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Nardi F, Pino PG, De Luca L, Riccio C, Cipriani M, Corda M, Francese GM, Gabrielli D, Oliva F, Gulizia MM, Colivicchi F. ANMCO position paper: 2022 focused update of appropriate use criteria for multimodality imaging: aortic valve disease. Eur Heart J Suppl 2022; 24:C289-C297. [PMID: 35602253 PMCID: PMC9117909 DOI: 10.1093/eurheartj/suac027] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
This document addresses the evaluation of the Appropriate Use Criteria (AUC) of multimodality imaging in the diagnosis and management of aortic valve disease. The goal of this AUC document is to provide a comprehensive resource for multimodality imaging in the context of aortic valve disease, encompassing multiple imaging modalities. Clinical scenarios are developed in a simple way to illustrate patient presentations encountered in everyday practice.
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Affiliation(s)
- Federico Nardi
- Cardiology Department, Ospedale Santo Spirito, Via Giolitti 2, Casale Monferrato 15033, AL, Italy
| | - Paolo Giuseppe Pino
- Consultant Cardiologist of the Echo-Lab, Ospedale Santo Spirito, Casale Monferrato, AL, Italy
| | - Leonardo De Luca
- Department of Cardio-Thoraco-Vascular, Azienda Ospedaliera San Camillo Forlanini, Roma, Italy
| | - Carmine Riccio
- Cardio-Vascular Department, AORN Sant'Anna and San Sebastiano, Caserta, Italy
| | - Manlio Cipriani
- Cardiology 2-Heart Failure and Transplants, Dipartimento Cardiotoracovascolare "A. De Gasperis", ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy
| | - Marco Corda
- Cardiology Department, Azienda Ospedaliera G. Brotzu, Cagliari, Italy
| | - Giuseppina Maura Francese
- Cardiology Department, Ospedale Garibaldi-Nesima-Azienda Rilievo Nazionale e Alta Specializzazione "Garibaldi", Catania, Italy
| | - Domenico Gabrielli
- Department of Cardio-Thoraco-Vascular, Azienda Ospedaliera San Camillo Forlanini, Roma, Italy
| | - Fabrizio Oliva
- Unit of Intensive Cardiological Care, Cardiology 1-Hemodynamics, Cardiothoracovascular Department "A. De Gasperis", ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy
| | - Michele Massimo Gulizia
- Cardiology Department, Ospedale Garibaldi-Nesima-Azienda Rilievo Nazionale e Alta Specializzazione "Garibaldi", Catania, Italy.,Fondazione per il Tuo cuore-Heart Care Foundation, Firenze, Italy
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Berretta P, Iafrancesco M, Settepani F, Mele D, Di Giannuario G, Murzi M, Fratto P, Pino PG, Mangino D, Moreo A, Di Eusanio M. [Follow-up after surgical treatment of type A acute aortic dissection: current evidence and controversies]. G Ital Cardiol (Rome) 2020; 21:858-864. [PMID: 33077992 DOI: 10.1714/3455.34440] [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
Type A acute aortic dissection (TA-AAD) is a catastrophic condition for which emergency surgery is the mainstay of therapy. Surgical treatment of TA-AAD is centered on excision of the proximal intimal tear, replacement of the ascending aorta and re-establishment of a dominant flow in the distal true lumen. In patients who survive surgery, a dissected distal and/or proximal aorta remains, posing a risk of subsequent aneurysmal degeneration, rupture and malperfusion, and secondary extensive interventions are often required. However, knowledge regarding the risk factors of progression of residual aortic dissection is limited, and no well-defined recommendations for clinical and imaging follow-up have been generated thus far. The aim of this paper is to review and discuss on the current evidence and controversies on the long-term management of patients operated on for TA-AAD.
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Affiliation(s)
- Paolo Berretta
- S.O.D. Cardiochirurgia, Lancisi, Centro Cardiovascolare di Alta Specializzazione del Medio Adriatico, Università Politecnica delle Marche, Ancona
| | - Mauro Iafrancesco
- U.O.C. Cardiochirurgia, Policlinico Universitario "A. Gemelli", Università Cattolica del Sacro Cuore, Roma
| | - Fabrizio Settepani
- U.O.C. Cardiochirurgia, Dipartimento CardioToracoVascolare "De Gasperis", ASST Grande Ospedale Metropolitano Niguarda, Milano
| | - Donato Mele
- U.O.C. Cardiologia, Azienda Ospedaliero-Universitaria, Ferrara
| | | | - Michele Murzi
- U.O.C. Cardiochirurgia, Ospedale del Cuore "G. Pasquinucci", Massa
| | - Pasquale Fratto
- U.O.C. Cardiochirurgia, Centro Cuore Calabria, Grande Ospedale Metropolitano "Bianchi-Melacrino-Morelli", Reggio Calabria
| | - Paolo Giuseppe Pino
- U.O.S.D. Diagnostica Cuore, Azienda Ospedaliera "San Camillo-Forlanini", Roma
| | - Domenico Mangino
- U.O.C. Cardiochirurgia, Dipartimento Cardiovascolare, Ospedale dell'Angelo di Mestre, Mestre
| | - Antonella Moreo
- Dipartimento CardioToracoVascolare "De Gasperis", ASST Grande Ospedale Metropolitano Niguarda, Milano
| | - Marco Di Eusanio
- S.O.D. Cardiochirurgia, Lancisi, Centro Cardiovascolare di Alta Specializzazione del Medio Adriatico, Università Politecnica delle Marche, Ancona
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Abrignani MG, Aiello A, Colivicchi F, Lucà F, Fattirolli F, Gulizia MM, Nardi F, Pino PG, Gregorio G. [Cardiovascular prevention in the elderly: limitations and opportunities]. G Ital Cardiol (Rome) 2020; 21:619-628. [PMID: 32686789 DOI: 10.1714/3405.33896] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The world's population is ageing; however, the prolonged life expectancy is barely associated with an increase of healthy aging, and an important part of this demographic shift is a rising susceptibility to development and progressive accumulation of multiple chronic illness, challenging healthcare systems. Aging, therefore, represents the major risk factor for multimorbidity, a milestone for progressive loss of resilience and age-related multisystem homeostatic dysregulation. Cardiovascular risk factors, time and comorbidities play a vicious role in the development of heart disease. Among the other comorbidities, age itself is one of the most important risk factors for the development of cardiovascular disease and the prevalence and incidence of cardiovascular disease in the elderly are significantly increased. Elderly subjects, particularly when frail and with comorbidities, however, are scarcely represented in primary and secondary prevention trial aimed to treat hypercholesterolemia, diabetes mellitus and arterial hypertension. In particular, concerns exist about whether treatment should more or less intensive according to tolerability and risk of interactions; as well as there is uncertainty about therapeutic targets at different ages.This article reviews the relationship between ageing and cardiovascular disease, focusing on several issues regarding cardiovascular prevention in the elderly.
