (STEMI). The extent of this phenomenon and its mechanisms are unclear.Methods and Results:This study prospectively included 50 consecutive STEMI patients admitted to our center for primary percutaneous coronary intervention (PCI) at the peak of the Italian COVID-19 outbreak. At admission, a COVID-19 test was positive in 24 patients (48%), negative in 26 (52%). The primary endpoint was in-hospital all-cause mortality. Upon admission, COVID-19 subjects had lower PO2/FiO2 (169 [100-425] vs. 390 [302-477], P<0.01), more need for oxygen support (62.5% vs. 26.9%, P=0.02) and a higher rate of myocardial dysfunction (ejection fraction <30% in 45.8% vs. 19.2%, P=0.04). All patients underwent emergency angiography. In 12.5% of COVID-19 patients, no culprit lesions were detected, thus PCI was performed in 87.5% and 100% of COVID-19 positive and negative patients, respectively (P=0.10). Despite a higher rate of obstinate thrombosis in the COVID-19 group (47.6% vs. 11.5%, P<0.01), the PCI result was similar (TIMI 2-3 in 90.5% vs. 100%, P=0.19). In-hospital mortality was 41.7% and 3.8% in COVID-19 positive and negative patients, respectively (P<0.01). Respiratory failure was the leading cause of death (80%) in the COVID-19 group, frequently associated with severe myocardial dysfunction. CONCLUSIONS In-hospital mortality of COVID-19 patients with STEMI remains high despite successful PCI, mainly due to coexisting severe respiratory failure. This may be a critical factor in patient management and treatment selection.
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Affiliation(s)
| | - Luigi Fiocca
- Cardiovascular Department, Papa Giovanni XXIII Hospital
| | | | - Paolo Canova
- Cardiovascular Department, Papa Giovanni XXIII Hospital
| | | | - Lara Faggi
- Cardiovascular Department, Papa Giovanni XXIII Hospital
| | - Michele Senni
- Cardiovascular Department, Papa Giovanni XXIII Hospital
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10
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Giordano A, Ferraro P, Finizio F, Biondi-Zoccai G, Denti P, Bedogni F, Rubbio AP, Petronio AS, Bartorelli AL, Mongiardo A, Giordano S, DE Felice F, Adamo M, Montorfano M, Baldi C, Tarantini G, Giannini F, Ronco F, Monteforte I, Villa E, Ferrario M, Fiocca L, Castriota F, Tamburino C. Implantation of one, two or multiple MitraClips for transcatheter mitral valve repair: insights from a 1824-patient multicenter study. Panminerva Med 2021; 64:1-8. [PMID: 34309332 DOI: 10.23736/s0031-0808.21.04497-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Transcatheter mitral valve repair (TMVR) with the MitraClip device is an established treatment for mitral regurgitation (MR). More than one MitraClip may be implanted if a single one does not reduce MR adequately. We aimed at appraising the outlook of patients undergoing implantation of one, two or multiple MitraClips for TMVR. METHODS Exploiting the ongoing prospective GIse registry Of Transcatheter treatment of mitral valve regurgitaTiOn (GIOTTO) Study dataset, we compared patients, procedural details and outcomes distinguishing those receiving one, two or multiple MitraClips. The primary endpoint was the composite of 1-year cardiac death or rehospitalization for heart failure. Additional endpoints included all cause death, surgical mitral repair, and functional class. Multivariable adjusted Cox proportional hazard analysis was used for confirmatory purposes. RESULTS As many as 1824 patients were included: 718 (39.4%) treated with a single MitraClip, and 940 (51.5%) receiving two MitraClips, and 166 (9.1%) receiving three or more. Significant differences were found for baseline features, including age, female gender, diabetes mellitus, hypertension, chronic obstructive pulmonary disease, prior myocardial infarction, atrial fibrillation, permanent pacemaker, cardiac resynchronization therapy, implantable cardioverter defibrillator, and prior mitral valve repair (all p<0.05). Several imaging features were also different, including left ventricular dimensions, MR severity and proportionality, mitral valve area, flail leaflet, and pulmonary vein flow (all p<0.05). Among procedural features, significant differences were found for anesthesia type, MitraClip type, fluoroscopy, device, and operating room times, postprocedural mitral gradient, residual MR, smoke-like effect, device success partial detachment and surgical conversion (all p<0.05). In-hospital death occurred more frequently in patients receiving multiple MitraClips, and the same applied severe residual MR (all p<0.05). Mid-term follow-up (15±13 months) showed significant difference in the risk of death, cardiac death, rehospitalization for heart failure, and their composites, mainly, but not solely, associated with multiple MitraClips (all p<0.05). Adjusted analysis confirmed the significantly increased risk of composite adverse events when comparing the multiple vs single MitraClip groups (p=0.014 for death and rehospitalization, p=0.013 for cardiac death or rehospitalization). CONCLUSIONS Implantation of one or two MitraClips is associated with favorable clinical outcomes. Conversely, bail-out implantation of three or more MitraClips may portend a worse long-term prognosis.
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Affiliation(s)
- Arturo Giordano
- Unità Operativa di Interventistica Cardiovascolare, Pineta Grande Hospital, Castel Volturno, Caserta, Italy
| | - Paolo Ferraro
- Unità Operativa di Emodinamica, Santa Lucia Hospital, San Giuseppe Vesuviano, Napoli, Italy
| | - Filippo Finizio
- Unità Operativa di Interventistica Cardiovascolare, Pineta Grande Hospital, Castel Volturno, Caserta, Italy
| | - Giuseppe Biondi-Zoccai
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy - .,Mediterranea Cardiocentro, Naples, Italy
| | - Paolo Denti
- Department of Cardiac Surgery, Vita-Salute San Raffaele University, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Francesco Bedogni
- Department of Cardiology, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | - Antonio P Rubbio
- Department of Cardiology, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | - Anna S Petronio
- Cardiothoracic and Vascular Department, University Hospital Pisa, Pisa, Italy
| | - Antonio L Bartorelli
- Centro Cardiologico Monzino, IRCCS, Milan, Italy.,Department of Biomedical and Clinical Sciences Luigi Sacco, University of Milan, Milan, Italy
| | - Annalisa Mongiardo
- Division of Cardiology, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy
| | - Salvatore Giordano
- Division of Cardiology, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy
| | - Francesco DE Felice
- Division of Interventional Cardiology, Azienda Ospedaliera S. Camillo Forlanini, Rome, Italy
| | - Marianna Adamo
- Cardiothoracic Department, Spedali Civili Brescia, Brescia, Italy
| | - Matteo Montorfano
- Cardio-Thoracic-Vascular Department, San Raffaele University Hospital, Milan, Italy
| | - Cesare Baldi
- Heart Department, University Hospital Scuola Medica Salernitana, Salerno, Italy
| | - Giuseppe Tarantini
- Department of Cardiac, Thoracic and Vascular Science, Interventional Cardiology Unit, University of Padua, Padua, Italy
| | - Francesco Giannini
- Interventional Cardiology Unit, GVM Care & Research, Maria Cecilia Hospital, Cotignola, Ravenna, Italy
| | - Federico Ronco
- Interventional Cardiology, Department of Cardio-Thoracic and Vascular Sciences, Ospedale dell'Angelo, AULSS3 Serenissima, Mestre, Venezia, Italy
| | - Ida Monteforte
- Divisione di Cardiologia, A.O. dei Colli, Ospedale Monaldi, Napoli, Italy
| | - Emmanuel Villa
- Department of Cardiac Surgery, Poliambulanza Foundation Hospital, Brescia, Italy
| | - Maurizio Ferrario
- Division of Cardiology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy
| | - Luigi Fiocca
- Cardiovascular Department, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Fausto Castriota
- Cardiovascular Department of Humanitas Gavazzeni Hospital, Bergamo, Italy
| | - Corrado Tamburino
- Division of Cardiology, Centro Alte Specialità e Trapianti (CAST), Azienda Ospedaliero-Universitaria Policlinico-Vittorio Emanuele, University of Catania, Catania, Italy
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11
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Frigerio M, Fiocca L, Bedogni F, Alfieri O, Margonato A, Galletti L, Indolfi C, Senni M, Grigioni F. [Grey zones on valvular heart disease: interventional cardiology versus cardiac surgery. Expert opinion]. G Ital Cardiol (Rome) 2020; 21:111-118. [PMID: 32051634 DOI: 10.1714/3300.32704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Clinical guidelines, while representing an objective reference to perform correct therapeutic choices, contain grey zones, where recommendations are not supported by solid evidence. In a conference held in Bergamo in October 2018, an attempt was made to highlight some of the main grey zones in Cardiology and, through a comparison between experts, to draw shared conclusions that can illuminate our clinical practice. This manuscript contains the statements of the symposium concerning the controversies in the percutaneous treatment of valvulopathies. The first topic concerns the durability of aortic bioprostheses, comparing percutaneous interventional with surgical experiences. The second issue examines the opportunity to extend percutaneous aortic replacement as standard care to low-risk patients. The last gap in evidence concerns the percutaneous treatment of functional mitral valve insufficiency, with the MitraClip system. The work has also been implemented with evidences deriving from important randomized studies published after the date of the Conference.
