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  1. Article ; Online: Genetic Basis, New Diagnostic Approaches, and Updated Therapeutic Strategies of the Syndromic Aortic Diseases: Marfan, Loeys-Dietz, and Vascular Ehlers-Danlos Syndrome.

    Asta, Laura / D'Angelo, Gianluca A / Marinelli, Daniele / Benedetto, Umberto

    International journal of environmental research and public health

    2023  Volume 20, Issue 16

    Abstract: Syndromic aortic diseases (SADs) encompass various pathological manifestations affecting the aorta caused by known genetic factors, such as aneurysms, dissections, and ruptures. However, the genetic mutation underlying aortic pathology also gives rise to ...

    Abstract Syndromic aortic diseases (SADs) encompass various pathological manifestations affecting the aorta caused by known genetic factors, such as aneurysms, dissections, and ruptures. However, the genetic mutation underlying aortic pathology also gives rise to clinical manifestations affecting other vessels and systems. As a consequence, the main syndromes currently identified as Marfan, Loeys-Dietz, and vascular Ehlers-Danlos are characterized by a complex clinical picture. In this contribution, we provide an overview of the genetic mutations currently identified in order to have a better understanding of the pathogenic mechanisms. Moreover, an update is presented on the basis of the most recent diagnostic criteria, which enable an early diagnosis. Finally, therapeutic strategies are proposed with the goal of improving the rates of patient survival and the quality of life of those affected by these SADs.
    MeSH term(s) Humans ; Ehlers-Danlos Syndrome, Type IV ; Marfan Syndrome/diagnosis ; Marfan Syndrome/genetics ; Marfan Syndrome/therapy ; Quality of Life ; Aortic Diseases ; Aorta
    Language English
    Publishing date 2023-08-20
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2175195-X
    ISSN 1660-4601 ; 1661-7827
    ISSN (online) 1660-4601
    ISSN 1661-7827
    DOI 10.3390/ijerph20166615
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Minimally Invasive Strategy to Repair Mitral Valve after Repeated Coronary Revascularization: A Case Report and Literature Review.

    Asta, Laura / Benedetto, Umberto / Tancredi, Fabrizio Costantino / Di Giammarco, Gabriele

    Journal of clinical medicine

    2023  Volume 12, Issue 22

    Abstract: Redo cardiac surgery after Coronary Artery Bypass Grafting (CABG) is burdened by high morbidity and mortality, either intraoperatively and postoperatively, with the repeated sternotomy playing a crucial role as risk factor. The right minithoracotomy ... ...

    Abstract Redo cardiac surgery after Coronary Artery Bypass Grafting (CABG) is burdened by high morbidity and mortality, either intraoperatively and postoperatively, with the repeated sternotomy playing a crucial role as risk factor. The right minithoracotomy approach guarantees a safer control on conduits integrity and the right ventricular wall and a low impact on the respiratory mechanics. Herein, we report a patient who previously underwent two CABG (coronary artery bypass grafting) procedures and who was admitted to the hospital with a picture of heart failure caused by a severe mitral regurgitation. He was successfully submitted to a mitral valve repair on a beating heart via the right minithoracotomy approach.
    Language English
    Publishing date 2023-11-15
    Publishing country Switzerland
    Document type Case Reports
    ZDB-ID 2662592-1
    ISSN 2077-0383
    ISSN 2077-0383
    DOI 10.3390/jcm12227096
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Stroke after Cardiac Surgery: A Risk Factor Analysis of 580,117 Patients from UK National Adult Cardiac Surgical Audit Cohort.

    Asta, Laura / Falco, Daniele / Benedetto, Umberto / Porreca, Annamaria / Majri, Fatma / Angelini, Gianni D / Sensi, Stefano / Di Giammarco, Gabriele

    Journal of personalized medicine

    2024  Volume 14, Issue 2

    Abstract: Cerebrovascular accident is the most ominous complication observed after cardiac surgery, carrying an increased risk of morbidity and mortality. Analysis of the problem shows its multidimensional nature. In this study, we aimed to identify major ... ...