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Affiliation(s)
| | | | | | - Fabiana Lucà
- U.O. Cardiologia Interventistica-UTIC, A.O. Bianchi Melacrino Morelli, Reggio Calabria
| | - Francesco Fattirolli
- Dipartimento di Medicina Sperimentale e Clinica, Università degli Studi di Firenze, AOU Careggi, Firenze
| | | | - Federico Nardi
- S.C. Cardiologia, Ospedale Santo Spirito, Casale Monferrato (AL)
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Nardi F, Pino PG, Gabrielli D, Colivicchi F, Abrignani MG, Amico AF, Aspromonte N, Benedetto FA, Bertella E, Boccardi LM, Bucciarelli Ducci C, Caldarola P, Campana M, Caso P, Citro R, Costante AM, De Chiara BC, Di Cesare E, Di Fusco SA, Domenicucci S, Enea I, Erba P, Faganello G, Favilli S, Geraci G, Giubbini R, Giunta N, Guido V, Imazio M, Khoury G, La Canna G, Mele D, Moreo AM, Mercuro GG, Musumeci G, Neglia D, Parrini I, Pinamonti B, Pollarolo L, Pontone G, Privitera C, Riccio C, Sinagra G, Urbinati S, Varbella F, Berisso MZ, Zuin G, Di Lenarda A, Gulizia MM. [ANMCO/SICI-GISE/SIC/SIECVI/SIRM Consensus document: Appropriateness of multimodality imaging in cardiovascular disease]. G Ital Cardiol (Rome) 2020; 21:34-88. [PMID: 31960833 DOI: 10.1714/3285.32588] [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: 02/05/2023]
Abstract
The complexity of cardiovascular diseases has led to an extensive use of technological instruments and the development of multimodality imaging. This extensive use of different cardiovascular imaging tests in the same patient has increased costs and waiting times.The concept of appropriateness has changed over time. Appropriateness criteria address the need for specific cardiovascular imaging tests in well-defined clinical scenarios, and define the kind of cardiovascular imaging that is appropriated for each clinical scenario in different stages of the disease. The concept of appropriateness criteria has replaced the old idea of appropriate use criteria and reflects the increasing effort of the international Scientific Societies to create and review in a critical way the management of diagnostic tests used by clinicians.The aim of this Italian consensus document is to address the use of multimodality imaging in the diagnosis and management of the major cardiovascular clinical scenarios, taking into consideration not only the international guidelines and scientific documents already published, but also the reality of Italian laws as well as the various professional profiles involved in patient management and availability of technological diagnostic instruments.
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Affiliation(s)
- Federico Nardi
- S.C. Cardiologia, Ospedale Santo Spirito, Casale Monferrato (AL)
| | - Paolo Giuseppe Pino
- U.O.S.D. Diagnostica Cuore, Dipartimento Cardiovascolare, Ospedale San Camillo, A.O. San Camillo-Forlanini, Roma
| | | | - Furio Colivicchi
- U.O.C. Cardiologia-UTIC, Presidio Ospedaliero San Filippo Neri, ASL Roma 1, Roma
| | | | | | | | | | | | | | | | | | - Marco Campana
- U.O. Cardiologia, Istituto Ospedaliero Fondazione Poliambulanza, Brescia
| | - Pio Caso
- U.O.C. Cardiologia, A.O.R.N. Ospedale dei Colli, P.O. Vincenzo Monaldi, Napoli
| | - Rodolfo Citro
- U.O.C. Cardiologia, Dipartimento Cuore, A.O.U. San Giovanni di Dio e Ruggi d'Aragona, Salerno
| | - Anna Maria Costante
- S.C. Cardiologia, Ospedale Civile SS. Antonio e Biagio e Cesare Arrigo, Alessandria
| | - Benedetta Carla De Chiara
- Cardiologia 4 - Diagnostica e Riabilitativa, ASST Grande Ospedale Metropolitano Niguarda, Milano - Dipartimento di Medicina e Chirurgia, Università degli Studi di Milano-Bicocca, Milano
| | - Ernesto Di Cesare
- Dipartimento di Medicina Clinica, Sanità Pubblica, Scienze della Vita e dell'Ambiente, Sezione di Medicina Clinica e Molecolare, Università degli Studi, L'Aquila
| | | | | | - Iolanda Enea
- U.O.C. Medicina e Chirurgia d'Urgenza, A.O. Sant'Anna e San Sebastiano, Caserta
| | - Paola Erba
- Centro Regionale di Medicina Nucleare, Azienda Ospedaliero-Universitaria Pisana, Dipartimento di Ricerca Traslazionale e delle Nuove Tecnologie in Medicina, Università degli Studi, Pisa
| | - Giorgio Faganello
- S.C. Cardiovascolare e Medicina dello Sport, Azienda Sanitaria Universitaria Integrata di Trieste
| | | | - Giovanna Geraci
- U.O. Cardiologia, A.O.R. Villa Sofia-Cervello, P.O. Cervello, Palermo
| | - Raffaele Giubbini
- Dipartimento Specialità Medico-Chirurgiche, Scienze Radiologiche e Sanità Pubblica, Divisione di Medicina Nucleare, Università degli Studi, Brescia
| | - Nicola Giunta
- U.O.C. Cardiologia-UTIC, Azienda di Rilievo Nazionale e Alta Specializzazione, P.O. Civico e Benfratelli, Palermo
| | | | - Massimo Imazio
- Cardiologia, Presidio Molinette, A.O.U. Città della Salute e della Scienza di Torino, Torino
| | | | | | - Donato Mele
- S.S.D. Cardiologia Non Invasiva, Azienda Ospedaliero-Universitaria di Ferrara, Arcispedale Sant'Anna, Ferrara
| | - Antonella Maurizia Moreo
- Cardiologia 4 - Diagnostica e Riabilitativa, ASST Grande Ospedale Metropolitano Niguarda, Milano
| | | | | | - Danilo Neglia
- Cardiologia e Medicina Cardiovascolare, Fondazione Toscana Gabriele Monasterio, Pisa
| | - Iris Parrini
- S.C. Cardiologia, Ospedale Mauriziano Umberto I, Torino
| | - Bruno Pinamonti
- S.C. Cardiologia, DAI Cardiovascolare, Azienda Sanitaria Universitaria Integrata di Trieste, Università degli Studi, Trieste
| | - Luigi Pollarolo
- S.C. Cardiologia, Ospedale Santo Spirito, Casale Monferrato (AL)
| | - Gianluca Pontone
- U.O. Risonanza Magnetica, Centro Cardiologico Monzino, IRCCS, Milano
| | | | - Carmine Riccio
- U.O.S.D. Follow-Up del Paziente Post-Acuto, A.O. Sant'Anna e San Sebastiano, Caserta
| | - Gianfranco Sinagra
- S.C. Cardiologia, DAI Cardiovascolare, Azienda Sanitaria Universitaria Integrata di Trieste, Università degli Studi, Trieste
| | | | | | | | | | - Andrea Di Lenarda
- S.C. Cardiovascolare e Medicina dello Sport, Azienda Sanitaria Universitaria Integrata di Trieste
| | - Michele Massimo Gulizia
- U.O.C. Cardiologia, Ospedale Garibaldi-Nesima, Azienda di Rilievo Nazionale e Alta Specializzazione "Garibaldi", Catania - Presidente Fondazione per il Tuo cuore
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Guido V, Campana M, Pino PG, Moreo A, De Chiara B, Bertella E, Khoury G. [Role of multimodality imaging in the clinical evaluation of hypertrophic cardiomyopathy]. G Ital Cardiol (Rome) 2019; 20:746-761. [PMID: 31834298 DOI: 10.1714/3271.32383] [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: 06/10/2023]
Abstract
Sarcomeric hypertrophic cardiomyopathy is the most common cardiovascular genetic disease. Clinical evaluation and comprehensive echocardiography are crucial for the diagnosis and early evaluation of the hypertrophic phenotype, but multimodality imaging approach is often required to better define diagnosis and differential diagnosis from phenocopies. This review aims to assess the role of multimodality imaging and, in particular, advanced echocardiography and cardiac magnetic resonance in relation to differential diagnosis and preclinical diagnosis, identification of different phenotypes, and assessment of disease progression and risk of sudden cardiac death. A multimodality imaging approach is also crucial for the selection of patients amenable to surgical or percutaneous septal myectomy and for guiding both procedures.
