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Article: Aortic Root Surgery in Adults: An Unsolved Problem.

Brega, Carlotta / Albertini, Alberto

Aorta (Stamford, Conn.)

2023 Volume 11, Issue 1, Page(s) 29–35

Abstract: Nowadays, despite the rapid advancements in interventional cardiology, open surgery still deals with aortic root diseases, to assure the best "ad hoc" treatment. In case of middle-aged adult patients, the optimal operation still represents a matter of ... ...

Abstract	Nowadays, despite the rapid advancements in interventional cardiology, open surgery still deals with aortic root diseases, to assure the best "ad hoc" treatment. In case of middle-aged adult patients, the optimal operation still represents a matter of debate. A review of the last 10-year literature was conducted, focusing on patients below 65 to 70 years of age. Because of the small sample and the heterogeneity of the papers, no metanalysis was possible. Bentall-de Bono procedure, valve sparing, and Ross operations are the surgical options currently available. The main issues in the Bentall - de Bono operation are lifelong anticoagulation therapy and cavitation in case of mechanical prosthesis implantation and structural valve degeneration in case of biological Bentall. As transcatheter procedures are currently performed as valve in valve, biological prosthesis may be preferable, if the diameter may prevent postoperative high gradients. Conservative techniques, such as remodeling and reimplantation, preferred in the young, guarantee physiologic aortic root dynamics and impose surgical analysis of the aortic root structures to get a durable result. The Ross operation, which shows excellent performance, involves autologous pulmonary valve implantation and is performed only in experienced and high-volume centers. Due to its technical difficulty, it requires a steep learning curve and presents some limitations in specific aortic valve diseases. All three have advantages and downsides, and no ideal solution has still been reported.
Language	English
Publishing date	2023-02-27
Publishing country	Germany
Document type	Journal Article
ISSN	2325-4637
ISSN	2325-4637
DOI	10.1055/s-0042-1757949
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Article ; Online: Simplified Tool for Sizing in Minimally Invasive Mitral Annuloplasty: A Homemade Technique.

Brega, Carlotta / Bianchi, Alessandro / Savini, Carlo

Innovations (Philadelphia, Pa.)

2023 Volume 18, Issue 3, Page(s) 274–275

Abstract: Currently, minimally invasive cardiac surgery (MICS) has been developing and has been largely approved for mitral valve surgery. The more development of MICS, the more the entire surgical setup needs to be appropriate. We developed a homemade tool for ... ...

Abstract	Currently, minimally invasive cardiac surgery (MICS) has been developing and has been largely approved for mitral valve surgery. The more development of MICS, the more the entire surgical setup needs to be appropriate. We developed a homemade tool for mitral annular sizing that is simple and fits the mini surgical access. It is a plastic-based foldable paper that can be easily inserted through the minithoracotomy, using a surgical forceps.
MeSH term(s)	Humans ; Mitral Valve Insufficiency/diagnostic imaging ; Mitral Valve Insufficiency/surgery ; Mitral Valve Annuloplasty/methods ; Mitral Valve/diagnostic imaging ; Mitral Valve/surgery ; Thoracotomy/methods ; Minimally Invasive Surgical Procedures/methods ; Treatment Outcome ; Heart Valve Prosthesis Implantation/methods
Language	English
Publishing date	2023-06-13
Publishing country	United States
Document type	Journal Article
ISSN	1559-0879
ISSN (online)	1559-0879
DOI	10.1177/15569845231178548
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Article: Aortic Root Surgery in Adults: An Unsolved Problem

Brega, Carlotta / Albertini, Alberto

AORTA

2023 Volume 11, Issue 01, Page(s) 29–35

Abstract: Nowadays, despite the rapid advancements in interventional cardiology, open surgery still deals with aortic root diseases, to assure the best “ad hoc” treatment. In case of middle-aged adult patients, the optimal operation still represents a matter of ... ...

