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Article ; Online: Case report: asymptomatic pseudoaneurysm of the native coronary soon after the graft anastomosis treated with off-pump repair.

Ruggerini, Sara / Pavasini, Rita / Quagliara, Teresa A P / Fiorani, Vinicio

European heart journal. Case reports

2022 Volume 6, Issue 2, Page(s) ytac014

Abstract: Background: Pseudoaneurysms (PSAs) of native coronary arteries are rare but potentially lethal complications occurring after coronary artery graft anastomosis mainly secondary to median sternotomy.: Case summary: A 61-year-old man underwent coronary ... ...

Abstract	Background: Pseudoaneurysms (PSAs) of native coronary arteries are rare but potentially lethal complications occurring after coronary artery graft anastomosis mainly secondary to median sternotomy. Case summary: A 61-year-old man underwent coronary artery bypass grafting because of stable angina. After the surgery, the patient was asymptomatic. A routine pre-discharge transthoracic echocardiogram was performed showing a haematoma of the apex partially involving the right ventricle with systolic colour Doppler flow going from the left ventricle to the pericardium. A coronary computed tomography scan was ordered and it revealed the presence of a PSA of the left anterior descending (LAD) artery distal to the graft anastomosis with the left internal mammary artery. An off-pump direct suture of the LAD injury through a redo sternotomy was successfully performed. Discussion: The development of a PSA of a native coronary artery after bypass grafting is a very rare and potentially fatal condition. A correct and prompt diagnosis is crucial to avoid lethal complication.
Language	English
Publishing date	2022-02-08
Publishing country	England
Document type	Case Reports
ISSN	2514-2119
ISSN (online)	2514-2119
DOI	10.1093/ehjcr/ytac014
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Article ; Online: Intrapericardial Ectopic Thyroid Arising From the Ascending Aorta.

Carrese, Elena / Rapicetta, Cristian / Borrelli, Roberto / Caprili, Luca / Matricardi, Alberto / Fiorani, Vinicio / Paci, Massimiliano

The Annals of thoracic surgery

2021 Volume 112, Issue 1, Page(s) e79

MeSH term(s)	Aged ; Aorta ; Female ; Humans ; Pericardium ; Thyroid Dysgenesis/diagnosis ; Tomography, X-Ray Computed
Language	English
Publishing date	2021-04-01
Publishing country	Netherlands
Document type	Case Reports ; Journal Article
ZDB-ID	211007-6
ISSN	1552-6259 ; 0003-4975
ISSN (online)	1552-6259
ISSN	0003-4975
DOI	10.1016/j.athoracsur.2021.03.064
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Article: Successful surgical employment of Impella recovery system for right ventricular failure after previous aortic valve replacement.

Krakulli, Klodian / Prifti, Edvin / Fiorani, Vinicio / Zogno, Mario

Journal of surgical case reports

2017 Volume 2017, Issue 5, Page(s) rjx091

Abstract: A 58-year-old woman underwent aortic valve replacement. On the second postoperative day the patient referred a sharply chest pain, and an emergent coronary angiography revealed total occlusion of the right coronary artery. An intra-aortic ballon pump was ...

Abstract	A 58-year-old woman underwent aortic valve replacement. On the second postoperative day the patient referred a sharply chest pain, and an emergent coronary angiography revealed total occlusion of the right coronary artery. An intra-aortic ballon pump was placed and the patient underwent emergent off-pump coronary revascularization of the right coronary artery. Five hours later, due to unstable hemodynamic the extracorporeal membrane oxygenation was implanted without improvement of the right ventricular (RV) function. Then we decided to implant the Impella Right Direct (RD). After 9 days of Impella's insertion the RV was recovered and the device was successfully explanted. After 16 days of Impella explanted the patient was discharged. This case suggest that implantation of Impella RD is clinically feasible, associated with hemodynamic improvement, and facilitate successful bridge-to-recovery in patients with post-cardiotomy RV failure due to myocardial infarction unresponsive to coronary artery bypass grafting, maximal medical therapy, contrapulsation and extracorporeal membrane oxygenation.
Language	English
Publishing date	2017-05-23
Publishing country	England
Document type	Case Reports
ISSN	2042-8812
ISSN	2042-8812
DOI	10.1093/jscr/rjx091
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Article: Cardiac Surgery in Nonagenarians Following the TAVI/TMVI Era: A Multicenter 23-Year Comparative Analysis.

