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  1. Article ; Online: Outcomes of Minimally Invasive Aortic Valve Replacement in Obese Patients: A Propensity-Matched Study.

    Cammertoni, Federico / Bruno, Piergiorgio / Pavone, Natalia / Nesta, Marialisa / Chiariello, Giovanni Alfonso / Grandinetti, Maria / D'Avino, Serena / Sanesi, Valerio / D'Errico, Denise / Massetti, Massimo

    Brazilian journal of cardiovascular surgery

    2024  Volume 39, Issue 2, Page(s) e20230159

    Abstract: Introduction: Obese patients are at risk of complications after cardiac surgery. The aim of this study is to investigate safety and efficacy of a minimally invasive approach via upper sternotomy in this setting.: Methods: We retrospectively reviewed ... ...

    Abstract Introduction: Obese patients are at risk of complications after cardiac surgery. The aim of this study is to investigate safety and efficacy of a minimally invasive approach via upper sternotomy in this setting.
    Methods: We retrospectively reviewed 203 obese patients who underwent isolated, elective aortic valve replacement between January 2014 and January 2023 - 106 with minimally invasive aortic valve replacement (MIAVR) and 97 with conventional aortic valve replacement (CAVR). To account for baseline differences, a propensity-matching analysis was performed obtaining two balanced groups of 91 patients each.
    Results: The 30-day mortality rate was comparable between groups (1.1% MIAVR vs. 0% CAVR, P=0.99). MIAVR patients had faster extubation than CAVR patients (6 ± 2 vs. 9 ± 2 hours, P<0.01). Continuous positive airway pressure therapy was less common in the MIAVR than in the CAVR group (3.3% vs. 13.2%, P=0.03). Other postoperative complications did not differ significantly. Intensive care unit stay (1.8 ± 1.2 vs. 3.2 ± 1.4 days, P<0.01), but not hospital stay (6.7 ± 2.1 vs. 7.2 ± 1.9 days, P=0.09), was shorter for MIAVR than for CAVR patients. Follow-up survival was comparable (logrank P-value = 0.58).
    Conclusion: MIAVR via upper sternotomy has been shown to be a safe and effective option for obese patients. Respiratory outcome was promising with shorter mechanical ventilation time and reduced need for post-extubation support. The length of stay in the intensive care unit was reduced. These advantages might be important for the obese patient to whom minimally invasive surgery should not be denied.
    MeSH term(s) Humans ; Aortic Valve/surgery ; Retrospective Studies ; Heart Valve Prosthesis Implantation/adverse effects ; Treatment Outcome ; Sternotomy/adverse effects ; Obesity/complications ; Obesity/surgery ; Length of Stay
    Language English
    Publishing date 2024-03-01
    Publishing country Brazil
    Document type Journal Article
    ZDB-ID 2031026-2
    ISSN 1678-9741 ; 1678-9741
    ISSN (online) 1678-9741
    ISSN 1678-9741
    DOI 10.21470/1678-9741-2023-0159
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  2. Article ; Online: Comparison of De-Kay repair versus De Vega suture for functional tricuspid regurgitation: a preliminary experience.

    Bruno, Piergiorgio / Grandinetti, Maria / Farina, Piero / D'Avino, Serena / Graziani, Francesca / Calabrese, Maria / Lillo, Rosa / Pasquini, Annalisa / Chiariello, Giovanni Alfonso / Cammertoni, Federico / Nesta, Marialisa / Pavone, Natalia / Massetti, Massimo

    The Journal of cardiovascular surgery

    2023  Volume 64, Issue 4, Page(s) 437–442

    Abstract: Background: In patients undergoing mitral valve surgery, restrictive suture annuloplasty (De Vega) for less-than-severe functional tricuspid regurgitation has been proven to be safe and effective. The aim of this study is to determine whether the ... ...