Abstract	Nowadays, despite the rapid advancements in interventional cardiology, open surgery still deals with aortic root diseases, to assure the best “ad hoc” treatment. In case of middle-aged adult patients, the optimal operation still represents a matter of debate. A review of the last 10-year literature was conducted, focusing on patients below 65 to 70 years of age. Because of the small sample and the heterogeneity of the papers, no metanalysis was possible. Bentall–de Bono procedure, valve sparing, and Ross operations are the surgical options currently available. The main issues in the Bentall – de Bono operation are lifelong anticoagulation therapy and cavitation in case of mechanical prosthesis implantation and structural valve degeneration in case of biological Bentall. As transcatheter procedures are currently performed as valve in valve, biological prosthesis may be preferable, if the diameter may prevent postoperative high gradients. Conservative techniques, such as remodeling and reimplantation, preferred in the young, guarantee physiologic aortic root dynamics and impose surgical analysis of the aortic root structures to get a durable result. The Ross operation, which shows excellent performance, involves autologous pulmonary valve implantation and is performed only in experienced and high-volume centers. Due to its technical difficulty, it requires a steep learning curve and presents some limitations in specific aortic valve diseases. All three have advantages and downsides, and no ideal solution has still been reported.
Keywords	aortic root ; aortic root surgery ; Bentall's procedure ; valve-sparing operations ; Ross' operation
Language	English
Publishing date	2023-02-01
Publisher	Thieme Medical Publishers, Inc.
Publishing place	Stuttgart ; New York
Document type	Article
ISSN	2325-4637
ISSN (online)	2325-4637
DOI	10.1055/s-0042-1757949
Database	Thieme publisher's database

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Article ; Online: Use of a negative pressure wound therapy system over closed incisions option in preventing post-sternotomy wound complications.

Brega, Carlotta / Calvi, Simone / Albertini, Alberto

Wound repair and regeneration : official publication of the Wound Healing Society [and] the European Tissue Repair Society

2021 Volume 29, Issue 5, Page(s) 848–852

Abstract: Post-sternotomy surgical site infections may be serious complications responsible for increased morbidity, mortality and length of hospital stay. A variety of wound-healing strategies can be used over closed surgical incisions, including negative ... ...

Abstract	Post-sternotomy surgical site infections may be serious complications responsible for increased morbidity, mortality and length of hospital stay. A variety of wound-healing strategies can be used over closed surgical incisions, including negative pressure wound therapy (NPWT). The aim of the study is to assess sternal wound complications after heart surgery using NPWT in patients at risk for surgical site complication. Considered risk factors affecting wound healing were type 2 diabetes, Body Mass Index (BMI) >30, chronic obstructive pulmonary disease (COPD), chronic renal failure (CRF) and myocardial revascularization by double mammary artery harvesting. With these premises, 90 patients were selected: 30 patients received traditional gauze dressings, 30 advanced dressings (hydrocolloid and carboxymethyl cellulose) and 30 patients NPWT. Thirty-four patients (37.7%) had two risk factors, 41 patients (45.5%) were affected by three risk factors and 15 patients (16.6%) by four risk factors. The NPWT group had lower rates of diabetes and CRF and only one patient presented four risk factors. With regard to surgical times and types of surgical procedure, no significant differences were observed within the three groups. The patients who received NPWT over closed incision experimented a significantly lower rate of deep sternal complication over traditional gauze and hydrocolloid and carboxymethyl cellulose dressings.
MeSH term(s)	Diabetes Mellitus, Type 2 ; Humans ; Negative-Pressure Wound Therapy ; Sternotomy/adverse effects ; Surgical Wound Infection/epidemiology ; Surgical Wound Infection/prevention & control ; Wound Healing
Language	English
Publishing date	2021-03-29
Publishing country	United States
Document type	Journal Article
ZDB-ID	1174873-4
ISSN	1524-475X ; 1067-1927
ISSN (online)	1524-475X
ISSN	1067-1927
DOI	10.1111/wrr.12914
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Zs.A 3890: Show issues

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Article ; Online: Periareolar approach in female patients undergoing mitral and tricuspid valve surgery: An almost invisible surgical access.

Brega, Carlotta / Raviola, Eliana / Zucchetta, Fabio / Tripodi, Alberto / Albertini, Alberto

Journal of cardiac surgery

2022 Volume 37, Issue 9, Page(s) 2581–2585

Abstract: Background and aim of the study: Periareolar minithoracotomy represents an interesting option in minimally invasive cardiac surgery and it is our preferred approach for women. Our aim is to assess the results in female patients, in terms of nipple ... ...