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Affiliation(s)
- Maria Frigerio
- Cardiologia 2 - Insufficienza Cardiaca e Trapianto, Dipartimento Cardiotoracovascolare - De Gasperis Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milano
| | - Luigi Fiocca
- Dipartimento Cardiovascolare, ASST Papa Giovanni XXIII, Bergamo
| | - Francesco Bedogni
- Dipartimento di Cardiologia, IRCCS Policlinico San Donato, San Donato Milanese (MI)
| | - Ottavio Alfieri
- Dipartimento di Cardiochirurgia, Ospedale Universitario San Raffaele, Milano
| | - Alberto Margonato
- Unità di Terapia Intensiva Cardiologica, Dipartimento Cardio-Toraco-Vascolare, Ospedale Universitario San Raffaele, Milano
| | | | - Ciro Indolfi
- U.O.C. Cardiologia Emodinamica ed UTIC, CNR-IFC, Università degli Studi "Magna Graecia", Catanzaro
| | - Michele Senni
- Dipartimento Cardiovascolare, ASST Papa Giovanni XXIII, Bergamo
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12
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Bernelli C, Pellegrini D, Pescetelli I, Garbo R, Sirbu V, Fiocca L, Canova P, Colombo F, Cereda A, Boccuzzi G, Rodriguez Pereira G, Bezerra H, Saia F, Capodanno D, Guagliumi G. Incidence, mechanisms and clinical impact of largely uncovered struts in current generation drug-eluting-stents: insight from the TRANSFORM-OCT Study. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2474] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Thin-strut drug-eluting stents (DES) and optimal implantation technique reduce the rate of stent failure significantly. Nevertheless, uncovered struts (US) have been observed as a key factor for stent thrombosis regardless of stent generation and time of follow-up. Associated factors and temporal evolution are currently unknown.
Purpose
To evaluate the prevalence, mechanisms and long-term clinical impact of largely-US after state-of-the-art DES implantation in complex coronary clinical/lesion cohorts
Methods
The study was a pre-specified analysis of TRASFORM-OCT, a randomized controlled trial comparing bioabsorbable or durable polymer DES by serial optical coherence tomography (OCT), obtained at baseline, immediately after procedure, at 3 and 18 months follow-up. Methods and results were published previously. For the current analysis enrolled patients (n=90) were divided in 2 groups according to the amount of US identified by OCT at 3 months: a largely US (LUS ≥30%) group and the control group (<30% US), to evaluate factors associated to LUS, and the clinical impact at follow-up.
Results
Out of 90 patients, 31 (34.4%) were assigned to the LUS group, and 59 (65.6%) to the control group. At baseline, LUS patients had larger vessels (reference area 5.51±1.1 vs. 4.27±1.5 mm2, p=0.001), a higher rate of plaque rupture (41.9 vs. 18.6%, p=0.02), thin-cap fibroatheroma (58.1% vs. 51.7% p=0.03) and thrombus (58.1% vs. 35.6%, p=0.001) as detected by OCT. 98% patients continued dual antiplatelet therapy up to 12 months, and 24% of them up to 18 months.
At stent implant, performed with high pressure dilation (21.18±3.8 vs 20.54±3.6 atm in LUS vs control group, p 0.48), the rate of apposed and embedded struts was high in both groups, although higher in controls (93.92±5.30% vs 96.46±3.68%, p 0.03 and 16.8±11.5% vs 21.7±15.8%, p=0.12, respectively for controls and LUS). At 3 months, US rate was 48.4±12% in the LUS group, and 13.3±7% in the control group (p<0.001). Global malapposition rate was 7.95±7.5% and 1.69±1.6% (p<0.001), respectively. 84.52±12.41% of the US in the LUS group and 86.49±19.98% in controls group were apposed to the wall (p 0.07). At 18 months, the rate of US dropped significantly to 8.4±10% in LUS group and 1.8±3% in control group (p<0.001), with malapposition rate being 1.4±3.3 and 0.16±0.43% (p 0.006). Of the US, 81.6±25.15 and 91.11±21.76% were apposed to the wall, respectively. At 5 years clinical follow-up, no differences were observed at the composite endpoint of major adverse cardiovascular events (detailed data will be presented).
Conclusions
In a setting of optimal PCI with modern DES and high-pressure inflation, LUS occur in 30% of patients at early follow-up, more frequently in large vessels with lipid-rich, complex plaques. The vast majority of US is apposed to the wall and near-complete coverage is observed at long-term follow-up, with no clinical impact compared to subjects with a low rate of US.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- C Bernelli
- Ospedale Santa Corona, Pietra Ligure, Italy
| | | | | | - R Garbo
- San Giovanni Bosco Hospital of Turino, Turin, Italy
| | - V Sirbu
- Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - L Fiocca
- Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - P Canova
- Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - F Colombo
- San Giovanni Bosco Hospital of Turino, Turin, Italy
| | - A Cereda
- ASST della Valtellina e dell'Alto Lario, Sondrio, Italy
| | - G Boccuzzi
- San Giovanni Bosco Hospital of Turino, Turin, Italy
| | | | - H Bezerra
- University Hospitals Case Medical Center, Cleveland, United States of America
| | - F Saia
- Universitary Hospital Sant'orsola Malpighi, Bologna, Italy
| | - D Capodanno
- AOU Policlinico - Vittorio Emanuele, Catania, Italy
| | - G Guagliumi
- Papa Giovanni XXIII Hospital, Bergamo, Italy
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13
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Senni M, Iacovoni A, Fiocca L. [The MITRA-FR and COAPT trials: the clinical cardiologist's point of view]. G Ital Cardiol (Rome) 2019; 20:190-193. [PMID: 30920544 DOI: 10.1714/3126.31070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- Michele Senni
- U.O.C. Cardiologia, Dipartimento Cardiovascolare, ASST Papa Giovanni XXIII, Bergamo
| | - Attilio Iacovoni
- U.O.C. Cardiologia, Dipartimento Cardiovascolare, ASST Papa Giovanni XXIII, Bergamo
| | - Luigi Fiocca
- U.O.C. Cardiologia, Dipartimento Cardiovascolare, ASST Papa Giovanni XXIII, Bergamo
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14
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Affiliation(s)
| | - Luigi Fiocca
- Cardiovascular Department, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Laura Cattaneo
- Cardiovascular Department, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Attilio Iacovoni
- Cardiovascular Department, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Sandro Sironi
- Department of Radiology, ASST Papa Giovanni XXIII, Bergamo, Italy.,University Milano - Bicocca, Milan, Italy
| | - Michele Senni
- Cardiovascular Department, ASST Papa Giovanni XXIII, Bergamo, Italy
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15
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Fiocca L, Cereda AF, Bernelli C, Canova PA, Serino F, Niglio T, Musumeci G, Guagliumi G, Vassileva A, Senni M, Valsecchi O. Autologous blood reinfusion during iatrogenic acute hemorrhagic cardiac tamponade: Safety and feasibility in a cohort of 30 patients. Catheter Cardiovasc Interv 2018; 93:E56-E62. [DOI: 10.1002/ccd.27784] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2018] [Revised: 05/29/2018] [Accepted: 06/20/2018] [Indexed: 01/25/2023]
Affiliation(s)
- Luigi Fiocca
- Cardiovascular Department; Ospedale Papa Giovanni XXIII; Bergamo Italy
| | - Alberto F. Cereda
- Cardiovascular Department; Ospedale Papa Giovanni XXIII; Bergamo Italy
| | - Chiara Bernelli
- Interventional Cardiology Unit, ASST Nord Milano; Ospedale Edoardo Bassini; Cinisello Balsamo (MI) Italy
| | - Paolo A. Canova
- Cardiovascular Department; Ospedale Papa Giovanni XXIII; Bergamo Italy
| | - Federica Serino
- Cardiovascular Department; Ospedale Papa Giovanni XXIII; Bergamo Italy
| | - Tullio Niglio
- Cardiovascular Department; Ospedale Papa Giovanni XXIII; Bergamo Italy
| | - Giuseppe Musumeci
- Cardiovascular Department; Ospedale Santa Croce e Carle; Cuneo Italy
| | - Giulio Guagliumi
- Cardiovascular Department; Ospedale Papa Giovanni XXIII; Bergamo Italy
| | | | - Michele Senni
- Cardiovascular Department; Ospedale Papa Giovanni XXIII; Bergamo Italy
| | - Orazio Valsecchi
- Cardiovascular Department; Ospedale Papa Giovanni XXIII; Bergamo Italy
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16
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Vassileva A, Valsecchi O, Guagliumi G, Fiocca L, Canova PA, Cereda AF. Bilateral Slender Transradial Aortic Balloon Valvuloplasty. J Invasive Cardiol 2018; 30:E48-E49. [PMID: 29799428] [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: 06/08/2023]
Abstract
Percutaneous aortic balloon valvuloplasty as a bridge-to-decision strategy was performed in an 89-year-old woman with multiple comorbidities and cachexia. The patient did well; after 2 weeks, she was discharged home and referred for possible TAVR.