    Abstract Cerebrovascular accident is the most ominous complication observed after cardiac surgery, carrying an increased risk of morbidity and mortality. Analysis of the problem shows its multidimensional nature. In this study, we aimed to identify major determinants among classic variables, either demographic, clinical or type of surgical procedure, based on the analysis of a large dataset of 580,117 patients from the UK National Adult Cardiac Surgical Audit (NACSA). For this purpose, univariate and multivariate logistic regression models were utilized to determine associations between predictors and dependent variable (Stroke after cardiac surgery). Odds ratios (ORs) and 95% confidence intervals (CIs) were constructed for each independent variable. Statistical analysis allows us to confirm with greater certainty the predictive value of some variables such as age, gender, diabetes mellitus (diabetes treated with insulin OR = 1.37, 95%CI = 1.23-1.53), and systemic arterial hypertension (OR = 1.11, 95%CI = 1.05-1.16);, to emphasize the role of preoperative atrial fibrillation (OR = 1.10, 95%CI = 1.03-1.16) extracardiac arteriopathy (OR = 1.70, 95%CI = 1.58-1.82), and previous cerebral vascular accident (OR 1.71, 95%CI = 1.6-1.9), and to reappraise others like smoking status (crude OR = 1.00, 95%CI = 0.93-1.07 for current smokers) or BMI (OR = 0.98, 95%CI = 0.97-0.98). This could allow for better preoperative risk stratification. In addition, identifying those surgical procedures (for example thoracic aortic surgery associated with a crude OR of 3.72 and 95%CI = 3.53-3.93) burdened by a high risk of neurological complications may help broaden the field of preventive and protective techniques.
    Language English
    Publishing date 2024-01-31
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2662248-8
    ISSN 2075-4426
    ISSN 2075-4426
    DOI 10.3390/jpm14020169
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: A rare localization of papillary fibroelastoma.

    Trombetti, Daniele / Nardi, Paolo / Asta, Laura / Pisano, Calogera / Altieri, Claudia / Ruvolo, Giovanni

    Kardiochirurgia i torakochirurgia polska = Polish journal of cardio-thoracic surgery

    2022  Volume 19, Issue 2, Page(s) 103–104

    Language English
    Publishing date 2022-06-29
    Publishing country Poland
    Document type Journal Article
    ZDB-ID 2237053-5
    ISSN 1897-4252 ; 1731-5530
    ISSN (online) 1897-4252
    ISSN 1731-5530
    DOI 10.5114/kitp.2022.117501
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article: Treating Mitroflow dysfunction by means of an open valve-in-valve Perceval implantation.

    Trombetti, Daniele / Pisano, Calogera / Altieri, Claudia / Nardi, Paolo / Ferrante, Sabrina Maria / Asta, Laura / Buioni, Dario / Ruvolo, Giovanni

    Kardiochirurgia i torakochirurgia polska = Polish journal of cardio-thoracic surgery

    2023  Volume 20, Issue 1, Page(s) 65–66

    Language English
    Publishing date 2023-04-03
    Publishing country Poland
    Document type Journal Article
    ZDB-ID 2237053-5
    ISSN 1897-4252 ; 1731-5530
    ISSN (online) 1897-4252
    ISSN 1731-5530
    DOI 10.5114/kitp.2023.126105
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article: Cardiac angiosarcoma: a formidable challenge.

    Trombetti, Daniele / Pisano, Calogera / Ferrante, Maria Sabrina / Asta, Laura / Altieri, Claudia / Nardi, Paolo / Buioni, Dario / Ruvolo, Giovanni

    Kardiochirurgia i torakochirurgia polska = Polish journal of cardio-thoracic surgery

    2023  Volume 20, Issue 1, Page(s) 53–56

    Language English
    Publishing date 2023-04-03
    Publishing country Poland
    Document type Journal Article
    ZDB-ID 2237053-5
    ISSN 1897-4252 ; 1731-5530
    ISSN (online) 1897-4252
    ISSN 1731-5530
    DOI 10.5114/kitp.2023.126101
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Long-Term Follow-Up of Device-Assisted Clampless Off-Pump Coronary Artery Bypass Grafting Compared with Conventional On-Pump Technique.