Abstract	Background and aim of the study: Periareolar minithoracotomy represents an interesting option in minimally invasive cardiac surgery and it is our preferred approach for women. Our aim is to assess the results in female patients, in terms of nipple postoperative pain, local sensitivity, and eventual alterations in mammography after surgery. Methods: Fifty-seven female patients underwent periareolar incision, as minithoracotomy approach, from December 2018 to December 2021. Their mean age was 56 ± 12 years, their body mass index was 22.5 ± 4.8; their surgery was elective in 93%, with mean Euroscore II about 2 ± 1.3. Results: Of 57 patients, 87.7% (50 patients) underwent mitral valve repair, whose six with associated procedures; 8.8% (five patients) underwent mitral valve replacement whose two with tricuspid annuloplasty associated and 3.5% (two patients) had isolated tricuspid surgery. The cardiopulmonary bypass and aortic cross-clamp time were 123.2 ± 30.2 and 101.3 ± min respectively. There were no conversions to either full sternotomy or larger thoracotomy approach. There were no in-hospital and follow-up deaths. No strokes or wound infections were observed. Mean follow-up was 16± 9 months. Within the investigated follow-up, 100% of the patients were satisfied with the esthetic result, no remarkable postoperative pain was reported, two patients had slight hyposensitivity in the nipple area. About 50% IThad mammography as prevention screening after surgery and no abnormalities were found. Conclusions: Periareolar minithoracotomy is a feasible surgical option in female patients, with excellent healing and cosmetic results and preserving the tissues of the mammary gland.
MeSH term(s)	Adult ; Aged ; Cardiac Surgical Procedures/methods ; Female ; Heart Valve Prosthesis Implantation/methods ; Humans ; Middle Aged ; Minimally Invasive Surgical Procedures/methods ; Mitral Valve/diagnostic imaging ; Mitral Valve/surgery ; Pain, Postoperative ; Retrospective Studies ; Thoracotomy/methods ; Treatment Outcome ; Tricuspid Valve/diagnostic imaging ; Tricuspid Valve/surgery
Language	English
Publishing date	2022-06-21
Publishing country	United States
Document type	Journal Article
ZDB-ID	639059-6
ISSN	1540-8191 ; 0886-0440
ISSN (online)	1540-8191
ISSN	0886-0440
DOI	10.1111/jocs.16693
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Zs.A 2221: Show issues

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Article ; Online: Coronary spasm: unpredictability and safety in treatment key role of hybrid setting.

Brega, Carlotta / Raviola, Eliana / Lansac, Emmanuel / Albertini, Alberto

Interactive cardiovascular and thoracic surgery

2021 Volume 33, Issue 4, Page(s) 637–639

Abstract: The present case highlights the crucial role of hybrid setting for diagnosis and treatment of refractory coronary spasms. ...

Abstract	The present case highlights the crucial role of hybrid setting for diagnosis and treatment of refractory coronary spasms.
MeSH term(s)	Coronary Angiography ; Coronary Vasospasm/diagnostic imaging ; Coronary Vasospasm/therapy ; Humans ; Spasm
Language	English
Publishing date	2021-04-26
Publishing country	England
Document type	Case Reports ; Journal Article
ZDB-ID	2095298-3
ISSN	1569-9285 ; 1569-9293
ISSN (online)	1569-9285
ISSN	1569-9293
DOI	10.1093/icvts/ivab128
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Zs.A 5730: Show issues

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Article ; Online: Surgical management of iatrogenic coronary artery perforations: when percutaneous treatment fails.

Brega, Carlotta / Pisani, Angelo / Braham, Wael / Nataf, Patrick

Indian journal of thoracic and cardiovascular surgery

2020 Volume 36, Issue 3, Page(s) 231–233

Abstract: Coronary perforation is a rare complication of percutaneous coronary interventions and a challenging scenario which imposes prompt recognition and treatment. Although it may be successfully managed percutaneously, a surgical treatment may be preferable ... ...

Abstract	Coronary perforation is a rare complication of percutaneous coronary interventions and a challenging scenario which imposes prompt recognition and treatment. Although it may be successfully managed percutaneously, a surgical treatment may be preferable in some cases. We report the case of a patient with a coronary perforation with initial percutaneous treatment complicated with extravascular implantation of a covered stent and liver laceration, who was succesfully treated by cardiac surgery. This case suggests the importance of the proximity of an onsite cardiac surgery center when complex coronary artery percutaneous interventions are performed in hospitals with offsite surgical support.
Language	English
Publishing date	2020-01-03
Publishing country	India
Document type	Case Reports
ZDB-ID	2164386-6
ISSN	0973-7723 ; 0970-9134
ISSN (online)	0973-7723
ISSN	0970-9134
DOI	10.1007/s12055-019-00900-4
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Article ; Online: ACURATE neo Bioprosthesis in Stenotic Bicuspid Aortic Valve Developing Aortic Ulceration and Endocarditis.

Zucchetta, Fabio / Raviola, Eliana / Brega, Carlotta / Mangieri, Antonio / Albertini, Alberto

JACC. Cardiovascular interventions

2020 Volume 14, Issue 2, Page(s) e11–e13

Language	English
Publishing date	2020-12-23
Publishing country	United States
Document type	Journal Article
ZDB-ID	2452157-7
ISSN	1876-7605 ; 1936-8798
ISSN (online)	1876-7605
ISSN	1936-8798
DOI	10.1016/j.jcin.2020.11.013
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Zs.A 6669: Show issues

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Article ; Online: Surgical aortic valve replacement for low-gradient aortic stenosis.