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17
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Guagliumi G, Shimamura K, Sirbu V, Garbo R, Boccuzzi G, Vassileva A, Valsecchi O, Fiocca L, Canova P, Colombo F, Tensol Rodriguez Pereira G, Nakamura D, Attizzani GF, Cereda A, Satogami K, De Luca L, Saia F, Capodanno D. Temporal course of vascular healing and neoatherosclerosis after implantation of durable- or biodegradable-polymer drug-eluting stents. Eur Heart J 2018; 39:2448-2456. [DOI: 10.1093/eurheartj/ehy273] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Accepted: 04/24/2018] [Indexed: 11/14/2022] Open
Affiliation(s)
- Giulio Guagliumi
- Cardiovascular Department, Ospedale Papa Giovanni XXIII, Bergamo, Italy
| | | | - Vasile Sirbu
- Cardiovascular Department, Ospedale Papa Giovanni XXIII, Bergamo, Italy
| | - Roberto Garbo
- Cardiovascular Department, Ospedale San Giovanni Bosco, Torino, Italy
| | - Giacomo Boccuzzi
- Cardiovascular Department, Ospedale San Giovanni Bosco, Torino, Italy
| | | | - Orazio Valsecchi
- Cardiovascular Department, Ospedale Papa Giovanni XXIII, Bergamo, Italy
| | - Luigi Fiocca
- Cardiovascular Department, Ospedale Papa Giovanni XXIII, Bergamo, Italy
| | - Paolo Canova
- Cardiovascular Department, Ospedale Papa Giovanni XXIII, Bergamo, Italy
| | - Francesco Colombo
- Cardiovascular Department, Ospedale San Giovanni Bosco, Torino, Italy
| | | | - Daisuke Nakamura
- Cardiovascular Imaging Core Laboratory, University Hospital, Case Medical Centre, Cleveland, OH, USA
| | - Guilherme F Attizzani
- Cardiovascular Imaging Core Laboratory, University Hospital, Case Medical Centre, Cleveland, OH, USA
| | - Alberto Cereda
- Cardiovascular Department, Ospedale Papa Giovanni XXIII, Bergamo, Italy
| | - Keisuke Satogami
- Cardiology Department, Wakayama Medical University, Wakayama, Japan
| | - Leonardo De Luca
- Cardiology Department, Ospedale San Giovanni Evangelista, Tivoli, Italy
| | - Francesco Saia
- Cardiothoracic Vascular Department, University Hospital, Bologna, Italy
| | - Davide Capodanno
- Cardio-Thoracic-Vascular and Transplant Department, A.O.U. “Vittorio Emanuele-Policlinico”, University of Catania, Catania, Italy
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18
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Schmitz C, Biffi M, Sievert H, Neuzil P, Brugaletta S, Frerker C, Zaman A, Fiocca L, Labrousse L, Annest L. TCT-815 Clinical benefits of less-invasive, device–based Left Ventricular Reconstruction: A hybrid option for patients with ischemic cardiomyopathy. J Am Coll Cardiol 2016. [DOI: 10.1016/j.jacc.2016.09.906] [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: 10/20/2022]
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19
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Fiocca L, Bernelli C, Sirbu V, Musumeci G, Guagliumi G, Vassileva A, Borghesi M, Valsecchi O. How to perform distal anchoring technique by 6French radial approach in complex coronary procedures. Cardiovascular Revascularization Medicine 2016; 17:339-43. [DOI: 10.1016/j.carrev.2016.02.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Revised: 02/11/2016] [Accepted: 02/15/2016] [Indexed: 10/22/2022]
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20
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Brucato A, D'Elia E, Pedrotti P, Valenti A, De Amici M, Fiocca L, Duino V, Senni M, Imazio M, Martini A. Reply to: "Effusive-constrictive pericarditis successfully treated with anakinra" G. Lazaros et al. Interleukin-1β receptor antagonist and pericardial constriction. Clin Exp Rheumatol 2015; 33:946. [PMID: 26517765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Accepted: 07/29/2015] [Indexed: 06/05/2023]
Affiliation(s)
- A Brucato
- Internal Medicine Department, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - E D'Elia
- Cardiovascular Department, Papa Giovanni XXIII Hospital, Bergamo, Italy.
| | - P Pedrotti
- Cardiovascular Department, Ca' Granda Niguarda Hospital, Milan, Italy
| | - A Valenti
- Internal Medicine Department, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - M De Amici
- Paediatric Clinic, IRCCS Polyclinic San Matteo, Pavia, Italy
| | - L Fiocca
- Cardiovascular Department, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - V Duino
- Cardiovascular Department, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - M Senni
- Cardiovascular Department, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Massimo Imazio
- Cardiology Department, Maria Vittoria Hospital, Torino, Italy
| | - A Martini
- University of Genova, Department of Paediatrics, IRCCS G. Gaslini, Genova, Italy
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Duino V, Fiocca L, Musumeci G, D'Elia E, Gori M, Cerchierini E, Valsecchi O, Senni M. An intriguing case report of functional mitral regurgitation treated with MitraClip. Medicine (Baltimore) 2015; 94:e608. [PMID: 25997036 PMCID: PMC4602878 DOI: 10.1097/md.0000000000000608] [Citation(s) in RCA: 3] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Functional mitral regurgitation (FMR) is frequent in patients with heart failure (HF). It develops as a consequence of left ventricle (LV) geometry alterations, causing imbalance between increased tethering forces and decreased closing forces exerted on the mitral valve apparatus during systole.FMR is known to change at rest and during effort, due to preload-afterload changes, myocardial ischemia, and/or LV dysfunction. Despite optimized medical therapy, an FMR can be responsible of shortness of breath limiting quality of life and decompensation. In this report, we present a case of dynamic FMR treated with MitraClip.MitraClip implantation is a successful and innovative opportunity for HF patients with FMR.
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Affiliation(s)
- Vincenzo Duino
- From the Cardiovascular Department (VD, LF, GM, ED, MG, OV, MS), Anesthesiology Department (EC), Hospital Papa Giovanni XXIII, Bergamo, Italy
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D'Elia E, Brucato A, Pedrotti P, Valenti A, De Amici M, Fiocca L, Duino V, Senni M, Imazio M, Martini A. Successful treatment of subacute constrictive pericarditis with interleukin-1β receptor antagonist (anakinra). Clin Exp Rheumatol 2015; 33:294-295. [PMID: 25664579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2014] [Accepted: 12/01/2014] [Indexed: 06/04/2023]
Affiliation(s)
- Emilia D'Elia
- Cardiovascular Department, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Antonio Brucato
- Department of Internal Medicine, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Patrizia Pedrotti
- Cardiovascular Department, Ca'Granda Niguarda Hospital, Milan, Italy
| | - Anna Valenti
- Department of Internal Medicine, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Mara De Amici
- Paediatric Clinic, IRCCS Polyclinic San Matteo, Pavia, Italy
| | - Luigi Fiocca
- Cardiovascular Department, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Vincenzo Duino
- Cardiovascular Department, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Michele Senni
- Cardiovascular Department, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Massimo Imazio
- Cardiology Department, Maria Vittoria Hospital, Torino, Italy
| | - Alberto Martini
- Department of Paediatrics University of Genova, IRCCS G. Gaslini, Genova, Italy
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Duino V, Fiocca L, Musumeci G, Cerchierini E, Gori M, D'Elia E, Ferrero P, Iacovoni A, Valsecchi O, Maisano F, Senni M, Feldman T, Smart S, Bozdag-Turan I, Kische S, Paranskaya L, Ortak J, Ince H. How should I treat a challenging case of MitraClip implantation? EUROINTERVENTION 2014; 10:887-90. [PMID: 24755272 DOI: 10.4244/eijv10i7a151] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND A 71-year-old woman affected by idiopathic dilated cardiomyopathy with normal coronary arteries and permanent atrial fibrillation was found to have severe mitral regurgitation at transthoracic echocardiography (TTE), due to annular dilatation and restricted motion of the posterior leaflet. Because of poor quality of life, high functional class (NYHA Class III) and the high risk of surgery, the patient agreed to undergo the implantation of a MitraClip device. During the procedure, the transoesophageal echocardiographic (TEE) images were of a poor quality since the view of the mitral valve in the mid-oesophageal and transgastric projections did not accurately show the valve leaflets and the convergence area of the regurgitation at colour Doppler, which is indispensable for the correct positioning of the clip. INVESTIGATION Physical examination, transthoracic echocardiography, transoesophageal echocardiography. DIAGNOSIS Severe mitral regurgitation suitable for MitraClip implantation. MANAGEMENT Transthoracic, and not transoesophageal, echocardiography approach during MitraClip procedure.