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Affiliation(s)
| | - Marco Campana
- Unità Diagnostica Non Invasiva, Istituto Ospedaliero Fondazione Poliambulanza, Brescia
| | | | - Antonella Moreo
- Cardiologia 4, ASST Grande Ospedale Metropolitano Niguarda, Milano
| | - Benedetta De Chiara
- Cardiologia 4, ASST Grande Ospedale Metropolitano Niguarda, Milano - Dipartimento di Medicina e Chirurgia, Università degli Studi di Milano-Bicocca, Milano
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Patanè L, Di Lenarda A, Aspromonte N, Bianca I, Capranzano P, Di Eusanio M, Di Fusco S, Di Tano G, Gabrielli D, Garatti A, Geraci G, Gerometta P, Miceli A, Montalto A, Musumeci F, Musumeci G, Nardi F, Parolari A, Pino PG, Rubino AS, Savini C, Troise G, Tarantini G, Urbinati S, Varbella F, Gulizia MM. [ANMCO/GISE/SICCH Inter-Society Consensus Document: Antithrombotic therapy after surgery or structural interventional procedures for valvular heart diseases: how to treat postoperative complications]. G Ital Cardiol (Rome) 2019; 20:149-186. [PMID: 30821297 DOI: 10.1714/3108.30964] [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
Continuous improvement of technologies, devices and drugs needs a renewal and update of current recommendations and guidelines on antithrombotic strategies, especially in those fields where literature lacks of established scientific evidences. Accordingly, the aim of this consensus statement is to provide support for antithrombotic therapy based on current guidelines and the most recent scientific evidences.After an overview on the currently available devices, the appropriate therapy according to type of procedure and implanted device is discussed. The occurrence of postoperative thromboembolic and/or hemorrhagic complications is analyzed, along with the appropriate diagnostic tools and therapeutic approach. A section is dedicated to counseling to pregnancy in women with heart valve prosthesis. Finally, the role of novel oral anticoagulants is discussed, and indications are provided for the management of patients undergoing surgery or interventional procedures on oral anticoagulation therapy.
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Affiliation(s)
| | - Andrea Di Lenarda
- S.C. Centro Cardiovascolare, Azienda Sanitaria Universitaria Integrata, Trieste
| | - Nadia Aspromonte
- Polo Scienze Cardiovascolari e Toraciche, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario "Agostino Gemelli", Roma
| | - Innocenzo Bianca
- U.O.C. Cardiologia Pediatrica, Dipartimento Materno-Infantile, Azienda di Rilievo Nazionale e Alta Specializzazione "Garibaldi", Catania
| | - Piera Capranzano
- Cardiologia, Ospedale Ferrarotto, Università degli Studi, Catania
| | - Marco Di Eusanio
- S.O.D. Cardiochirurgia, Azienda Ospedaliero-Universitaria, Ospedali Riuniti "Umberto I-Lancisi-Salesi", Ancona
| | | | | | | | - Andrea Garatti
- U.O. Cardiochirurgia, IRCCS Policlinico San Donato, San Donato Milanese (MI)
| | - Giovanna Geraci
- U.O.C. Cardiologia, P.O. "V. Cervello", Azienda Ospedaliera Ospedali Riuniti Villa Sofia-Cervello, Palermo
| | | | - Antonio Miceli
- Dipartimento di Chirurgia Mininvasiva, Istituto Clinico Sant'Ambrogio, Milano
| | | | - Francesco Musumeci
- U.O.C. Cardiochirurgia e Centro Trapianti di Cuore, A.O. San Camillo-Forlanini, Roma
| | - Giuseppe Musumeci
- S.C. Cardiologia, Azienda Sanitaria Ospedaliera Santa Croce e Carle, Cuneo
| | - Federico Nardi
- S.C. Cardiologia, Ospedale Santo Spirito, Casale Monferrato (AL)
| | - Alessandro Parolari
- U.O. Cardiochirurgia Universitaria, Policlinico San Donato IRCCS, Università degli Studi, Milano
| | | | - Antonino Salvatore Rubino
- U.O.C. Cardiochirurgia Generale, Dipartimento di Scienze Mediche Traslazionali, Università degli Studi della Campania "Luigi Vanvitelli", Caserta
| | - Carlo Savini
- U.O. Cardiochirurgia, Azienda Ospedaliero-Universitaria Policlinico Sant'Orsola-Malpighi, Bologna
| | - Giovanni Troise
- Cardiochirurgia, Istituto Ospedaliero Fondazione Poliambulanza, Brescia
| | - Giuseppe Tarantini
- Dipartimento di Scienze Cardiache, Toraciche e Vascolari, Università degli Studi, Padova
| | | | | | - Michele Massimo Gulizia
- U.O.C. Cardiologia, Ospedale Garibaldi-Nesima, Azienda di Rilievo Nazionale e Alta Specializzazione "Garibaldi", Catania - Fondazione per il Tuo cuore - Heart Care Foundation Onlus, Firenze
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Pergolini A, Zampi G, Pontillo D, Venturini E, Pino PG, Musumeci F. Atypical recurrence of Takotsubo syndrome. J Cardiovasc Med (Hagerstown) 2017; 18:631-632. [DOI: 10.2459/jcm.0000000000000502] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Pulignano G, Gulizia MM, Baldasseroni S, Bedogni F, Cioffi G, Indolfi C, Romeo F, Murrone A, Musumeci F, Parolari A, Patanè L, Pino PG, Mongiardo A, Spaccarotella C, Di Bartolomeo R, Musumeci G. ANMCO/SIC/SICI-GISE/SICCH Executive Summary of Consensus Document on Risk Stratification in elderly patients with aortic stenosis before surgery or transcatheter aortic valve replacement. Eur Heart J Suppl 2017; 19:D354-D369. [PMID: 28751850 PMCID: PMC5520760 DOI: 10.1093/eurheartj/sux012] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Aortic stenosis is one of the most frequent valvular diseases in developed countries, and its impact on public health resources and assistance is increasing. A substantial proportion of elderly people with severe aortic stenosis is not eligible to surgery because of the advanced age, frailty, and multiple co-morbidities. Transcatheter aortic valve implantation (TAVI) enables the treatment of very elderly patients at high or prohibitive surgical risk considered ineligible for surgery and with an acceptable life expectancy. However, a significant percentage of patients die or show no improvement in quality of life (QOL) in the follow-up. In the decision-making process, it is important to determine: (i) whether and how much frailty of the patient influences the risk of procedures; (ii) how the QOL and the individual patient's survival are influenced by aortic valve disease or from other associated conditions; and (iii) whether a geriatric specialist intervention to evaluate and correct frailty or other diseases with their potential or already manifest disabilities can improve the outcome of surgery or TAVI. Consequently, in addition to risk stratification with conventional tools, a number of factors including multi-morbidity, disability, frailty, and cognitive function should be considered, in order to assess the expected benefit of both surgery and TAVI. The pre-operative optimization through a multidisciplinary approach with a Heart Team can counteract the multiple damage (cardiac, neurological, muscular, respiratory, and kidney) that can potentially aggravate the reduced physiological reserves characteristic of frailty. The systematic application in clinical practice of multidimensional assessment instruments of frailty and cognitive function in the screening and the adoption of specific care pathways should facilitate this task.