Brega, Carlotta / Calvi, Simone / Pin, Maurizio / Anderlucci, Laura / Falcone, Roberta / Albertini, Alberto

Journal of cardiovascular medicine (Hagerstown, Md.)

2021 Volume 23, Issue 5, Page(s) 338–343

Abstract: Aims: Low-gradient aortic stenosis is a challenging entity that needs accurate preoperative evaluation. For this high-risk patient population, ad hoc predictive scores are not available and profile risk is currently revealed by the EuroSCOREs. Aims of ... ...

Abstract	Aims: Low-gradient aortic stenosis is a challenging entity that needs accurate preoperative evaluation. For this high-risk patient population, ad hoc predictive scores are not available and profile risk is currently revealed by the EuroSCOREs. Aims of this study are to verify the suitability of the ES II as predictor of mortality in low-gradient aortic stenosis and to analyse the role of surgery as a treatment. Methods: From June 2013 to August 2019, 414 patients underwent surgical aortic valve replacement for low-gradient aortic stenosis. Mean age was 75.78 ± 6.77 years and 190 were women. The prognostic value of Logistic EuroSCORE and EuroSCORE II were compared by receiver-operating characteristics (ROC) curve analysis. Results: In-hospital, 30-day and 1-year mortality rates were respectively 3.4, 2.9 and 4.8% (14, 12 and 20 patients over 414). In-hospital mortality risk calculated by the Additive EuroSCORE was 7.2 ± 2.7%, by the Logistic EuroSCORE was 9 ± 5.2% and by the ES II was 4.13 ± 2.56%. The prognostic values of the EuroSCORE II and of the EuroSCORE were analysed in a ROC curve analysis for the prediction of in-hospital mortality [area under the curve (AUC): 0.62 vs. 0.58], 30-day mortality (AUC: 0.63 vs. 0.64) and 1-year mortality (AUC: 0.79 vs. 0.65). Both scores did not show significant differences with the only exception of 1-year mortality, for which EuroSCORE II had a better predictive ability than the Logistic EuroSCORE (P < 0.05). Conclusion: In low-gradient aortic stenosis undergoing surgery, the EuroSCORE II is a strong predictor of 1-year mortality.
MeSH term(s)	Aged ; Aged, 80 and over ; Aortic Valve/diagnostic imaging ; Aortic Valve/surgery ; Aortic Valve Stenosis/diagnostic imaging ; Aortic Valve Stenosis/surgery ; Female ; Heart Valve Prosthesis ; Heart Valve Prosthesis Implantation/adverse effects ; Humans ; Male ; Risk Assessment
Language	English
Publishing date	2021-11-08
Publishing country	United States
Document type	Journal Article
ZDB-ID	2223461-5
ISSN	1558-2035 ; 1558-2027
ISSN (online)	1558-2035
ISSN	1558-2027
DOI	10.2459/JCM.0000000000001292
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Zs.A 5210: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
Zs.MO 559: Show issues

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Article ; Online: Radial artery supply to the left mammary artery in a redo coronary bypass.

Brega, Carlotta / Raviola, Eliana / Zucchetta, Fabio / Panzavolta, Marco / Tripodi, Alberto / Albertini, Alberto

Journal of cardiac surgery

2020 Volume 36, Issue 1, Page(s) 349–352

Abstract: Background: Single-inflow coronary bypass through left internal thoracic artery and Y graft is effective in myocardial revascularization, but left sublavian diseases may affect its safety.: Aim of the study: To assess that, in presence of a composite ...

Abstract	Background: Single-inflow coronary bypass through left internal thoracic artery and Y graft is effective in myocardial revascularization, but left sublavian diseases may affect its safety. Aim of the study: To assess that, in presence of a composite Y graft, issues involving the origin of the left internal thoracic artery are relatively easy to manage, even in reoperations. Methods: A critical stenosis of the subclavian artery involving the origin of a bilateral internal thoracic artery Y graft was bypassed using a free radial artery graft. Results: Bypass was performed between the left thoracic artery and the ascending aorta, off-pump and with excellent results. Conclusions: In consideration of the excellent long term results of total arterial revascularization, radial artery is a feasible graft option, even in case of a composite Y graft in place.
MeSH term(s)	Coronary Angiography ; Coronary Artery Bypass ; Humans ; Mammary Arteries ; Myocardial Revascularization ; Radial Artery ; Treatment Outcome
Language	English
Publishing date	2020-10-30
Publishing country	United States
Document type	Case Reports
ZDB-ID	639059-6
ISSN	1540-8191 ; 0886-0440
ISSN (online)	1540-8191
ISSN	0886-0440
DOI	10.1111/jocs.15183
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