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Affiliation(s)
- Vincenzo Duino
- Cardiovascular Department, AO Papa Giovanni XXIII, Bergamo, Italy
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D'Elia E, Fiocca L, Ferrero P, Iacovoni A, Baio P, Medolago G, Duino V, Gori M, Gavazzi A, Senni M. Ranolazine in Heart Failure With Preserved Left Ventricular Ejection Fraction and Microvascular Dysfunction: Case Report and Literature Review. J Clin Pharmacol 2013; 53:665-9. [DOI: 10.1002/jcph.80] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2013] [Accepted: 03/07/2013] [Indexed: 12/19/2022]
Affiliation(s)
- Emilia D'Elia
- Cardiovascular Department; AO Papa Giovanni XXIII; Bergamo; Italy
| | - Luigi Fiocca
- Cardiovascular Department; AO Papa Giovanni XXIII; Bergamo; Italy
| | - Paolo Ferrero
- Cardiovascular Department; AO Papa Giovanni XXIII; Bergamo; Italy
| | - Attilio Iacovoni
- Cardiovascular Department; AO Papa Giovanni XXIII; Bergamo; Italy
| | - Pierangelo Baio
- Cardiovascular Department; AO Papa Giovanni XXIII; Bergamo; Italy
| | - Giuseppe Medolago
- Department of Nuclear Medicine; AO Papa Giovanni XXIII; Bergamo; Italy
| | - Vincenzo Duino
- Cardiovascular Department; AO Papa Giovanni XXIII; Bergamo; Italy
| | - Mauro Gori
- Cardiovascular Department; AO Papa Giovanni XXIII; Bergamo; Italy
| | | | - Michele Senni
- Cardiovascular Department; AO Papa Giovanni XXIII; Bergamo; Italy
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Guagliumi G, Capodanno D, Ikejima H, Bezerra HG, Sirbu V, Musumeci G, Fiocca L, Lortkipanidze N, Vassileva A, Tahara S, Valsecchi O, Costa MA. Impact of different stent alloys on human vascular response to everolimus-eluting stent: An optical coherence tomography study: The OCTEVEREST. Catheter Cardiovasc Interv 2012; 81:510-8. [DOI: 10.1002/ccd.24374] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2012] [Accepted: 02/12/2012] [Indexed: 02/03/2023]
Affiliation(s)
| | - Davide Capodanno
- Cardiology Department; Ferrarotto Hospital, Catania, and University of Catania; Catania; Italy
| | | | - Hiram G. Bezerra
- University Hospitals Case Medical Center; Case Western Reserve University; Cleveland; Ohio
| | - Vasile Sirbu
- Cardiovascular Department; Ospedali Riuniti; Bergamo; Italy
| | | | - Luigi Fiocca
- Cardiovascular Department; Ospedali Riuniti; Bergamo; Italy
| | | | | | - Satoko Tahara
- University Hospitals Case Medical Center; Case Western Reserve University; Cleveland; Ohio
| | | | - Marco A. Costa
- University Hospitals Case Medical Center; Case Western Reserve University; Cleveland; Ohio
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Guagliumi G, Bezerra HG, Sirbu V, Ikejima H, Musumeci G, Biondi-Zoccai G, Lortkipanidze N, Fiocca L, Capodanno D, Wang W, Tahara S, Vassileva A, Matiashvili A, Valsecchi O, Costa MA. Serial Assessment of Coronary Artery Response to Paclitaxel-Eluting Stents Using Optical Coherence Tomography. Circ Cardiovasc Interv 2012; 5:30-8. [PMID: 22298797 DOI: 10.1161/circinterventions.111.965582] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [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: 02/05/2023]
Affiliation(s)
- Giulio Guagliumi
- From the Cardiovascular Department, Ospedali Riuniti, Bergamo, Italy (G.G., V.S., H.I., G.M., N.L., L.F., A.V., A.M., O.V.); University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, Ohio (H.G.B., W.W., S.T., M.A.C.); Division of Cardiology, University of Modena and Reggio Emilia, Modena, Italy (G.B.-Z.); Cardiology Department, Ferrarotto Hospital, Catania, and University of Catania, Catania, Italy (D.C.)
| | - Hiram G. Bezerra
- From the Cardiovascular Department, Ospedali Riuniti, Bergamo, Italy (G.G., V.S., H.I., G.M., N.L., L.F., A.V., A.M., O.V.); University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, Ohio (H.G.B., W.W., S.T., M.A.C.); Division of Cardiology, University of Modena and Reggio Emilia, Modena, Italy (G.B.-Z.); Cardiology Department, Ferrarotto Hospital, Catania, and University of Catania, Catania, Italy (D.C.)
| | - Vasile Sirbu
- From the Cardiovascular Department, Ospedali Riuniti, Bergamo, Italy (G.G., V.S., H.I., G.M., N.L., L.F., A.V., A.M., O.V.); University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, Ohio (H.G.B., W.W., S.T., M.A.C.); Division of Cardiology, University of Modena and Reggio Emilia, Modena, Italy (G.B.-Z.); Cardiology Department, Ferrarotto Hospital, Catania, and University of Catania, Catania, Italy (D.C.)
| | - Hideyuki Ikejima
- From the Cardiovascular Department, Ospedali Riuniti, Bergamo, Italy (G.G., V.S., H.I., G.M., N.L., L.F., A.V., A.M., O.V.); University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, Ohio (H.G.B., W.W., S.T., M.A.C.); Division of Cardiology, University of Modena and Reggio Emilia, Modena, Italy (G.B.-Z.); Cardiology Department, Ferrarotto Hospital, Catania, and University of Catania, Catania, Italy (D.C.)
| | - Giuseppe Musumeci
- From the Cardiovascular Department, Ospedali Riuniti, Bergamo, Italy (G.G., V.S., H.I., G.M., N.L., L.F., A.V., A.M., O.V.); University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, Ohio (H.G.B., W.W., S.T., M.A.C.); Division of Cardiology, University of Modena and Reggio Emilia, Modena, Italy (G.B.-Z.); Cardiology Department, Ferrarotto Hospital, Catania, and University of Catania, Catania, Italy (D.C.)
| | - Giuseppe Biondi-Zoccai
- From the Cardiovascular Department, Ospedali Riuniti, Bergamo, Italy (G.G., V.S., H.I., G.M., N.L., L.F., A.V., A.M., O.V.); University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, Ohio (H.G.B., W.W., S.T., M.A.C.); Division of Cardiology, University of Modena and Reggio Emilia, Modena, Italy (G.B.-Z.); Cardiology Department, Ferrarotto Hospital, Catania, and University of Catania, Catania, Italy (D.C.)
| | - Nikoloz Lortkipanidze
- From the Cardiovascular Department, Ospedali Riuniti, Bergamo, Italy (G.G., V.S., H.I., G.M., N.L., L.F., A.V., A.M., O.V.); University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, Ohio (H.G.B., W.W., S.T., M.A.C.); Division of Cardiology, University of Modena and Reggio Emilia, Modena, Italy (G.B.-Z.); Cardiology Department, Ferrarotto Hospital, Catania, and University of Catania, Catania, Italy (D.C.)
| | - Luigi Fiocca
- From the Cardiovascular Department, Ospedali Riuniti, Bergamo, Italy (G.G., V.S., H.I., G.M., N.L., L.F., A.V., A.M., O.V.); University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, Ohio (H.G.B., W.W., S.T., M.A.C.); Division of Cardiology, University of Modena and Reggio Emilia, Modena, Italy (G.B.-Z.); Cardiology Department, Ferrarotto Hospital, Catania, and University of Catania, Catania, Italy (D.C.)
| | - Davide Capodanno
- From the Cardiovascular Department, Ospedali Riuniti, Bergamo, Italy (G.G., V.S., H.I., G.M., N.L., L.F., A.V., A.M., O.V.); University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, Ohio (H.G.B., W.W., S.T., M.A.C.); Division of Cardiology, University of Modena and Reggio Emilia, Modena, Italy (G.B.-Z.); Cardiology Department, Ferrarotto Hospital, Catania, and University of Catania, Catania, Italy (D.C.)
| | - Wei Wang
- From the Cardiovascular Department, Ospedali Riuniti, Bergamo, Italy (G.G., V.S., H.I., G.M., N.L., L.F., A.V., A.M., O.V.); University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, Ohio (H.G.B., W.W., S.T., M.A.C.); Division of Cardiology, University of Modena and Reggio Emilia, Modena, Italy (G.B.-Z.); Cardiology Department, Ferrarotto Hospital, Catania, and University of Catania, Catania, Italy (D.C.)
| | - Satoko Tahara
- From the Cardiovascular Department, Ospedali Riuniti, Bergamo, Italy (G.G., V.S., H.I., G.M., N.L., L.F., A.V., A.M., O.V.); University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, Ohio (H.G.B., W.W., S.T., M.A.C.); Division of Cardiology, University of Modena and Reggio Emilia, Modena, Italy (G.B.-Z.); Cardiology Department, Ferrarotto Hospital, Catania, and University of Catania, Catania, Italy (D.C.)
| | - Angelina Vassileva
- From the Cardiovascular Department, Ospedali Riuniti, Bergamo, Italy (G.G., V.S., H.I., G.M., N.L., L.F., A.V., A.M., O.V.); University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, Ohio (H.G.B., W.W., S.T., M.A.C.); Division of Cardiology, University of Modena and Reggio Emilia, Modena, Italy (G.B.-Z.); Cardiology Department, Ferrarotto Hospital, Catania, and University of Catania, Catania, Italy (D.C.)
| | - Aleksandre Matiashvili
- From the Cardiovascular Department, Ospedali Riuniti, Bergamo, Italy (G.G., V.S., H.I., G.M., N.L., L.F., A.V., A.M., O.V.); University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, Ohio (H.G.B., W.W., S.T., M.A.C.); Division of Cardiology, University of Modena and Reggio Emilia, Modena, Italy (G.B.-Z.); Cardiology Department, Ferrarotto Hospital, Catania, and University of Catania, Catania, Italy (D.C.)
| | - Orazio Valsecchi
- From the Cardiovascular Department, Ospedali Riuniti, Bergamo, Italy (G.G., V.S., H.I., G.M., N.L., L.F., A.V., A.M., O.V.); University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, Ohio (H.G.B., W.W., S.T., M.A.C.); Division of Cardiology, University of Modena and Reggio Emilia, Modena, Italy (G.B.-Z.); Cardiology Department, Ferrarotto Hospital, Catania, and University of Catania, Catania, Italy (D.C.)
| | - Marco A. Costa
- From the Cardiovascular Department, Ospedali Riuniti, Bergamo, Italy (G.G., V.S., H.I., G.M., N.L., L.F., A.V., A.M., O.V.); University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, Ohio (H.G.B., W.W., S.T., M.A.C.); Division of Cardiology, University of Modena and Reggio Emilia, Modena, Italy (G.B.-Z.); Cardiology Department, Ferrarotto Hospital, Catania, and University of Catania, Catania, Italy (D.C.)