    Abstract Background: In patients undergoing mitral valve surgery, restrictive suture annuloplasty (De Vega) for less-than-severe functional tricuspid regurgitation has been proven to be safe and effective. The aim of this study is to determine whether the adjunct of the plication of the posterior tricuspid leaflet with the same running suture (bicuspidized De Vega or "De Kay") is equally safe and effective.
    Methods: Single center, retrospective study on patients submitted to suture repair of the tricuspid valve during mitral valve surgery, with either conventional or De Kay, between January 2014 and December 2020. Comparison was based on degree of residual tricuspid valve regurgitation and right ventricular assessment at discharge.
    Results: Over the course of the study period, 255 patients undergoing mitral valve surgery had a dilated (>40 mm or >20 mm/m
    Conclusions: De Kay repair guarantees the same tricuspidal regurgitation reduction as compared with conventional De Vega early after surgery.
    MeSH term(s) Humans ; Tricuspid Valve Insufficiency/diagnostic imaging ; Tricuspid Valve Insufficiency/surgery ; Retrospective Studies ; Tricuspid Valve/diagnostic imaging ; Tricuspid Valve/surgery ; Cardiac Surgical Procedures/adverse effects ; Sutures ; Treatment Outcome
    Language English
    Publishing date 2023-07-04
    Publishing country Italy
    Document type Journal Article
    ZDB-ID 80143-4
    ISSN 1827-191X ; 0021-9509
    ISSN (online) 1827-191X
    ISSN 0021-9509
    DOI 10.23736/S0021-9509.23.12565-1
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    In stock of ZB MED Cologne/Königswinter

    Zs.A 469: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

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  3. Article ; Online: Two innovative aortic bioprostheses evaluated in the real-world setting. First results from a two-center study.

    Chiariello, Giovanni A / Villa, Emmanuel / Bruno, Piergiorgio / Pasquini, Annalisa / Nesta, Marialisa / Ferraro, Francesco / D'Avino, Serena / Sanesi, Valerio / Vecchio, Claudia / Messina, Antonio / Dalla Tomba, Margherita / Calabrese, Maria / Raweh, Abdallah / Montini, Luca / Troise, Giovanni / Massetti, Massimo

    The Journal of cardiovascular surgery

    2023  Volume 64, Issue 3, Page(s) 338–347

    Abstract: Background: The increasing use of biological substitutes for surgical aortic valve replacement (AVR), has led to the development of new bioprostheses with improved hemodynamics and expected durability.: Methods: In this observational retrospective ... ...

    Abstract Background: The increasing use of biological substitutes for surgical aortic valve replacement (AVR), has led to the development of new bioprostheses with improved hemodynamics and expected durability.
    Methods: In this observational retrospective two-center cohort study, two innovative bioprostheses, INSPIRIS Resilia and AVALUS were analyzed. We analyzed early and 2.4-year follow-up results in terms of safety, clinical outcome and hemodynamic performance.
    Results: From November 2017 to February 2021, 148 patients underwent AVR with INSPIRIS Resilia (N.=74) or AVALUS (N.=74) bioprosthesis. The 30-day and mid-term mortality was comparable (1% vs. 3%, P=0.1 and 7% vs. 4%, P=0.4, respectively). Valve-related mortality was observed in one AVALUS patient. Three (4%) patients of the AVALUS group developed prosthetic endocarditis and two of them died after reoperation. No other cases of prosthetic endocarditis were observed. No cases of structural valve degeneration or significant paravalvular leak were detected at follow-up. Median follow-up peak pressure gradient was 21 vs. 23 mmHg (P=0.4) and the mean pressure gradient was 12 vs. 13 mmHg (P=0.9) for Inspiris and AVALUS, respectively. The effective orifice area (EOA) and indexed EOA were 1.5 cm
    Conclusions: INSPIRIS Resilia and AVALUS bioprostheses were reliable with comparable results in safety, clinical outcome and hemodynamic performance. After statistical adjustment, AVALUS was associated with better left ventricular mass reduction. Long-term follow-up would provide definitive comparative results.
    MeSH term(s) Humans ; Heart Valve Prosthesis Implantation/adverse effects ; Heart Valve Prosthesis Implantation/methods ; Bioprosthesis ; Aortic Valve Stenosis/diagnostic imaging ; Aortic Valve Stenosis/surgery ; Retrospective Studies ; Cohort Studies ; Aortic Valve/diagnostic imaging ; Aortic Valve/surgery ; Heart Valve Prosthesis ; Hemodynamics ; Endocarditis ; Prosthesis Design ; Treatment Outcome
    Language English
    Publishing date 2023-04-20
    Publishing country Italy
    Document type Observational Study ; Journal Article
    ZDB-ID 80143-4
    ISSN 1827-191X ; 0021-9509
    ISSN (online) 1827-191X
    ISSN 0021-9509
    DOI 10.23736/S0021-9509.23.12534-1
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    Zs.A 469: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
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    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

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  4. Article ; Online: Bleeding Complications in Patients With Perioperative COVID-19 Infection Undergoing Cardiac Surgery: A Single-Center Matched Case-Control Study.