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Affiliation(s)
- Giovanni Pulignano
- Cardiology Department 1, Ospedale San Camillo-Forlanini, Via O. Regnoli, 8 00152 Rome, Italy
| | - Michele Massimo Gulizia
- Cardiology Department, Ospedale Garibaldi-Nesima, Azienda di Rilievo Nazionale e Alta Specializzazione "Garibaldi" Catania, Italy
| | | | - Francesco Bedogni
- CCU-Cardiology Unit, IRCCS Policlinico San Donato, San Donato Milanese (Milano), Italy
| | - Giovanni Cioffi
- Cardiology and Medicine Unit, Casa di Cura Villa Bianca, Trento, Italy
| | - Ciro Indolfi
- Cardiology Unit- Campus Universitario, Azienda Ospedaliera Universitaria Mater Domini, Catanzaro, Italy
| | - Francesco Romeo
- Cardiology and Interventional Cardiology Department, Policlinico "Tor Vergata", Rome, Italy
| | - Adriano Murrone
- Cardiology and Cardiovascular Pathophysiology Department, Azienda Ospedaliera di Perugia, Perugia, Italy
| | | | - Alessandro Parolari
- Heart Surgery Unit, Centro Cardiologico Monzino IRCCS, Università degli Studi, Milano, Italy
| | - Leonardo Patanè
- Cardiology Cardiac Surgery Department (Centro Cuore), Centro Clinico Diagnostico G.B. Morgagni, Pedara (Catania), Italy
| | | | - Annalisa Mongiardo
- Cardiology Unit- Campus Universitario, Azienda Ospedaliera Universitaria Mater Domini, Catanzaro, Italy
| | - Carmen Spaccarotella
- Cardiology Unit- Campus Universitario, Azienda Ospedaliera Universitaria Mater Domini, Catanzaro, Italy
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Pergolini A, Zampi G, Tinti MD, Vallone A, Pino PG. Floating thrombus in the false lumen: an unusual finding in aortic dissection. Kardiol Pol 2017; 73:782. [PMID: 26389856 DOI: 10.5603/kp.2015.0164] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2015] [Accepted: 01/08/2015] [Indexed: 11/25/2022]
Affiliation(s)
| | - Giordano Zampi
- UOC Cardiologia, UTIC ed Emodinamica, Ospedale Belcolle, Viterbo, Italy.
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Pulignano G, Gulizia MM, Baldasseroni S, Bedogni F, Cioffi G, Indolfi C, Romeo F, Murrone A, Musumeci F, Parolari A, Patanè L, Pino PG, Mongiardo A, Spaccarotella C, Di Bartolomeo R, Musumeci G. [ANMCO/SIC/SICI-GISE/SICCH Consensus document: Risk stratification in elderly patients undergoing cardiac surgery and transcatheter aortic valve implantation]. G Ital Cardiol (Rome) 2016; 17:756-789. [PMID: 27869890 DOI: 10.1714/2448.25664] [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
Aortic stenosis is one the most frequent valvular diseases in developed countries, and its impact on public healthcare resources and assistance is increasing. A substantial proportion of elderly patients with severe aortic stenosis is frequently not eligible for surgery because of advanced age, frailty and multiple comorbidities. Transcatheter aortic valve implantation (TAVI) enables the treatment of very elderly patients at high or prohibitive surgical risk considered ineligible for surgery and with an acceptable life expectancy. However, a significant proportion of patients die or do not achieve an improvement of quality of life in the short to medium-term follow-up. It is important to determine: 1) whether and how much patient frailty influences the procedural risk; 2) whether quality of life and the individual patient survival are influenced by aortic valve disease alone or by other associated factors; 3) whether a geriatric specialist intervention to evaluate and correct other diseases with their potential or already evident disabilities can improve the results of TAVI, in particular patient quality of life. Consequently, in addition to risk stratification with conventional tools, a number of factors including multimorbidity, disability, frailty and cognitive function should be considered in order to assess the expected benefit of TAVI. Preoperative optimization through a multidisciplinary approach with a Heart Team can counteract the multiple damage (cardiac, neurological, muscular, respiratory, renal) that can potentially worsen the reduced physiological reserves characteristic of frailty. The systematic implementation into clinical practice of multidimensional assessment instruments of frailty and cognitive function for screening and exercise, and the adoption of specific care pathways should facilitate this task.
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Affiliation(s)
| | - Michele Massimo Gulizia
- U.O.C. Cardiologia, Ospedale Garibaldi-Nesima, Azienda di Rilievo Nazionale e Alta Specializzazione "Garibaldi", Catania
| | | | - Francesco Bedogni
- U.O. Cardiologia-UTIC, IRCCS Policlinico San Donato, San Donato Milanese (MI)
| | - Giovanni Cioffi
- U.O. Cardiologia e Medicina, Casa di Cura Villa Bianca, Trento
| | - Ciro Indolfi
- U.O. Cardiologia - Campus Universitario, Azienda Ospedaliera Universitaria Mater Domini, Catanzaro
| | - Francesco Romeo
- U.O.C. Cardiologia e Cardiologia Interventistica, Policlinico "Tor Vergata", Roma
| | - Adriano Murrone
- Cardiologia e Fisiopatologia Cardiovascolare, Azienda Ospedaliera di Perugia, Perugia
| | | | - Alessandro Parolari
- U.O. Cardiochirurgia, Centro Cardiologico Monzino IRCCS, Università degli Studi, Milano
| | - Leonardo Patanè
- Presidio Cardiologico Cardiochirurgico (Centro Cuore), Centro Clinico Diagnostico G.B. Morgagni, Pedara (CT)
| | | | - Annalisa Mongiardo
- U.O. Cardiologia - Campus Universitario, Azienda Ospedaliera Universitaria Mater Domini, Catanzaro
| | - Carmen Spaccarotella
- U.O. Cardiologia - Campus Universitario, Azienda Ospedaliera Universitaria Mater Domini, Catanzaro
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Cottini M, Polizzi V, Pino PG, Buffa V, Musumeci F. Transesophageal Echocardiography and Radiation-induced Damages. Heart Views 2016; 17:114-116. [PMID: 27867461 PMCID: PMC5105223 DOI: 10.4103/1995-705x.192561] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
The long-term sequelae of mantle therapy include, especially lung and cardiac disease but also involve the vessels and the organs in the neck and thorax (such as thyroid, aorta, and esophagus). We presented the case of 66-year-old female admitted for congestive heart failure in radiation-induced heart disease. The patient had undergone to massive radiotherapy 42 years ago for Hodgkin's disease (type 1A). Transesophageal echocardiography was performed unsuccessfully with difficulty because of the rigidity and impedance of esophageal walls. Our case is an extraordinary report of radiotherapy's latency effect as a result of dramatic changes in the structure of mediastinum, in particular in the esophagus, causing unavailability of a transesophageal echocardiogram.