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Gritti P, Fiocca L, Lanterna LA, Bowman J, Lunghi A. Direct intraclot thrombolysis for cardiac arrest following massive pulmonary embolism in a neurosurgical patient. Treating on the edge? Resuscitation 2011; 82:e15-7. [DOI: 10.1016/j.resuscitation.2011.07.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2011] [Accepted: 07/18/2011] [Indexed: 10/17/2022]
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Guagliumi G, Ikejima H, Sirbu V, Bezerra H, Musumeci G, Lortkipanidze N, Fiocca L, Tahara S, Vassileva A, Matiashvili A, Valsecchi O, Costa M. Impact of Drug Release Kinetics on Vascular Response to Different Zotarolimus-Eluting Stents Implanted in Patients With Long Coronary Stenoses. JACC Cardiovasc Interv 2011; 4:778-85. [PMID: 21777886 DOI: 10.1016/j.jcin.2011.04.007] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [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] [Received: 12/16/2010] [Revised: 02/22/2011] [Accepted: 04/13/2011] [Indexed: 11/19/2022]
Affiliation(s)
- Giulio Guagliumi
- Division of Cardiology, Cardiovascular Department, Ospedali Riuniti, Bergamo, Italy.
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Rossini R, Musumeci G, Lettieri C, Limbruno U, Capodanno D, Mantovani P, Calabria P, Nijaradze T, Tomasi L, Micheli A, Mihalcsik L, Fiocca L, Angiolillo D, Gavazzi A. LONG-TERM PROGNOSIS OF PATIENTS WITH ACUTE CORONARY SYNDROME AND NON-OBSTRUCTIVE CORONARY ARTERY DISEASE. J Am Coll Cardiol 2011. [DOI: 10.1016/s0735-1097(11)61768-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Sirbu V, Musumeci G, Fiocca L, Vassileva A, Rossini R, Lortkipanidze N, Matiashvili A, Mihalcsik L, Gavazzi A, Valsecchi O, Guagliumi G. Optical coherence tomography in ST-elevation myocardial infarction treated with novel drug-eluting stent: preprocedural, postimplant and 2-month follow-up findings. J Cardiovasc Med (Hagerstown) 2010; 12:55-8. [PMID: 21045717 DOI: 10.2459/jcm.0b013e3283403409] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [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
The use of drug-eluting stents (DES) allowed the reduction in the need for repeat revascularization. At the culprit site in acute myocardial infarction patients treated with first-generation DES, the interaction between the eluted drug and the underlying necrotic core may generate different patterns of pathologic vessel response and delayed healing. A new generation DES intrepide elutes trapidil. Its modes of action are neither cytotoxic nor cytostatic, and may promote normal re-endothelialization. Due to its high resolution, optical coherence tomography (OCT) allows accurate detection of thrombus deposition and stent strut coverage at follow-up. Intravascular ultrasound (IVUS) has enhanced tissue penetration and provides information on vessel remodeling. Using OCT and IVUS, we evaluated the intravascular morphology of the culprit vessel, the acute and intermediate result of novel DES implanted to treat an ST-segment elevation myocardial infarction.
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Affiliation(s)
- Vasile Sirbu
- Dipartimento Cardiovascolare, Ospedali Riuniti di Bergamo, Bergamo, Italy
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Guagliumi G, Sirbu V, Bezerra H, Biondi-Zoccai G, Fiocca L, Musumeci G, Matiashvili A, Lortkipanidze N, Tahara S, Valsecchi O, Costa M. Strut coverage and vessel wall response to zotarolimus-eluting and bare-metal stents implanted in patients with ST-segment elevation myocardial infarction: the OCTAMI (Optical Coherence Tomography in Acute Myocardial Infarction) Study. JACC Cardiovasc Interv 2010; 3:680-7. [PMID: 20630463 DOI: 10.1016/j.jcin.2010.04.005] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.9] [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: 02/02/2010] [Revised: 03/29/2010] [Accepted: 04/14/2010] [Indexed: 02/08/2023]
Abstract
OBJECTIVES Using optical coherence tomography, we assessed the proportion of uncovered struts at 6-month follow-up in zotarolimus-eluting stents (ZES), specifically Endeavor (Medtronic CardioVascular, Santa Rosa, California) stents, and identical bare-metal stents (BMS) implanted in patients with ST-segment elevation myocardial infarction (STEMI). BACKGROUND Sirolimus- and paclitaxel-eluting stents implanted in STEMI have been associated with delayed healing and incomplete strut coverage. ZES are associated with a more complete and uniform strut coverage in stable patients, but whether this holds true also after STEMI is unknown. METHODS Forty-four patients with STEMI who underwent primary PCI were randomized to ZES or BMS (3:1 randomization). Angiographic, intravascular ultrasound, and optical coherence tomography follow-up was conducted at 6 months and clinical follow-up at 1 year. All images were analyzed by an independent core laboratory that was blind to stent assignments. RESULTS There were no differences between ZES and BMS in percentage of uncovered struts (median: 0.00% [interquartile range (IQR): 0.00% to 1.78%] vs. 1.98% [IQR: 0.21% to 7.33%], p = 0.13), maximum length of uncovered segments (0.00 [IQR: 0.00 to 1.19] mm vs. 1.38 [IQR: 0.65 to 3.30] mm, p = 0.10), percentage of malapposed struts (0.00% [IQR: 0.00% to 0.23%] vs. 0.15% [IQR: 0.00% to 5.81%], p = 0.16), and maximum length of malapposed segments (0.00 [IQR: 0.00 to 0.67] mm vs. 0.33 [IQR: 0.00 to 2.55] mm, p = 0.20). Neointimal response was similar between ZES and BMS (332 [IQR: 240 to 429] microm vs. 186 [IQR: 136 to 348] microm, p = 0.99) and evenly distributed. No late acquired malapposition was observed in both groups. There were no deaths, myocardial infarction, or stent thromboses at 1 year. CONCLUSIONS This optical coherence tomography study found no difference in strut coverage and similar vessel response to ZES, when compared with identical BMS, implanted during primary percutaneous coronary intervention in STEMI patients. (Six-Month Coverage and Vessel Wall Response of the Zotarolimus Drug-Eluting Stent Implanted in AMI Assessed by Optical Coherence Tomography [OCTAMI]; NCT00704561).
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Affiliation(s)
- Giulio Guagliumi
- Division of Cardiology, Cardiovascular Department, Ospedali Riuniti, Bergamo, Italy.
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Guagliumi G, Musumeci G, Sirbu V, Bezerra HG, Suzuki N, Fiocca L, Matiashvili A, Lortkipanidze N, Trivisonno A, Valsecchi O, Biondi-Zoccai G, Costa MA. Optical coherence tomography assessment of in vivo vascular response after implantation of overlapping bare-metal and drug-eluting stents. JACC Cardiovasc Interv 2010; 3:531-9. [PMID: 20488410 DOI: 10.1016/j.jcin.2010.02.008] [Citation(s) in RCA: 122] [Impact Index Per Article: 8.7] [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: 11/20/2009] [Revised: 02/01/2010] [Accepted: 02/22/2010] [Indexed: 02/08/2023]
Abstract
OBJECTIVES We designed a randomized trial exploiting optical coherence tomography (OCT) to assess coverage and apposition of overlapping bare-metal stents (BMS) and drug-eluting stents (DES) in human coronary arteries. BACKGROUND Overlapping DES impair healing in animals. Optical coherence tomography allows accurate in vivo assessment of stent strut coverage and apposition. METHODS Seventy-seven patients with long coronary stenoses were randomized to overlapping sirolimus-eluting stents (SES), paclitaxel-eluting stents (PES), zotarolimus-eluting stents (ZES), or BMS. The primary goal of the study was to determine the rate of uncovered/malapposed struts in overlap versus nonoverlap segments, according to stent type, at 6-month follow-up with OCT. RESULTS A total of 53,047 struts were analyzed. The rate of uncovered/malapposed struts was 1.5 +/- 3.4% and 0.6 +/- 2.7% in overlap versus nonoverlap BMS (p = NS), respectively, and 4.3 +/- 11% and 3.6 +/- 8% in overlap versus nonoverlap DES (p = NS), respectively. There were no differences in the rates of uncovered/malapposed struts between overlapping BMS and DES, likely due to low frequency of uncovered/malapposed struts in ZES (0.1 +/- 0.4%), which offset the higher rates observed in SES (6.7 +/- 9.6%) and PES (6.7 +/- 16.5%, p < 0.05). Overlap segments showed greater neointimal volume obstruction versus nonoverlap segments in all DES (p < 0.05 for all DES types). Strut-level neointimal thickness at overlap and nonoverlap segments were lowest in SES (0.16 +/- 0.1 mm and 0.12 +/- 0.1 mm, respectively) compared with PES (0.27 +/- 0.1 mm and 0.20 +/- 0.1 mm, respectively), ZES (0.40 +/- 0.16 mm and 0.33 +/- 0.13 mm, respectively), and BMS (0.55 +/- 0.31 mm and 0.53 +/- 0.25 mm, respectively, p < 0.05). CONCLUSIONS As assessed by OCT the impact of DES on vascular healing was similar at overlapping and nonoverlapping sites. However, strut malapposition, coverage pattern, and neointimal hyperplasia differ significantly according to DES type. (Optical Coherence Tomography for Drug Eluting Stent Safety [ODESSA]; NCT00693030).