    Bassano, Carlo / Nardi, Paolo / Buioni, Dario / Asta, Laura / Pisano, Calogera / Bertoldo, Fabio / Altieri, Claudia / Ruvolo, Giovanni

    International journal of environmental research and public health

    2021  Volume 19, Issue 1

    Abstract: Study objective: To evaluate the long-term outcomes of clampless off-pump coronary artery bypass grafting (C-OPCAB) compared with conventional on-pump double clamping coronary artery bypass grafting (C-CABG).: Methods: From October 2006 to December ... ...

    Abstract Study objective: To evaluate the long-term outcomes of clampless off-pump coronary artery bypass grafting (C-OPCAB) compared with conventional on-pump double clamping coronary artery bypass grafting (C-CABG).
    Methods: From October 2006 to December 2011, 366 patients underwent isolated coronary artery bypass grafting. After propensity score matching of preoperative variables, 143 pairs were selected who received C-OPCAB with the use of device-assisted PAS-Port proximal venous graft anastomoses or C-CABG, performed by the same surgeon experienced in both techniques. Data of the two groups of patients were retrospectively analyzed up to 14 years of follow-up.
    Results: As compared with C-OPCAB, in the C-CABG patients, the performed number of grafts per patient was higher (2.9 ± 0.5 vs. 2.6 ± 0.6,
    Conclusions: Our single-center study analysis suggests that clampless OPCAB using device-assisted proximal anastomoses proved to be not inferior to double-clamping CABG in the long-term follow-up, provided that involved surgeons are familiar with both techniques. These conclusions are supported by a large and long-term follow-up period, eliminating potential bias, i.e., by means of the propensity score matching and analyzing single-surgeon experience.
    MeSH term(s) Coronary Artery Bypass ; Follow-Up Studies ; Hospital Mortality ; Humans ; Retrospective Studies ; Stroke Volume ; Treatment Outcome ; Ventricular Function, Left
    Language English
    Publishing date 2021-12-27
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2175195-X
    ISSN 1660-4601 ; 1661-7827
    ISSN (online) 1660-4601
    ISSN 1661-7827
    DOI 10.3390/ijerph19010275
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Bentall Operation: Early Surgical Results, Seven-Year Outcomes, and Risk Factors Analysis.

    Nardi, Paolo / Pisano, Calogera / Bassano, Carlo / Bertoldo, Fabio / Salvati, Alessandro Cristian / Buioni, Dario / Trombetti, Daniele / Asta, Laura / Scognamiglio, Mattia / Altieri, Claudia / Ruvolo, Giovanni

    International journal of environmental research and public health

    2022  Volume 20, Issue 1

    Abstract: Aim: To analyze early and mid-term outcomes of the Bentall operation. Methods: Two hundred and seventeen patients (mean age 65.6 ± 15.9 years, males/females 172/45) underwent Bentall operation in a 7-year period (January 2015−December 2021), on average, ... ...