    Chiariello, Giovanni A / Bruno, Piergiorgio / Pavone, Natalia / Calabrese, Maria / D'Avino, Serena / Ferraro, Francesco / Nesta, Marialisa / Farina, Piero / Cammertoni, Federico / Pasquini, Annalisa / Montone, Rocco A / Montini, Luca / Massetti, Massimo

    Journal of cardiothoracic and vascular anesthesia

    2021  Volume 36, Issue 7, Page(s) 1919–1926

    Abstract: Objective: Previous studies reported a poor outcome in patients with coronavirus 2019 (COVID-19) undergoing cardiac surgery. Complications most frequently described were respiratory failure, renal failure, and thromboembolic events. In their recent ... ...

    Abstract Objective: Previous studies reported a poor outcome in patients with coronavirus 2019 (COVID-19) undergoing cardiac surgery. Complications most frequently described were respiratory failure, renal failure, and thromboembolic events. In their recent experience, the authors observed a very high incidence of bleeding complications. The purpose of the study was to investigate a possible significant correlation between perioperative COVID-19 infection and hemorrhagic complications compared to non-COVID-19 patients.
    Design: Single-center, observational, retrospective, matched case-control (1:2) study involving patients who underwent open-heart cardiac surgery from February 2020 and March 2021 with positive perioperative diagnosis of COVID-19 infection, matched with patients without COVID-19 infection.
    Setting: Cardiac surgery unit and intensive care unit of a university tertiary center in a metropolitan area.
    Participants: In the study period, 773 patients underwent cardiac surgery on cardiopulmonary bypass (CPB). Among them, 23 consecutive patients had perioperative diagnosis of COVID-19 infection (study group). These patients were compared with 46 corresponding controls (control group) that matched for age, sex, body mass index, and Society of Thoracic Surgeons score.
    Interventions: Open-heart cardiac surgery on CPB.
    Measurements and main results: In the study group, 2 patients (9%) died in the intensive care unit from severe respiratory failure, shock, and multiple organ failure. In the study group, patients showed a significantly higher incidence of bleeding complications (48% v 2%, p = 0.0001) and cases of surgical reexploration for bleeding (35% v 2%, p = 0.0001), a higher incidence of severe postoperative thrombocytopenia (39% v 6%, p = 0.0007), and a higher need of blood components transfusions (74% v 30%, p = 0.0006). Chest tubes blood loss and surgical hemostasis time were markedly prolonged (p = 0.02 and p = 0.003, respectively).
    Conclusions: A worrisome increased risk of early and late bleeding complications in COVID-19 patients was observed, and it should be considered when assessing the operative risk. CPB-related inflammatory reaction could exacerbate the deleterious effect of COVID-19 on the coagulation system and likely deviate it toward a hemorrhagic pattern.
    MeSH term(s) COVID-19/complications ; Cardiac Surgical Procedures/adverse effects ; Cardiopulmonary Bypass/adverse effects ; Case-Control Studies ; Humans ; Postoperative Complications/diagnosis ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Respiratory Insufficiency/etiology ; Retrospective Studies
    Language English
    Publishing date 2021-11-13
    Publishing country United States
    Document type Journal Article ; Observational Study
    ZDB-ID 1067317-9
    ISSN 1532-8422 ; 1053-0770
    ISSN (online) 1532-8422
    ISSN 1053-0770
    DOI 10.1053/j.jvca.2021.11.013
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    Zs.A 2203: Show issues Location:
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    Zs.MO 31: Show issues

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  5. Article ; Online: Urgent desensitization in patients bridged to heart transplantation under extracorporeal membrane oxygenation support: A preliminary experience.