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Affiliation(s)
- Giulio Guagliumi
- Division of Cardiology, Cardiovascular Department, Ospedali Riuniti di Bergamo, Bergamo, Italy.
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Gleria M, Bertani R, Po′ R, Giannotta G, Fiocca L, Fambri L, Mantia FL, Scaffaro R, Resnati G. CYCLOPHOSPHAZENES AS VERSATILE SUBSTRATES IN POLYMER CHEMISTRY. PHOSPHORUS SULFUR 2010. [DOI: 10.1080/10426500490427268] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- M. Gleria
- a Istituto di Scienze e Tecnologie Molecolari del C.N.R. , Padova, Italy
| | - R. Bertani
- b Dipartimento di Processi Chimici dell'Ingegneria , Padova, Italy
| | - R. Po′
- c Istituto G. Donegani , Novara, Italy
| | | | - L. Fiocca
- c Istituto G. Donegani , Novara, Italy
| | - L. Fambri
- d Università di Trento , Trento, Italy
| | | | | | - G. Resnati
- f Dipartimento di Chimica, Materiali e Ingegneria Chimica “Giulio Natta” , Milano, Italy
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Guagliumi G, Sirbu V, Musumeci G, Bezerra HG, Aprile A, Kyono H, Fiocca L, Matiashvili A, Lortkipanidze N, Vassileva A, Popma JJ, Allocco DJ, Dawkins KD, Valsecchi O, Costa MA. Strut Coverage and Vessel Wall Response to a New-Generation Paclitaxel-Eluting Stent With an Ultrathin Biodegradable Abluminal Polymer. Circ Cardiovasc Interv 2010; 3:367-75. [DOI: 10.1161/circinterventions.110.950154] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.9] [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: 01/24/2023]
Abstract
Background—
Polymer-coated drug-eluting stents are effective in preventing restenosis but have been associated with delayed healing and incomplete strut coverage. It is unknown whether paclitaxel-eluting stents (PES) with minimal biodegradable abluminal coating enhances strut coverage while preventing neointimal hyperplasia. Using optical coherence tomography (OCT) as a primary imaging modality, we assessed the proportion of uncovered struts at 6-month follow-up in PES coated with durable versus ultrathin (<1 μm) biodegradable abluminal polymers.
Methods and Results—
In this pilot trial, 60 patients with de novo lesions (≤25 mm) in native coronary vessels were randomly assigned to receive either TAXUS Liberté PES or JACTAX PES, a Liberté stent with polymer deposited abluminally as microdots (JACTAX HD: 9.2 μg each of polymer and paclitaxel per 16-mm stent; JACTAX LD: 5 μg each). OCT follow-up occurred at 6 months with clinical follow-up through 1 year. The primary end point was percent uncovered struts by OCT. An independent core laboratory blinded to stent assignment analyzed images. The 6-month rate of uncovered struts per patient was 5.3±14.7% for TAXUS Liberté, 7.0±12.2% for JACTAX HD, and 4.6±7.3% for JACTAX LD (
P
=0.81); percent malapposed struts was 1.4±4.4%, 0.8±1.9%, and 1.1±2.8%, respectively (
P
=0.86). Strut-level intimal thickness was 0.20±0.10, 0.22±0.15, and 0.24±0.15 mm (
P
=0.64); percent volume obstruction by OCT was 22.2±12.8, 22.5±16.2, and 25.8±15.2 (
P
=0.69). There were no deaths, Q-wave myocardial infarctions, or stent thromboses through 1 year.
Conclusions—
JACTAX PES with an ultrathin microdot biodegradable abluminal polymer did not result in improved strut coverage at 6 months compared with TAXUS Liberté.
Clinical Trial Registration—
URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT00776204.
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Affiliation(s)
- Giulio Guagliumi
- From the Division of Cardiology (G.G., V.S., G.M., A.A., L.F., A.M., N.L., A.V., O.V.), Cardiovascular Department, Ospedali Riuniti di Bergamo, Italy; University Hospitals Case Medical Center (H.G.B., H.K., M.A.C.), Case Western Reserve University Medical School, Cleveland, Ohio; Beth Israel Deaconess Medical Center (J.J.P.), Boston, Mass; and Boston Scientific Corporation (D.J.A., K.D.D.), Natick, Mass
| | - Vasile Sirbu
- From the Division of Cardiology (G.G., V.S., G.M., A.A., L.F., A.M., N.L., A.V., O.V.), Cardiovascular Department, Ospedali Riuniti di Bergamo, Italy; University Hospitals Case Medical Center (H.G.B., H.K., M.A.C.), Case Western Reserve University Medical School, Cleveland, Ohio; Beth Israel Deaconess Medical Center (J.J.P.), Boston, Mass; and Boston Scientific Corporation (D.J.A., K.D.D.), Natick, Mass
| | - Giuseppe Musumeci
- From the Division of Cardiology (G.G., V.S., G.M., A.A., L.F., A.M., N.L., A.V., O.V.), Cardiovascular Department, Ospedali Riuniti di Bergamo, Italy; University Hospitals Case Medical Center (H.G.B., H.K., M.A.C.), Case Western Reserve University Medical School, Cleveland, Ohio; Beth Israel Deaconess Medical Center (J.J.P.), Boston, Mass; and Boston Scientific Corporation (D.J.A., K.D.D.), Natick, Mass
| | - Hiram G. Bezerra
- From the Division of Cardiology (G.G., V.S., G.M., A.A., L.F., A.M., N.L., A.V., O.V.), Cardiovascular Department, Ospedali Riuniti di Bergamo, Italy; University Hospitals Case Medical Center (H.G.B., H.K., M.A.C.), Case Western Reserve University Medical School, Cleveland, Ohio; Beth Israel Deaconess Medical Center (J.J.P.), Boston, Mass; and Boston Scientific Corporation (D.J.A., K.D.D.), Natick, Mass
| | - Alessandro Aprile
- From the Division of Cardiology (G.G., V.S., G.M., A.A., L.F., A.M., N.L., A.V., O.V.), Cardiovascular Department, Ospedali Riuniti di Bergamo, Italy; University Hospitals Case Medical Center (H.G.B., H.K., M.A.C.), Case Western Reserve University Medical School, Cleveland, Ohio; Beth Israel Deaconess Medical Center (J.J.P.), Boston, Mass; and Boston Scientific Corporation (D.J.A., K.D.D.), Natick, Mass
| | - Hiroyuki Kyono
- From the Division of Cardiology (G.G., V.S., G.M., A.A., L.F., A.M., N.L., A.V., O.V.), Cardiovascular Department, Ospedali Riuniti di Bergamo, Italy; University Hospitals Case Medical Center (H.G.B., H.K., M.A.C.), Case Western Reserve University Medical School, Cleveland, Ohio; Beth Israel Deaconess Medical Center (J.J.P.), Boston, Mass; and Boston Scientific Corporation (D.J.A., K.D.D.), Natick, Mass
| | - Luigi Fiocca
- From the Division of Cardiology (G.G., V.S., G.M., A.A., L.F., A.M., N.L., A.V., O.V.), Cardiovascular Department, Ospedali Riuniti di Bergamo, Italy; University Hospitals Case Medical Center (H.G.B., H.K., M.A.C.), Case Western Reserve University Medical School, Cleveland, Ohio; Beth Israel Deaconess Medical Center (J.J.P.), Boston, Mass; and Boston Scientific Corporation (D.J.A., K.D.D.), Natick, Mass
| | - Aleksandre Matiashvili
- From the Division of Cardiology (G.G., V.S., G.M., A.A., L.F., A.M., N.L., A.V., O.V.), Cardiovascular Department, Ospedali Riuniti di Bergamo, Italy; University Hospitals Case Medical Center (H.G.B., H.K., M.A.C.), Case Western Reserve University Medical School, Cleveland, Ohio; Beth Israel Deaconess Medical Center (J.J.P.), Boston, Mass; and Boston Scientific Corporation (D.J.A., K.D.D.), Natick, Mass
| | - Nikoloz Lortkipanidze
- From the Division of Cardiology (G.G., V.S., G.M., A.A., L.F., A.M., N.L., A.V., O.V.), Cardiovascular Department, Ospedali Riuniti di Bergamo, Italy; University Hospitals Case Medical Center (H.G.B., H.K., M.A.C.), Case Western Reserve University Medical School, Cleveland, Ohio; Beth Israel Deaconess Medical Center (J.J.P.), Boston, Mass; and Boston Scientific Corporation (D.J.A., K.D.D.), Natick, Mass
| | - Angelina Vassileva
- From the Division of Cardiology (G.G., V.S., G.M., A.A., L.F., A.M., N.L., A.V., O.V.), Cardiovascular Department, Ospedali Riuniti di Bergamo, Italy; University Hospitals Case Medical Center (H.G.B., H.K., M.A.C.), Case Western Reserve University Medical School, Cleveland, Ohio; Beth Israel Deaconess Medical Center (J.J.P.), Boston, Mass; and Boston Scientific Corporation (D.J.A., K.D.D.), Natick, Mass
| | - Jeffrey J. Popma
- From the Division of Cardiology (G.G., V.S., G.M., A.A., L.F., A.M., N.L., A.V., O.V.), Cardiovascular Department, Ospedali Riuniti di Bergamo, Italy; University Hospitals Case Medical Center (H.G.B., H.K., M.A.C.), Case Western Reserve University Medical School, Cleveland, Ohio; Beth Israel Deaconess Medical Center (J.J.P.), Boston, Mass; and Boston Scientific Corporation (D.J.A., K.D.D.), Natick, Mass