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Affiliation(s)
- Marzia Cottini
- Department of Heart and Vessels, Cardiac Surgery Unit and Heart Transplantation Center, S. Camillo-Forlanini Hospital, Rome, Italy
| | - Vincenzo Polizzi
- Department of Heart and Vessels, Cardiac Surgery Unit and Heart Transplantation Center, S. Camillo-Forlanini Hospital, Rome, Italy
| | - Paolo Giuseppe Pino
- Department of Heart and Vessels, Cardiac Surgery Unit and Heart Transplantation Center, S. Camillo-Forlanini Hospital, Rome, Italy
| | - Vitaliano Buffa
- Department of Heart and Vessels, Cardiac Surgery Unit and Heart Transplantation Center, S. Camillo-Forlanini Hospital, Rome, Italy
| | - Francesco Musumeci
- Department of Heart and Vessels, Cardiac Surgery Unit and Heart Transplantation Center, S. Camillo-Forlanini Hospital, Rome, Italy
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Cottini M, Pergolini A, Zampi G, Buffa V, Pino PG, Polizzi V, Ranocchi F, Luzi G, Montalto A, Musumeci F. Posterior wall as atypical localization of left atrial myxoma : Diagnosis and management. Herz 2016; 42:390-394. [PMID: 27752714 DOI: 10.1007/s00059-016-4480-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2016] [Revised: 08/06/2016] [Accepted: 08/07/2016] [Indexed: 10/20/2022]
Abstract
Atrial myxomas are the most common benign cardiac neoplasms. Although the majority occur in the left atrium (LA) and are attached to the interatrial septum (75-80 % of cases), they can arise from any part of the LA and the cardiac chambers. We report the case of a 65-year-old woman who presented with features of worsening dyspnea and persistent headache. During transthoracic echocardiography, a suspected cardiac myxoma was found arising from the posterior wall of the LA.
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Affiliation(s)
- M Cottini
- Department of Cardiovascular Science, Cardiac Surgery Unit and Heart Transplantation Center, S. Camillo-Forlanini Hospital, Circonvallazione Gianicolense 87, 00149, Rome, Italy.
| | - A Pergolini
- Department of Cardiovascular Science, Cardiac Surgery Unit and Heart Transplantation Center, S. Camillo-Forlanini Hospital, Circonvallazione Gianicolense 87, 00149, Rome, Italy
| | - G Zampi
- Department of Heart and Vessels, Cardiac Unit, Belcolle Hospital, 01100, Viterbo, Italy
| | - V Buffa
- Department of Cardiovascular Science, Radiology Unit, S. Camillo-Forlanini Hospital, Rome, Italy
| | - P G Pino
- Department of Cardiovascular Science, Cardiac Surgery Unit and Heart Transplantation Center, S. Camillo-Forlanini Hospital, Circonvallazione Gianicolense 87, 00149, Rome, Italy
| | - V Polizzi
- Department of Cardiovascular Science, Cardiac Surgery Unit and Heart Transplantation Center, S. Camillo-Forlanini Hospital, Circonvallazione Gianicolense 87, 00149, Rome, Italy
| | - F Ranocchi
- Department of Cardiovascular Science, Cardiac Surgery Unit and Heart Transplantation Center, S. Camillo-Forlanini Hospital, Circonvallazione Gianicolense 87, 00149, Rome, Italy
| | - G Luzi
- Department of Cardiovascular Science, Cardiac Surgery Unit and Heart Transplantation Center, S. Camillo-Forlanini Hospital, Circonvallazione Gianicolense 87, 00149, Rome, Italy
| | - A Montalto
- Department of Cardiovascular Science, Cardiac Surgery Unit and Heart Transplantation Center, S. Camillo-Forlanini Hospital, Circonvallazione Gianicolense 87, 00149, Rome, Italy
| | - F Musumeci
- Department of Cardiovascular Science, Cardiac Surgery Unit and Heart Transplantation Center, S. Camillo-Forlanini Hospital, Circonvallazione Gianicolense 87, 00149, Rome, Italy
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14
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Pergolini A, Zampi G, Tinti MD, Polizzi V, Pino PG, Pontillo D, Musumeci F, Luzi G. Combined venoarterial extracorporeal membrane oxygenation and transcatheter aortic valve implantation for the treatment of acute aortic prosthesis dysfunction in a high-risk patient. Rev Port Cardiol 2016; 35:445.e1-4. [PMID: 27402446 DOI: 10.1016/j.repc.2015.10.013] [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] [Subscribe] [Scholar Register] [Received: 07/05/2015] [Accepted: 10/16/2015] [Indexed: 11/19/2022] Open
Abstract
We describe the case of a patient with acute bioprosthesis dysfunction in cardiogenic shock, in whom hemodynamic support was provided by venoarterial extracorporeal membrane oxygenation, and successfully treated by transcatheter aortic valve implantation.
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Affiliation(s)
- Amedeo Pergolini
- Department of Cardiovascular Science, "S. Camillo-Forlanini" Hospital, Rome, Italy
| | - Giordano Zampi
- Department of Cardiology, Belcolle Hospital, Viterbo, Italy.
| | - Maria Denitza Tinti
- Department of Cardiovascular Science, "S. Camillo-Forlanini" Hospital, Rome, Italy
| | - Vincenzo Polizzi
- Department of Cardiovascular Science, "S. Camillo-Forlanini" Hospital, Rome, Italy
| | - Paolo Giuseppe Pino
- Department of Cardiovascular Science, "S. Camillo-Forlanini" Hospital, Rome, Italy
| | - Daniele Pontillo
- Department of Cardiomyopathies and Heart Failure, Belcolle Hospital, Montefiascone Facility, Montefiascone (VT), Italy
| | - Francesco Musumeci
- Department of Cardiovascular Science, "S. Camillo-Forlanini" Hospital, Rome, Italy
| | - Giampaolo Luzi
- Department of Cardiovascular Science, "S. Camillo-Forlanini" Hospital, Rome, Italy
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15
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Pergolini A, Zampi G, Tinti MD, Pontillo D, Di Paolo B, Buffa V, Pulignano G, Pino PG, Minardi G, Musumeci F. The Strange Case of the Infarcted Myxoma. Echocardiography 2015; 33:476-8. [PMID: 26593682 DOI: 10.1111/echo.13122] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
In the setting of an acute coronary syndrome, the differential diagnosis between a thrombus and a myxoma may be cumbersome. We describe the case of a patient presenting with an acute coronary syndrome associated with an aneurysmatic apical left ventricular myxoma.