Nasso, Giuseppe / Santarpino, Giuseppe / Di Bari, Nicola / Fattouch, Khalil / Condello, Ignazio / Moscarelli, Marco / Del Giglio, Mauro / Paparella, Domenico / Lamarra, Mauro / Savini, Carlo / Coppola, Roberto / Fiorani, Vinicio / Speziale, Giuseppe

Journal of clinical medicine

2023 Volume 12, Issue 6

Abstract: Background: Studies reporting on the outcome of 90-year-old patients undergoing cardiac surgery are scant in literature; and currently, those regarding the implementation of trans-catheter techniques number even fewer.: Methods: We compared patients ... ...

Abstract	Background: Studies reporting on the outcome of 90-year-old patients undergoing cardiac surgery are scant in literature; and currently, those regarding the implementation of trans-catheter techniques number even fewer. Methods: We compared patients aged >89 years operated on between 1998 and 2008 at 8 Italian cardiac surgery centers, with patients of the same age operated on between 2009 and 2021. All of the patients were operated on with "open" surgery, with the exclusion of percutaneous valve repair/implantation procedures. Results: The patients of the two groups (group 98-08-127 patients, and group 09-21-101 patients) had comparable preoperative risk factors in terms of the LogEuroSCORE (98-08: 21.3 ± 6.1 vs. 09-21: 20.9 ± 11.1, Conclusions: Accurate pre-, intra-, and post-operative evaluation/management to reduce biological impacts facilitate significant improvements in the outcomes in nonagenarian patients when compared to the results recorded in previous years.
Language	English
Publishing date	2023-03-10
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm12062177
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Article ; Online: Sutureless versus transcatheter aortic valve replacement: A multicenter analysis of "real-world" data.

Santarpino, Giuseppe / Lorusso, Roberto / Moscarelli, Marco / Mikus, Elisa / Wisniewski, Konrad / Dell'Aquila, Angelo Maria / Margari, Vito / Carrozzo, Alessandro / Barbato, Luciano / Fiorani, Vinicio / Lamarra, Mauro / Fattouch, Khalil / Squeri, Angelo / Giannini, Francesco / Marchese, Alfredo / Farahani, Kia / Gregorini, Renato / Comoglio, Chiara / Martinelli, Luigi /

Calvi, Simone / Avolio, Maria / Paparella, Domenico / Albertini, Alberto / Speziale, Giuseppe

Journal of cardiology

2021 Volume 79, Issue 1, Page(s) 121–126

Abstract: Background: Recent data suggested that transcatheter aortic valve replacement (TAVR) may be indicated also for low-risk patients. However, robust evidence is still lacking, particularly regarding valve performance at follow-up that confers a limitation ... ...