| | - Dominic J. Allocco
- From the Division of Cardiology (G.G., V.S., G.M., A.A., L.F., A.M., N.L., A.V., O.V.), Cardiovascular Department, Ospedali Riuniti di Bergamo, Italy; University Hospitals Case Medical Center (H.G.B., H.K., M.A.C.), Case Western Reserve University Medical School, Cleveland, Ohio; Beth Israel Deaconess Medical Center (J.J.P.), Boston, Mass; and Boston Scientific Corporation (D.J.A., K.D.D.), Natick, Mass
| | - Keith D. Dawkins
- From the Division of Cardiology (G.G., V.S., G.M., A.A., L.F., A.M., N.L., A.V., O.V.), Cardiovascular Department, Ospedali Riuniti di Bergamo, Italy; University Hospitals Case Medical Center (H.G.B., H.K., M.A.C.), Case Western Reserve University Medical School, Cleveland, Ohio; Beth Israel Deaconess Medical Center (J.J.P.), Boston, Mass; and Boston Scientific Corporation (D.J.A., K.D.D.), Natick, Mass
| | - Orazio Valsecchi
- From the Division of Cardiology (G.G., V.S., G.M., A.A., L.F., A.M., N.L., A.V., O.V.), Cardiovascular Department, Ospedali Riuniti di Bergamo, Italy; University Hospitals Case Medical Center (H.G.B., H.K., M.A.C.), Case Western Reserve University Medical School, Cleveland, Ohio; Beth Israel Deaconess Medical Center (J.J.P.), Boston, Mass; and Boston Scientific Corporation (D.J.A., K.D.D.), Natick, Mass
| | - Marco A. Costa
- From the Division of Cardiology (G.G., V.S., G.M., A.A., L.F., A.M., N.L., A.V., O.V.), Cardiovascular Department, Ospedali Riuniti di Bergamo, Italy; University Hospitals Case Medical Center (H.G.B., H.K., M.A.C.), Case Western Reserve University Medical School, Cleveland, Ohio; Beth Israel Deaconess Medical Center (J.J.P.), Boston, Mass; and Boston Scientific Corporation (D.J.A., K.D.D.), Natick, Mass
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Montenero AS, Mollichelli N, Zumbo F, Antonelli A, Dolci A, Barberis M, Sirolla C, Staine T, Fiocca L, Bruno N, O'Connor S. Helicobacter pylori and atrial fibrillation: a possible pathogenic link. Heart 2005; 91:960-1. [PMID: 15958372 PMCID: PMC1769015 DOI: 10.1136/hrt.2004.036681] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
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36
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Montenero AS, Bruno N, Zumbo F, Antonelli A, Fiocca L, Barbieri L, De Bernardi F, Andrew P, Affinito V. Cryothermal Ablation Treatment of Atrial Flutter—Experience with a New 9 French 8 mm Tip Catheter. J Interv Card Electrophysiol 2005; 12:45-54. [PMID: 15717151 DOI: 10.1007/s10840-005-5840-3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2004] [Accepted: 10/01/2004] [Indexed: 11/30/2022]
Abstract
BACKGROUND Cardiac cryoablation has been used to successfully treat a variety of arrhythmias. OBJECTIVE This study documents our experience with a new 9 French (FR) 8 mm cryocatheter for ablation treatment of symptomatic atrial flutter. METHODS A total of 77 consecutive patients with symptomatic atrial flutter were treated. Electrophysiological studies (EPS) were performed with diagnostic catheters and ablation was performed with a 9FR, 8 mm tip, quadripolar cryocatheter (Freezor MAX catheter, CryoCath Technologies Inc., Kirkland, Canada). Cryoablation at -75 degrees C for 8 minutes was performed, beginning at the inferior rim of the coronary sinus (CS) os and creating a posterior line to the Eustachian ridge. Safety, bidirectional isthmus block at intervention, and recurrence at 3 months post procedure were assessed. RESULTS There were no adverse events reported. All patients remained free of discomfort on cryoenergy delivery. The acute success rate at intervention was 96% for all patients and 100% for those with common atrial flutter. Follow-up data from 47 patients showed 33 (70%) patients without conduction recurrence on repeat EPS at 3 months. Although, 1 (2%) patient had both symptom and conduction recurrence. Data available from 53 acutely successful patients at 6 month clinical follow-up showed that 48 (91%) patients were asymptomatic and 5 (9%) patients had recurrence documented by ECG and/or patient diary records. CONCLUSIONS Our experience with a new 9FR, 8 mm tip, quadripolar cryocatheter yielded a high success rate at intervention and an excellent safety profile. Although repeat EPS at 3 months post ablation identified conduction recurrence in 30% of patients, at 6 month clinical follow-up only 9% of patients had recurrence. Further monitoring is necessary to assess whether the relatively low recurrence rate observed at 6 month clinical follow-up is maintained over the long term.
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Affiliation(s)
- Annibale S Montenero
- Cardiology Department and Arrhythmia Center of Policlinico MultiMedica, Sesto S. Giovanni, Milan, Italy.
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37
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Bonoldi L, Abis L, Fiocca L, Fusco R, Longo L, Simone F, Spera S. Monotitanocene catalysts: an ESR study of Ti(III) derivatives formed in presence of MAO and other organoaluminium compounds. ACTA ACUST UNITED AC 2004. [DOI: 10.1016/j.molcata.2004.04.029] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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38
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Fiocca L, Clerissi J, Bronzini R, Zumbo F, Di Biasi M, Montenero AS. Myocardial ischemia due to a coronary-pulmonary fistula treated with coil embolization. Ital Heart J 2004; 5:551-3. [PMID: 15487275] [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: 05/01/2023]
Abstract
We describe one case of myocardial ischemia due to a coronary-pulmonary fistula, successfully treated with coils. Coronary fistulae are a rare cause of angina in adults with normal coronary arteries. Percutaneous treatment represents an alternative to surgery and may be offered as a relatively low risk procedure. The choice between surgical and percutaneous treatment must take into account clinical and anatomical considerations.
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Affiliation(s)
- Luigi Fiocca
- Department of lnterventional Cardiology, MultiMedica Hospital, Sesto San Giovanni (MI), Italy.
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39
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Fiocca L, Zumbo F, Montenero AS, Tesoro-Tess JD. Magnetic resonance angiography in an adult with aortic coarctation associated with subclavian stenosis. Heart 2004; 90:424. [PMID: 15020519 PMCID: PMC1768148 DOI: 10.1136/hrt.2003.022020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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40
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Fiocca L, Di Biasi M, Bruno N, Ciuffreda M, Zumbo F, Mangiameli D, Montenero AS. Coronary vasospasm and aborted sudden death treated with an implantable defibrillator and stenting. Ital Heart J 2002; 3:270-3. [PMID: 12025377] [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: 02/25/2023]
Abstract
In selected patients suffering from variant angina, an implantable cardioverter-defibrillator (ICD) and coronary stenting can be helpful to prevent sudden death and treat coronary artery spasm. We report a case of a 47-year-old woman suffering from variant angina, who experienced an episode of ventricular fibrillation promptly cardioverted. After coronary angiography documentation of a mild atherosclerosis, an ICD was implanted and oral nitrates and calcium antagonists were prescribed. The recurrence of chest pain and palpitations prompted us to perform a second coronary angiography that documented a focal coronary artery spasm successfully treated with stent implantation. No other episodes of angina or ventricular arrhythmia were documented during the following 6 months of follow-up.
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Affiliation(s)
- Luigi Fiocca
- Department of Cardiology, Multimedica Hospital, Sesto San Giovanni, MI, Italy.