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Affiliation(s)
- Amedeo Pergolini
- Department of Cardiovascular Science, "S. Camillo-Forlanini" Hospital, Rome, Italy
| | - Giordano Zampi
- Department of Cardiology, Belcolle Hospital, Viterbo, Italy
| | - Maria Denitza Tinti
- Department of Cardiovascular Science, "S. Camillo-Forlanini" Hospital, Rome, Italy
| | | | - Barbara Di Paolo
- Department of Pathology, "S. Camillo-Forlanini" Hospital, Rome, Italy
| | - Vitaliano Buffa
- Department of Radiology, "S. Camillo-Forlanini" Hospital, Rome, Italy
| | - Giovanni Pulignano
- Department of Cardiovascular Science, "S. Camillo-Forlanini" Hospital, Rome, Italy
| | - Paolo Giuseppe Pino
- Department of Cardiovascular Science, "S. Camillo-Forlanini" Hospital, Rome, Italy
| | - Giovanni Minardi
- Department of Cardiovascular Science, "S. Camillo-Forlanini" Hospital, Rome, Italy
| | - Francesco Musumeci
- Department of Cardiovascular Science, "S. Camillo-Forlanini" Hospital, Rome, Italy
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Pulignano G, Tinti MD, Tolone S, Musto C, De Lio L, Pino PG, Minardi G, Violini R, Uguccioni M. Noncompaction and embolic myocardial infarction: The importance of oral anticoagulation. Rev Port Cardiol 2015; 34:497.e1-4. [DOI: 10.1016/j.repc.2015.01.014] [Citation(s) in RCA: 7] [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] [Received: 10/05/2014] [Accepted: 01/02/2015] [Indexed: 11/24/2022] Open
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Pergolini A, Zampi G, Casali G, Madeo A, Visconti CL, Cipullo PL, Pino PG, Musumeci F. Takotsubo Syndrome After Mitral Valve Replacement: Case Report and Brief Review of the Literature. J Cardiothorac Vasc Anesth 2015; 29:431-5. [DOI: 10.1053/j.jvca.2013.09.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2013] [Indexed: 11/11/2022]
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Pergolini A, Zampi G, Tinti MD, Vallone A, Pino PG, Musumeci F, Luzi G. Idiopathic ascending aortitis as a rare cause of supravalvular aortic stenosis. Heart Lung Vessel 2015; 7:81-2. [PMID: 25861594 PMCID: PMC4381826] [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] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
- Amedeo Pergolini
- Department of Cardiovascular Science, "S. Camillo-Forlanini" Hospital, Rome, Italy
| | - Giordano Zampi
- Department of Cardiology, Belcolle Hospital, Viterbo, Italy
| | - Maria Denitza Tinti
- Department Heart and Great Vessels "A. Reale", Policlinico Umberto I, "La Sapienza", Rome, Italy
| | - Andrea Vallone
- Department of Cardiovascular Science, "S. Camillo-Forlanini" Hospital, Rome, Italy
| | - Paolo Giuseppe Pino
- Department of Cardiovascular Science, "S. Camillo-Forlanini" Hospital, Rome, Italy
| | - Francesco Musumeci
- Department of Cardiovascular Science, "S. Camillo-Forlanini" Hospital, Rome, Italy
| | - Giampaolo Luzi
- Department of Cardiovascular Science, "S. Camillo-Forlanini" Hospital, Rome, Italy
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Minardi G, Pergolini A, Zampi G, Pulignano G, Pero G, Sbaraglia F, Pino PG, Cioffi G, Musumeci F. St. Jude Trifecta versus Carpentier-Edwards Perimount Magna valves for the treatment of aortic stenosis: comparison of early Doppler-echocardiography and hemodynamic performance. Monaldi Arch Chest Dis 2014; 80:126-32. [PMID: 24818319 DOI: 10.4081/monaldi.2013.74] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE Aim of this study was to compare the hemodynamic profiles of 2 aortic valve bioprostheses: the Carpentier Edwards Perimount Magna (CEPM) valve and the Trifecta valve. METHODS 100 patients who underwent AVR for severe symptomatic AS between September 2011 and October 2012 were analyzed by means of standard trans-thoracic Doppler-echocardiography. RESULTS Mean and peak gradients were significantly lower for the 21 mm Trifecta vs CEPM (11 +/- 4 vs 15 +/- 4 mmHg, and 20 +/- 6 vs 26 +/- 7 mmHg, respectively; all p < 0.05) and the 23 mm Trifecta vs CEPM (8 +/- 2 vs 14 +/- 4 mmHg, and 17 +/- 6 vs 25 +/- 9 mmHg; all p < 0.05). Effective orifice area tended to be slightly higher for the Trifecta valve. CONCLUSION The new bioprosthetic valve Trifecta has an excellent hemodynamic profile, and lower trans-prosthesic gradients when compared to CEPM valve.
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Pino PG, Pergolini A, Zampi G, Vallone A, Minardi G, Musumeci F. Localized epicarditis mimicking right atrial mass. Rev Port Cardiol 2014; 33:313-4. [DOI: 10.1016/j.repc.2013.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2013] [Accepted: 11/06/2013] [Indexed: 11/16/2022] Open
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21
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Affiliation(s)
- Amedeo Pergolini
- Department of Cardiovascular Science; “S. Camillo-Forlanini” Hospital; Rome Italy
| | - Paolo Giuseppe Pino
- Department of Cardiovascular Science; “S. Camillo-Forlanini” Hospital; Rome Italy
| | - Giordano Zampi
- U.O.C. Cardiologia ed Emodinamica Ospedale Belcolle; Viterbo Italy
| | - Vincenzo Polizzi
- Department of Cardiovascular Science; “S. Camillo-Forlanini” Hospital; Rome Italy
| | - Francesco Musumeci
- Department of Cardiovascular Science; “S. Camillo-Forlanini” Hospital; Rome Italy
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22
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Pino PG, Pergolini A, Zampi G, Pero G, Minardi G. Massive Thrombosis of the Left Ventricle: An Echo Round. Can J Cardiol 2013; 29:1139.e1-2. [DOI: 10.1016/j.cjca.2012.12.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2012] [Revised: 12/10/2012] [Accepted: 12/10/2012] [Indexed: 10/27/2022] Open
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23
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Pergolini A, Zampi G, Madeo A, della Monica PL, Pino PG. A Mitraclip affaire: early detachment and iatrogenic interatrial defect. Eur Heart J Cardiovasc Imaging 2013; 15:188. [PMID: 23980059 DOI: 10.1093/ehjci/jet156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Amedeo Pergolini
- Department of Cardiovascular Science, 'S. Camillo-Forlanini' Hospital, Rome, Italy
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24
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de Santis F, Pergolini A, Zampi G, Pero G, Pino PG, Minardi G. An unusual ST-segment elevation: Apical hypertrophic cardiomyopathy shows the ace up its sleeve. Revista Portuguesa de Cardiologia (English Edition) 2013. [DOI: 10.1016/j.repce.2012.11.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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25
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Giuseppe Pino P, Zampi G, Pergolini A, Cao P, Musumeci F. Endovascular aortic repair after elephant trunk: a three-dimensional echocardiography sight. Eur Heart J Cardiovasc Imaging 2013; 14:836. [PMID: 23513232 DOI: 10.1093/ehjci/jet039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Paolo Giuseppe Pino
- Department of Cardiovascular Science, S. Camillo-Forlanini Hospital, Rome, Italy
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26
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Pino PG, Zampi G, Pergolini A, Minardi G, Boccardi L. An unusual couple: Bjork-Shiley aortic and Smeloff-Cutter mitral prostheses — 42 years in action. Kardiol Pol 2013; 71:315. [DOI: 10.5603/kp.2013.0051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2012] [Indexed: 11/25/2022]
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27
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Pino PG, Pergolini A, Zampi G, Minardi G, Pero G, Polizzi V, Musumeci F. The importance of being "three-dimensional": how to save a mitral valve. Case report. Med Ultrason 2012; 14:355-357. [PMID: 23243651] [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: 06/01/2023]
Abstract
In a 72-year-old male patient an acute coronary syndrome (ACS) was complicated by left ventricular aneurysm and severe mitral regurgitation. Two-dimensional echocardiography failed in detecting mechanism of mitral regurgitation. Transthoracic three dimensional echocardiography allowed us to obtain a better visualization of the relationship between papillary muscles, ventricular walls and mitral leaflets and dynamic systolic displacement of the posterior papillary muscle associated with restriction of both leaflets with greater apical tethering of anterior leaflet (A3-A2 scallops). Echocardiography performed after cardiac surgery revealed that ventricular reshaping after posterior papillary muscle realignment allowed the mitral regurgitation resolution.