    Guihaire, Julien / D'Avino, Serena / Stephan, Francois / Kloeckner, Martin / To, Ngoc Tram / Potier, Agathe / Gaillard, Maïra / Ramadan, Ramzi / Taupin, Jean-Luc / Le Pavec, Jerome / Deleuze, Philippe

    Clinical transplantation

    2020  Volume 35, Issue 1, Page(s) e14146

    Abstract: Antihuman leukocyte antigen (HLA) antibodies restrict the access to cardiac allografts. Desensitization therapy is a major challenge in patients with cardiogenic shock waiting for urgent heart transplantation (HT). We retrospectively reviewed six ... ...

    Abstract Antihuman leukocyte antigen (HLA) antibodies restrict the access to cardiac allografts. Desensitization therapy is a major challenge in patients with cardiogenic shock waiting for urgent heart transplantation (HT). We retrospectively reviewed six patients (mean age of 37.5 years [16-70]) who underwent plasmapheresis (PP) under extracorporeal membrane oxygenation (ECMO) before transplant between January 2017 and September 2018. The average duration of follow-up was 25 months [20-32]. Mean fluorescence intensity (MFI) of HLA-specific antibodies was reported as follows: score 4 for MFI < 1000, score 6 for 1000 < MFI < 3000 and score 8 for MFI > 3000. The mean duration of ECMO support was 29 days [1-74] and 6.8 [1-29] PP sessions were performed per patient before transplant. The mean number of HLA-specific antibodies before HT was 9.6 for score 6 [4-13] and 5.8 for score 8 [1-12]. Four patients had major complications after transplantation (2 hemorrhagic shocks, 5 infectious events). Mean MFI reduction rate was 94% [79-100] for Class I and 44.2% for Class II [0-83]. Hospital survival was 100%, and early antibody-mediated rejection was diagnosed in one patient at 7 days after HT. Plasmapheresis under ECMO support was associated with favorable early outcomes in highly sensitized candidates for urgent heart transplantation.
    MeSH term(s) Adult ; Extracorporeal Membrane Oxygenation ; HLA Antigens ; Heart Transplantation ; Humans ; Retrospective Studies ; Shock, Cardiogenic/therapy
    Chemical Substances HLA Antigens
    Language English
    Publishing date 2020-11-23
    Publishing country Denmark
    Document type Journal Article
    ZDB-ID 639001-8
    ISSN 1399-0012 ; 0902-0063
    ISSN (online) 1399-0012
    ISSN 0902-0063
    DOI 10.1111/ctr.14146
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    Zs.A 2204: Show issues Location:
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  6. Article: Human Cytochrome P450 3A4 as a Biocatalyst: Effects of the Engineered Linker in Modulation of Coupling Efficiency in 3A4-BMR Chimeras.

    Degregorio, Danilo / D'Avino, Serena / Castrignanò, Silvia / Di Nardo, Giovanna / Sadeghi, Sheila J / Catucci, Gianluca / Gilardi, Gianfranco

    Frontiers in pharmacology

    2017  Volume 8, Page(s) 121

    Abstract: Human liver cytochrome P450 3A4 is the main enzyme involved in drug metabolism. This makes it an attractive target for biocatalytic applications, such as the synthesis of pharmaceuticals and drug metabolites. However, its poor solubility, stability and ... ...

    Abstract Human liver cytochrome P450 3A4 is the main enzyme involved in drug metabolism. This makes it an attractive target for biocatalytic applications, such as the synthesis of pharmaceuticals and drug metabolites. However, its poor solubility, stability and low coupling have limited its application in the biotechnological context. We previously demonstrated that the solubility of P450 3A4 can be increased by creating fusion proteins between the reductase from
    Language English
    Publishing date 2017-03-21
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2587355-6
    ISSN 1663-9812
    ISSN 1663-9812
    DOI 10.3389/fphar.2017.00121
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  7. Article: Modulation of the interaction between human P450 3A4 and B. megaterium reductase via engineered loops.

    Castrignanò, Silvia / D'Avino, Serena / Di Nardo, Giovanna / Catucci, Gianluca / Sadeghi, Sheila J / Gilardi, Gianfranco

    Biochimica et biophysica acta. Proteins and proteomics

    2017  Volume 1866, Issue 1, Page(s) 116–125

    Abstract: Chimerogenesis involving cytochromes P450 is a successful approach to generate catalytically self-sufficient enzymes. However, the connection between the different functional modules should allow a certain degree of flexibility in order to obtain ... ...