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41
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Danzi GB, Capuano C, Zapparoli L, Sesana M, Fiocca L. [New coronary imaging modality. I. Digital angiography (cineless) and low-energy digital fluoroangioscopy systems]. Ital Heart J Suppl 2001; 2:118-24. [PMID: 11255879] [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: 02/19/2023]
Abstract
The advent of digital medical imaging offered unique new possibilities of analyzing, visualizing and communicating medical images. This article reviews the impact of the digital technology in the cardiac catheterization laboratory and covers a range of topics such as the standard DICOM, the transition to cineless angiography, the digital cardiac archive, the network system for imaging exchange and the role of the cardiac digital mobile imaging systems.
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Affiliation(s)
- G B Danzi
- Unità Funzionale di Cardiologia Interventistica Casa di Cura Poliambulanza Via Bissolati, 57 25124 Brescia.
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42
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Abstract
This study sought to investigate the degree of acute recoil of four different stents by means of quantitative coronary angiography. Four hundred and six patients underwent stent implantation for single discrete coronary artery lesion: 105 received a 16 mm Paragon stent, 112 an 18 mm Multilink Duet, 97 a 16 mm NIR Primo stent, and 92 a 15 or 18 mm NIR Royal Advance. Elastic recoil was defined as the difference between mean balloon cross-sectional area (CSA) at the highest pressure and mean CSA after PTCA. The mean stent recoil was 13% +/- 10% CSA (P < 0.001), being statistically greater for the nitinol Paragon stent (21% +/- 11%), intermediate for the multicellular Multilink Duet stent (14% +/- 7%), and minimum for the NIR family (9% +/- 6% and 8% +/- 7%, respectively). The recoil was not homogeneously distributed along the stent length but was lower at the two ends (11% +/- 12% and 13% +/- 11%) and highest in the central part (15% +/- 12%)(P < 0.001). Thus, acute recoil is a significant phenomenon regardless of the mechanical properties and design of new-generation tubular stents.
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Affiliation(s)
- G Danzi
- Department of Cardiology and Cardiac Surgery, Poliambulanza Hospital, Brescia, Italy.
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43
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Danzi GB, Capuano C, Fiocca L, Dallavalle F, Pirelli S, Mauri L, Quaini E. Stent implantation without predilation in patients with a single, noncalcified coronary artery lesion. Am J Cardiol 1999; 84:1250-3, A8. [PMID: 10569338 DOI: 10.1016/s0002-9149(99)00540-8] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.5] [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
The purpose of this study was to assess the feasibility of stent implantation without predilation in patients with a single, noncalcified coronary artery lesion. A total of 122 patients were randomized to receive a stent with or without predilation; direct stent placement was possible in 59 of the 61 patients (97%) with an immediate and long-term clinical follow-up similar to that observed in the group of patients treated conventionally.
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Affiliation(s)
- G B Danzi
- Department of Cardiology and Cardiac Surgery, Casa di Cura Poliambulanza, Brescia, Italy.
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44
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Danzi GB, Fiocca L, Capuano C, Mauri L, Dallavalle F, Quaini E. [Direct stenting of the unprotected common trunk in patients at an elevated surgical risk; the authors' personal experience and a review of the literature]. G Ital Cardiol 1999; 29:568-74. [PMID: 10367227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Affiliation(s)
- G B Danzi
- Unità Funzionale di Cardiologia, Interventistica, Casa di Cura Poliambulanza, Brescia
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45
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Apicella B, Di Serio M, Fiocca L, Po R, Santacesaria E. Kinetic and catalytic aspects of the formation of poly(ethylene terephthalate) (PET) investigated with model molecules. J Appl Polym Sci 1998. [DOI: 10.1002/(sici)1097-4628(19980919)69:12<2423::aid-app13>3.0.co;2-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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46
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Danzi GB, Fiocca L, Dallavalle F, Capuano C, Chioin R, Riva S, Quaini E. [The hemodynamics laboratory without cine film. A comparison between the production costs of 35-mm film and the recordable compact disk]. G Ital Cardiol 1998; 28:887-92. [PMID: 9773314] [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
BACKGROUND For more than 35 years, cine film has been used as the standard recording medium for coronary angiography. At present, the DICOM and the CD-R format have been established as the standard media for the transport of cardiac angiographic images in place of cine angiographic film. The aim of the study was to compare the media production costs between two cardiac catheterization laboratories, with and without cine film. METHODS We collected data from two different laboratories in the same geographic area which perform about 1000 procedures/year, using a similar digital x-ray imaging system. In one lab, images are recorded on 35-mm film at 25 frames/sec. In the other one, the image support is based on a CD-R. For each laboratory we considered both direct patient and variable equipment costs. Direct patient costs in the film-lab include: cine film, processing chemicals, processing labor, chemical disposal, maintenance; in the digital lab: CD-R costs and masterization time. Equipment costs in the film-lab include: cine camera, cine film processor and cine projector; in the filmless lab a DICOM formatter and a review workstation. The equipment amortization costs are considered over a three-year period. RESULTS Total direct patient costs are 90,000 lira for the film and 14,000 lira for the CD-R. Equipment costs are 193,000,000 lira in the film-lab and 150,000,000 lira in the filmless one. Overall cost per patient is 154,300 lira for the cine film and 64,000 lira for the CD-R. CONCLUSIONS This study shows that the media costs per patient for a digital DICOM CD-R format system are substantially less than for 35-mm film, permitting savings of more than 90,000,000 Italian lira per year in a mid-volume cardiac catheterization laboratory.
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Affiliation(s)
- G B Danzi
- Laboratorio di Emodinamica, Casa di Cura Poliambulanza, Brescia
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47
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Di Serio M, Apicella B, Grieco G, Iengo P, Fiocca L, Po R, Santacesaria E. Kinetic and catalytic aspects of dimethylterephtalate transesterification also through the use of model molecules. ACTA ACUST UNITED AC 1998. [DOI: 10.1016/s1381-1169(97)00224-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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48
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Ramondo A, Bertaglia E, Fiocca L, Isabella G, Cardaioli P, Razzolini R, Chioin R. [Immediate and long-term results of treatment of focal lesions with aortocoronary venous bypass with a stent implant]. Cardiologia 1997; 42:1271-6. [PMID: 9534322] [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: 02/07/2023]
Abstract
Patients with recurrent angina after coronary artery bypass graft surgery pose a problem. Stent implantation has been advocated in an effort to avoid repeat operation and to address the limitations of balloon angioplasty. Aim of the present study was to determine the in-hospital and long-term results of stent deployment in focal, de novo lesions of vein grafts. Thirty-five focal, de novo lesions of vein grafts in 31 patients were treated with stent deployment. Twenty-four patients (77%) had three vessels, 6 (20%) two vessels and 1 (3%) single vessel disease. Saphenous vein grafts aged 9.7 +/- 4.2 years (range 1-19 years). Twenty-two lesions (63%) were located within the body of the saphenous graft, 8 (23%) at the graft/coronary artery anastomosis and 5 (14%) at the aorta/graft anastomosis. The indications for stent deployment included: suboptimal result from balloon angioplasty (defined as > or = 50% post-angioplasty residual stenosis) in 29/35 lesions (83%); post-angioplasty coronary dissection with threatening occlusion in 4/35 (11%); abrupt closure in 2/35 (6%). Patients were screened for death, myocardial infarction, bypass surgery and repeat angioplasty during in-hospital stay and after a follow-up of 12 +/- 8 months. Even-free survival curve was constructed by the Kaplan-Meier method. Stent deployment was successful in all patients. One stent was deployed in 24/35 lesions (69%), half Palmaz-Schatz stent in 6/35 (17%) and 2 or more stents in 5/35 (14%). The balloon/vessel ratio resulted of 1.0 +/- 0.1 Minimal lumen diameter increased from 0.8 +/- 0.4 to 3.8 +/- 0.6 mm, with a mean gain of 1.8 +/- 0.6 mm (range 1.8-4.0 mm). During the in-hospital period 1 patient (3.2%) died and 1 (3.2%) had a non Q wave myocardial infarction. Therefore, the clinical success rate, was 94%. During the follow-up period, 2 patients died (6.9%), 2 (6.9%) developed a non Q wave myocardial infarction, 1 (3.4%) underwent bypass surgery and 3 (10.3%) underwent repeat angioplasty. The estimated 2-year event-free survival rate (free from myocardial infarction, repeat surgery and repeat angioplasty) was 62%. In conclusion, Palmaz-Schatz stent deployment in focal, de novo vein grafts presents a high rate of procedural success, a low rate of acute complications and good long-term results.
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Affiliation(s)
- A Ramondo
- Servizio di Emodinamica e Cardiologia Interventistica, Università degli Studi, Padova
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Fiocca L, Floreani A, Bellotto F. [Association of primary pulmonary hypertension and portal hypertension. Review of the literature and description of 2 further cases]. G Ital Cardiol 1994; 24:773-8. [PMID: 8088477] [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: 01/28/2023]
Abstract
Previous studies have shown that the association between primary pulmonary hypertension and portal hypertension is not merely coincidental. Pathogenesis of this rare combination is unclear, and several hypotheses have been advanced. In the present article, we reviewed the literature on this topic. Two new cases of this syndrome, recently admitted to our hospital, are described. Clinical and laboratory findings of our patients agree with data of the previous case reports.
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Affiliation(s)
- L Fiocca
- Cattedra di Cardiologia dell'Università di Padova
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