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Affiliation(s)
- Paolo Giuseppe Pino
- Department of Cardiovascular Science, "S. Camillo-Forlanini" Hospital, Rome, Italy
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28
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Pino PG, Zampi G, Pergolini A, Minardi G. A closer sight to the transapical cardiac resynchronization therapy. Anadolu Kardiyol Derg 2012; 12:E35-E36. [PMID: 22877914 DOI: 10.5152/akd.2012.205] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Affiliation(s)
- Paolo Giuseppe Pino
- Department of Cardiology and Cardiovascular Surgery, Azienda Ospedaliera San Camillo-Forlanini, Rome-Italy
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29
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Manzara C, Zampi G, Pergolini A, Minardi G, Orsini FM, Pino PG. Real-Time 3D echocardiography in a young adult with idiopathic dilatation of the pulmonary artery: a case report. Med Ultrason 2012; 14:161-163. [PMID: 22675719] [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: 06/01/2023]
Abstract
Idiopathic dilatation of the pulmonary artery (IDPA) is an uncommon anomaly occurring in 0.6% of patients with congenital heart disease. IDPA is characterized by the enlargement of the main pulmonary artery with or without dilatation of the right and left pulmonary arteries. We describe 2D and Real-Time 3D Echocardiography findings in a young adult with IDPA. To the best of our knowledge this is the first case reporting all echocardiographic findings diagnostic for IDPA.
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Affiliation(s)
- Carla Manzara
- Department of Cardiovascular Science, S Camillo-Forlanini Hospital, Rome, Italy
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30
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Pino PG, Pergolini A, Zampi G. Echocardiographic findings of iatrogenic septal defect during TA-AVI. Revista Portuguesa de Cardiologia (English Edition) 2012. [DOI: 10.1016/j.repce.2012.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
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31
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Pino PG, Pergolini A, Zampi G. Echocardiographic findings of iatrogenic septal defect during TA-AVI. Rev Port Cardiol 2012; 31:177-8. [PMID: 22230098 DOI: 10.1016/j.repc.2011.12.007] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2011] [Accepted: 09/16/2011] [Indexed: 11/18/2022] Open
Affiliation(s)
- Paolo Giuseppe Pino
- Department of Cardiovascular Science, "S. Camillo-Forlanini" Hospital, Rome, Italy
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Affiliation(s)
- Paolo Giuseppe Pino
- Department of Cardiovascular Science, S. Camillo-Forlanini Hospital, Circonvallazione Gianicolense, 87, 00151 Rome, Italy
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Minardi G, Pulignano G, Pino PG, Pergolini A, Musumeci F. Double-chambered right ventricle associated with ventricular septal defect and subaortic stenosis in an adult. Anadolu Kardiyol Derg 2011; 11:E27-E28. [PMID: 21967795 DOI: 10.5152/akd.2011.179] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Affiliation(s)
- Giovanni Minardi
- Department of Cardiology and Cardiovascular Surgery, Azienda Ospedaliera S. Camillo-Forlanini, Rome-Italy.
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34
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Pino PG, Pergolini A, Zampi G, Calicchia A, Chialastri C, Orsini FM, Fini F, Buffa V, Minardi G. Congenitally corrected transposition of the great arteries with severely stenotic bicuspid aortic valve in an adult: a case report. Echocardiography 2011; 29:E13-5. [PMID: 21967613 DOI: 10.1111/j.1540-8175.2011.01522.x] [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: 12/01/2022] Open
Abstract
Congenitally corrected transposition of the great arteries (CCTGA) is a rare disease accounting for 0.5-1.4% of patients with congenital heart disease. In this congenital cardiopathy, the left atrium is connected to the right ventricle, from which the aorta stems. We present a case of an adult with CCTGA associated with aortic stenosis and bicuspid aortic valve-an association not yet described to our knowledge.
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Affiliation(s)
- Paolo Giuseppe Pino
- Department of Cardiovascular Science, S. Camillo-Forlanini Hospital Department Heart and Great Vessels Attilio Reale, Sapienza University of Rome Department of Radiology, S. Camillo-Forlanini Hospital, Rome, Italy
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35
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Boccardi L, Fini F, Pino PG, Minardi G. Cardiopatie e rischio cardiovascolare in pazienti candidati alla terapia antitumorale. Che cosa deve sapere l’oncologo. J Cardiovasc Echogr 2011. [DOI: 10.1016/j.jcecho.2011.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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36
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Minardi G, Leonetti S, Bernardi L, Pulignano G, Pino PG, Boccardi L, Manzara C, Musumeci F. An isolated anterior mitral leaflet cleft: a case report. Cardiovasc Ultrasound 2010; 8:26. [PMID: 20626902 PMCID: PMC2918532 DOI: 10.1186/1476-7120-8-26] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2010] [Accepted: 07/13/2010] [Indexed: 12/05/2022] Open
Abstract
Introduction The anterior mitral leaflet cleft is an unusual congenital lesion most often encountered in association with other congenital heart defects. The isolated anterior leaflet cleft is quite a rare anomaly and is usually cause of mitral valve regurgitation. The importance of the lesion is that it is often correctable. When feasible, cleft suture and, eventually, annuloplasty are preferable to valve replacement. Echocardiography is the first choice technique in the evaluation of mitral valve disease, providing useful information about valve anatomy and hemodynamic parameters. Case presentation We present a case of an isolated anterior mitral leaflet cleft producing moderate-severe mitral regurgitation correctly identified by echocardiography and successfully surgically corrected. Conclusion Isolated cleft is a rare aberration, that has to be known in order to be diagnosed. Transthoracic and transesophageal echocardiography is the most useful non invasive technique for cleft diagnosis and to indicate the right surgical correction.
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Affiliation(s)
- Giovanni Minardi
- Cardiodiagnostica non invasiva, Department of Cardiology and Cardiovascular Surgery, Azienda Ospedaliera San Camillo-Forlanini, Rome, Italy.