    Abstract Aim: To analyze early and mid-term outcomes of the Bentall operation. Methods: Two hundred and seventeen patients (mean age 65.6 ± 15.9 years, males/females 172/45) underwent Bentall operation in a 7-year period (January 2015−December 2021), on average, 30 Bentall operations occurred per year, using biological (n = 104) or mechanical (n = 113) valved conduits for the treatment of ascending aorta−aortic root aneurysms. Associate procedures were performed in 58 patients (26.7%); coronary artery bypass grafting (CABG) in 35 (16%). Mean follow-up was 55.2 ± 24 (median 60.2) months. Cox model analysis was used to assess risk factors, Kaplan−Meier and log-rank tests were used to assess different survival rates. Results: Operative mortality was 1.38%. At 7 years, survival, freedom from cardiac death, and event-free survival were 93% ± 2%, 99% ± 1%, and 81% ± 5%. NYHA class (p < 0.0001), trans-aortic valve mean (p < 0.0001) and maximum (p < 0.000) gradients, left ventricular hypertrophy (p < 0.05), and pulmonary arterial pressure (p = 0.002) significantly improved vs. preoperative values. Concomitant CABG during Bentall operation independently affected late outcomes (HR 1.9−2.3; p-values < 0.05). Late survival was affected by concomitant CABG (84% ± 8% vs. 95% ± 2%, p = 0.04), preoperative myocardial infarction (91% ± 9% vs. 97% ± 2%, p = 0.02), and biological vs. mechanical prostheses valved conduits (91% ± 9% vs. 95% ± 3%, p = 0.02). Event-free survival also was affected by concomitant CABG (62% ± 14% vs. 85% ± 5%, p = 0.005) and biological prostheses (78% ± 8% vs. 84% ± 6%, p = 0.06). Freedom from endocarditis−redo operation was 83% ± 9% for biological prostheses vs. 89% ± 6% for mechanical prostheses (p = 0.49). Conclusions: Low rates of operative mortality and late complications make Bentall operation the gold standard for the treatment of ascending aorta−aortic root aneurysms. Coronary ischemic disease affects late outcomes. Biological prostheses should be preferred for the elderly.
    MeSH term(s) Humans ; Male ; Female ; Aged ; Middle Aged ; Aged, 80 and over ; Treatment Outcome ; Aorta ; Aortic Valve/surgery ; Aortic Aneurysm/complications ; Aortic Aneurysm/surgery ; Time Factors ; Risk Factors ; Retrospective Studies
    Language English
    Publishing date 2022-12-23
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2175195-X
    ISSN 1660-4601 ; 1661-7827
    ISSN (online) 1660-4601
    ISSN 1661-7827
    DOI 10.3390/ijerph20010212
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Role of Cachexia and Fragility in the Patient Candidate for Cardiac Surgery.

    Pisano, Calogera / Polisano, Daniele / Balistreri, Carmela Rita / Altieri, Claudia / Nardi, Paolo / Bertoldo, Fabio / Trombetti, Daniele / Asta, Laura / Ferrante, Maria Sabrina / Buioni, Dario / Foti, Calogero / Ruvolo, Giovanni

    Nutrients

    2021  Volume 13, Issue 2

    Abstract: Frailty is the major expression of accelerated aging and describes a decreased resistance to stressors, and consequently an increased vulnerability to additional diseases in elderly people. The vascular aging related to frail phenotype reflects the high ... ...

    Abstract Frailty is the major expression of accelerated aging and describes a decreased resistance to stressors, and consequently an increased vulnerability to additional diseases in elderly people. The vascular aging related to frail phenotype reflects the high susceptibility for cardiovascular diseases and negative postoperative outcomes after cardiac surgery. Sarcopenia can be considered a biological substrate of physical frailty. Malnutrition and physical inactivity play a key role in the pathogenesis of sarcopenia. We searched on Medline (PubMed) and Scopus for relevant literature published over the last 10 years and analyzed the strong correlation between frailty, sarcopenia and cardiovascular diseases in elderly patient. In our opinion, a right food intake and moderate intensity resistance exercise are mandatory in order to better prepare patients undergoing cardiac operation.
    MeSH term(s) Aging/physiology ; Biomarkers/metabolism ; Blood Vessels/metabolism ; Blood Vessels/physiology ; Cachexia/complications ; Cardiac Surgical Procedures ; Cardiovascular Diseases/etiology ; Cardiovascular Diseases/metabolism ; Eating ; Frailty/complications ; Frailty/metabolism ; Humans ; Malnutrition/complications ; Phenotype ; Preoperative Care ; Preoperative Exercise/physiology ; Resistance Training/methods ; Sarcopenia/complications ; Sarcopenia/diagnosis ; Sarcopenia/prevention & control ; Sedentary Behavior
    Chemical Substances Biomarkers
    Language English
    Publishing date 2021-02-05
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2518386-2
    ISSN 2072-6643 ; 2072-6643
    ISSN (online) 2072-6643
    ISSN 2072-6643
    DOI 10.3390/nu13020517
    Database MEDical Literature Analysis and Retrieval System OnLINE

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