    Abstract Chimerogenesis involving cytochromes P450 is a successful approach to generate catalytically self-sufficient enzymes. However, the connection between the different functional modules should allow a certain degree of flexibility in order to obtain functional and catalytically efficient proteins. We previously applied the molecular Lego approach to develop a chimeric P450 3A4 enzyme linked to the reductase domain of P450 BM3 (BMR). Three constructs were designed with the connecting loop containing no glycine, 3 glycine or 5 glycine residues and showed a different catalytic activity and coupling efficiency. Here we investigate how the linker affects the ability of P450 3A4 to bind substrates and inhibitors. We measure the electron transfer rates and the catalytic properties of the enzyme also in the presence of ketoconazole as inhibitor. The data show that the construct 3A4-5GLY-BMR with the longest loop better retains the binding ability and cooperativity for testosterone, compared to P450 3A4. In both 3A4-3GLY-BMR and 3A4-5GLY-BMR, the substrate induces an increase in the first electron transfer rate and a shorter lag phase related to a domain rearrangements, when compared to the construct without Gly. These data are consistent with docking results and secondary structure predictions showing a propensity to form helical structures in the loop of the 3A4-BMR and 3A4-3GLY-BMR. All three chimeras retain the ability to bind the inhibitor ketoconazole and show an IC
    MeSH term(s) Bacillus megaterium/enzymology ; Bacillus megaterium/genetics ; Bacterial Proteins/antagonists & inhibitors ; Bacterial Proteins/chemistry ; Bacterial Proteins/genetics ; Bacterial Proteins/metabolism ; Binding Sites ; Cytochrome P-450 CYP3A/chemistry ; Cytochrome P-450 CYP3A/genetics ; Cytochrome P-450 CYP3A/metabolism ; Cytochrome P-450 CYP3A Inhibitors/chemistry ; Cytochrome P-450 CYP3A Inhibitors/metabolism ; Gene Expression ; Humans ; Ketoconazole/chemistry ; Ketoconazole/metabolism ; Kinetics ; Ligands ; Molecular Docking Simulation ; NADPH-Ferrihemoprotein Reductase/antagonists & inhibitors ; NADPH-Ferrihemoprotein Reductase/chemistry ; NADPH-Ferrihemoprotein Reductase/genetics ; NADPH-Ferrihemoprotein Reductase/metabolism ; Protein Binding ; Protein Conformation, alpha-Helical ; Protein Conformation, beta-Strand ; Protein Engineering ; Protein Interaction Domains and Motifs ; Recombinant Fusion Proteins/chemistry ; Recombinant Fusion Proteins/genetics ; Recombinant Fusion Proteins/metabolism ; Structure-Activity Relationship ; Substrate Specificity ; Testosterone/chemistry ; Testosterone/metabolism
    Chemical Substances Bacterial Proteins ; Cytochrome P-450 CYP3A Inhibitors ; Ligands ; Recombinant Fusion Proteins ; Testosterone (3XMK78S47O) ; Cytochrome P-450 CYP3A (EC 1.14.14.1) ; CYP3A4 protein, human (EC 1.14.14.55) ; NADPH-Ferrihemoprotein Reductase (EC 1.6.2.4) ; Ketoconazole (R9400W927I)
    Language English
    Publishing date 2017-07-19
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 60-7
    ISSN 1879-2596 ; 1879-260X ; 1872-8006 ; 1879-2642 ; 1879-2618 ; 1879-2650 ; 1570-9639 ; 0006-3002 ; 0005-2728 ; 0005-2736 ; 0304-4165 ; 0167-4838 ; 1388-1981 ; 0167-4889 ; 0167-4781 ; 0304-419X ; 0925-4439 ; 1874-9399
    ISSN (online) 1879-2596 ; 1879-260X ; 1872-8006 ; 1879-2642 ; 1879-2618 ; 1879-2650
    ISSN 1570-9639 ; 0006-3002 ; 0005-2728 ; 0005-2736 ; 0304-4165 ; 0167-4838 ; 1388-1981 ; 0167-4889 ; 0167-4781 ; 0304-419X ; 0925-4439 ; 1874-9399
    DOI 10.1016/j.bbapap.2017.07.009
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