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Minardi G, Pino PG, Manzara CC, Pulignano G, Stefanini GG, Viceconte GN, Leonetti S, Madeo A, Gaudio C, Musumeci F. Preoperative scallop-by-scallop assessment of mitral prolapse using 2D-transthoracic echocardiography. Cardiovasc Ultrasound 2010; 8:1. [PMID: 20044927 PMCID: PMC2806252 DOI: 10.1186/1476-7120-8-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2009] [Accepted: 01/01/2010] [Indexed: 11/11/2022] Open
Abstract
Background This study was conducted to assess the accuracy of harmonic imaging 2D-transthoracic echocardiography (2D-TTE) segmental analysis compared to surgical findings, in degenerative mitral regurgitation (MR). Methods Seventy-seven consecutive patients with severe degenerative MR were prospectively enrolled. Preoperative 2D-TTE with precise localization of prolapsing or flailing scallops/segments was performed. All patients underwent mitral valve surgical repair. Surgical reports (SR), including valve description, were used as references for comparisons. A postoperative control 2D-TTE was performed. Results Out of 462 scallops/segments studied, surgical inspection identified 102 prolapses or flails (22%), 92 of which had previously been detected by 2D-TTE (90.2% sensitivity, 100% specificity). Agreement between preoperative 2D-TTE segmental analysis and SR was 97.8% (k = 0.93; p < 0.0001). Sixty-nine out of 77 2D-TTE reports were completely concordant with SR (89.6% diagnostic accuracy). None of the 8 non-concordant 2D-TTE reports were in complete disagreement with SR. P2 scallop was always involved in posterior leaflet prolapse or flail and was described correctly by 2D-TTE in 68 out of 69 patients (98,7% agreement, k = 0,93; 98.5% sensitivity). The anterior leaflet was involved in 14 patients (18%); A2 segment was involved in all of those cases and was correctly detected by 2D-TTE in 13 (98,7% agreement, k = 0,95; 92,8% sensitivity). Antero-lateral and postero-medial para-commissural prolapse or flail had a lower prevalence (14% and 10% respectively), with 2D-TTE sensitivity respectively of 64% and 50%. Conclusions 2D-TTE, performed by an experienced echo-lab, has very good diagnostic accuracy in localizing the scallops/segments involved in degenerative MR, particularly for the middle ones (P2-A2), which represent almost the totality of prolapses. More invasive, time consuming and expensive exams should be reserved to selected cases.
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Affiliation(s)
- Giovanni Minardi
- Department of Cardiovascular Science, S Camillo-Forlanini Hospital, Rome, Italy.
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Mazza A, Fera MS, Pugliese M, Leggio M, Bendini MG, Poli V, Manzara C, Minardi G, Pino PG, Pompa D, Fiorella AT, De Santis F, Giovannini E. Biphasic transoesophageal vs. transthoracic electrical cardioversion of persistent atrial fibrillation. J Cardiovasc Med (Hagerstown) 2006; 7:594-600. [PMID: 16858238 DOI: 10.2459/01.jcm.0000237907.88258.7e] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To compare the efficacy and safety of transoesophageal (TOC) vs. transthoracic (TTC) electrical cardioversion, both with biphasic shocks, for sinus rhythm (SR) restoration in patients with persistent atrial fibrillation (AF). METHODS We randomised 210 patients (151 male, 59 female, mean age 66 +/- 9 years) with persistent AF into two groups: group 1 (n = 104) undergoing TOC with a step-up protocol of 30, 50, 70 and 100 J, and group 2 (n = 106) undergoing TTC with a step-up protocol of 70, 100, 120 and 150 J. RESULTS The two groups were homogeneous as for clinical and instrumental characteristics, except for left ventricular ejection fraction (50.5 +/- 10% in group 1 vs. 53 +/- 8% in group 2, P < 0.05) and thoracic impedance (63 +/- 8 Omega in group 1 vs. 66 +/- 6 Omega in group 2, P < 0.005). SR was restored in 98 (94%) group 1 patients vs. 99 (93%) group 2 patients (P = NS). First shock was effective in 48 (46%) group 1 patients vs. 54 (51%) group 2 patients (P = NS). Mean delivered energy was 50.4 +/- 23.6 and 95.1 +/- 29.6 J; mean effective energy was 47.3 +/- 20.7 and 91.2 +/- 26.6 J in group 1 and group 2, respectively. Cross-over to the highest energy level was never effective. TOC tolerability was optimal (mean discomfort score 1.2 on a 1-4 grading scale). Markers of myocardial necrosis did not increase and no procedure-related complications occurred. On logistic regression analysis, the most predictive variables of unsuccessful cardioversion were AF duration (P = 0.0001) and low left atrial appendage emptying velocity (P = 0.02). CONCLUSIONS Both TOC and TTC with biphasic shocks are effective and safe for SR restoration in patients with persistent AF; however, the considerably lower levels of delivered and effective energies for SR restoration allow TOC to be performed during mild sedation with optimal tolerability, thus avoiding general anaesthesia.
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Affiliation(s)
- Andrea Mazza
- 1st Cardiology Operative Unit, Cardiovascular Department, San Camillo-Forlanini Hospital, Rome, Italy
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Boccardi L, Pino PG. [Primary lymphoma of the right atrium: a case report]. Ital Heart J Suppl 2004; 5:487-91. [PMID: 15471154] [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: 04/30/2023]
Abstract
Primary cardiac tumor is an extremely rare disease and is associated with a high mortality. The cases described in the literature are recently increased thanks to the employment of the new diagnostic methodologies (computed tomography, nuclear magnetic resonance, transesophageal echocardiography). Particularly the primitive lymphoma, non-HIV correlated, is very rare (< 1.5% of all cardiac tumors), but it is treatable when appropriately diagnosed. We report a case of 52-year-old patient who presented with an infiltrative mass in the right atrium. The examination of the tissue obtained by transvenous intracardiac biopsy with transesophageal echocardiography guidance revealed high grade non-Hodgkin's lymphoma of B-cell lineage. The patient achieved complete tumor remission after treatment with standard chemotherapy. This case demonstrates that early diagnosis might contribute to a better prognosis for patients with malignant lymphoma of the heart.
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MESH Headings
- Antibiotics, Antineoplastic/administration & dosage
- Antibiotics, Antineoplastic/therapeutic use
- Antineoplastic Agents, Phytogenic/administration & dosage
- Antineoplastic Agents, Phytogenic/therapeutic use
- Biopsy
- Doxorubicin/administration & dosage
- Doxorubicin/therapeutic use
- Drug Therapy, Combination
- Echocardiography, Doppler
- Echocardiography, Transesophageal
- Electrocardiography
- Follow-Up Studies
- Heart Atria/pathology
- Heart Neoplasms/diagnosis
- Heart Neoplasms/diagnostic imaging
- Heart Neoplasms/drug therapy
- Heart Neoplasms/pathology
- Humans
- Lymphoma, B-Cell/diagnosis
- Lymphoma, B-Cell/diagnostic imaging
- Lymphoma, B-Cell/drug therapy
- Lymphoma, B-Cell/pathology
- Male
- Middle Aged
- Remission Induction
- Time Factors
- Vincristine/administration & dosage
- Vincristine/therapeutic use
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Affiliation(s)
- Lidia Boccardi
- Dipartimento di Malattie Cardiovascolari, Azienda Ospedaliera San Camillo-Forlanini, Roma.
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Boccardi L, Colecchia D, Curti S, Pino PG, Rulli V. [The utility of electrocardiography in the age of exercise echocardiography]. Cardiologia 1995; 40:807-12. [PMID: 8706058] [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: 02/01/2023]
Affiliation(s)
- L Boccardi
- Servizio di Valutazione Funzionale del Cardiopatico, Ospedale S Camillo, Roma
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Jacovella G, Pino PG, Costa M, Celli P, Castellari M, Sebastiani F. [Evaluation of biological prostheses using the Doppler method]. G Ital Cardiol 1990; 20:58-65. [PMID: 2184072] [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: 12/30/2022]
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Jacovella G, Pino PG, Sebastiani F. [Echocardiography study of mechanical heart valve prosthesis]. Cardiologia 1986; 31:641-51. [PMID: 3815443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Ascarelli AA, Gambelli G, Pino PG, Salati A. [Xerotomographic and rheographic study of the pulmonary circulation in chronic bronchopneumonopathies]. Radiol Med 1980; 66:145-8. [PMID: 7455224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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