Abstract	Background: Recent data suggested that transcatheter aortic valve replacement (TAVR) may be indicated also for low-risk patients. However, robust evidence is still lacking, particularly regarding valve performance at follow-up that confers a limitation to its use in young patients. Moreover, a literature gap exists in terms of 'real-world' data analysis. The aim of this study is to compare the cost-effectiveness of sutureless aortic valve replacement (SuAVR) versus transfemoral TAVR. Methods: Prospectively collected data were retrieved from a centralized database of nine cardiac surgery centers between 2010 and 2018. Follow-up was completed in June 2019. A propensity score matching (PSM) analysis was performed. Results: Patients in the TAVR group (n=1002) were older and with more comorbidities than SuAVR patients (n=443). The PSM analysis generated 172 pairs. No differences were recorded between groups in 30-day mortality [SuAVR vs TAVR: n=7 (4%) vs n=5 (2.9%); p=0.7] and need for pacemaker implant [n=10 (5.8%) vs n=20 (11.6%); p=0.1], but costs were lower in the SuAVR group (20486.6±4188€ vs 24181.5±3632€; p<0.01). Mean follow-up was 1304±660 days. SuAVR patients had a significantly higher probability of survival than TAVR patients (no. of fatal events: 22 vs 74; p<0.014). Median follow-up was 2231 days and 2394 days in the SuAVR and TAVR group, respectively. Conclusion: The treatment of aortic valve stenosis with surgical sutureless or transcatheter prostheses is safe and effective. By comparing the two approaches, patients who can undergo surgery after heart team evaluation show longer lasting results and a more favorable cost ratio.
MeSH term(s)	Aortic Valve/surgery ; Aortic Valve Stenosis ; Heart Valve Prosthesis Implantation/methods ; Humans ; Risk Factors ; Transcatheter Aortic Valve Replacement/adverse effects ; Treatment Outcome
Language	English
Publishing date	2021-09-10
Publishing country	Netherlands
Document type	Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
ZDB-ID	639364-0
ISSN	1876-4738 ; 0386-2887 ; 0914-5087
ISSN (online)	1876-4738
ISSN	0386-2887 ; 0914-5087
DOI	10.1016/j.jjcc.2021.08.022
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Article ; Online: Papillary fibroelastoma of an anomalous mitral valve chorda.

Pederzolli, Nicola / Tappainer, Ernesto / Manfredi, Jacopo / Fiorani, Vinicio / Nocchi, Andrea / Agostini, Francesco / Zogno, Mario

Journal of cardiovascular medicine (Hagerstown, Md.)

2010 Volume 11, Issue 4, Page(s) 291–293

Abstract: Cardiac papillary fibroelastoma (CPF) is a rare primary cardiac tumour. This tumour constitutes about 10-15% of all primary cardiac tumours. We report here a case of CPF of an anomalous mitral valve chorda. ...

Abstract	Cardiac papillary fibroelastoma (CPF) is a rare primary cardiac tumour. This tumour constitutes about 10-15% of all primary cardiac tumours. We report here a case of CPF of an anomalous mitral valve chorda.
MeSH term(s)	Chordae Tendineae/abnormalities ; Chordae Tendineae/pathology ; Female ; Fibroma/pathology ; Heart Neoplasms/pathology ; Heart Valve Diseases/pathology ; Humans ; Middle Aged
Language	English
Publishing date	2010-02-04
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	2223461-5
ISSN	1558-2035 ; 1558-2027
ISSN (online)	1558-2035
ISSN	1558-2027
DOI	10.2459/jcm.0b013e3283307fa1
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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)
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Article ; Online: Safe wrapping of the borderline dilated ascending aorta during aortic valve replacement

Tappainer Ernesto / Fiorani Vinicio / Nocchi Andrea / Likaj Ermal / Memishaj Sabjan / Zogno Mario

Journal of Cardiothoracic Surgery, Vol 2, Iss 1, p

2007 Volume 15

Abstract: Abstract Background Techniques of reduction aortoplasty are widely published in the literature with conflicting results. External support seems to be an important factor in preventing recurrence but, in some cases, this technique caused erosion of the ... ...

Abstract	Abstract Background Techniques of reduction aortoplasty are widely published in the literature with conflicting results. External support seems to be an important factor in preventing recurrence but, in some cases, this technique caused erosion of the aorta because of the wrinkles the prosthesis creates in the rear side of the aorta. Case presentation A 73 year old patient with aortic valve stenosis and borderline dilated ascending aorta had aortic valve replacement and simple wrapping without aortoplasty. To avoid the formation of wrinkles, the dacron external support was tailored appropriately to obtain a curved, custom-made prosthesis. This custom-made prosthesis had the same diameter as the dilated aorta and, after valve replacement, fitted it properly. After 18 months neither computerized axial tomography nor ecocardiography detected wrinkles or dilatation recurrence. Conclusion A safe, simple and probably new way to prepare an external wrapping is presented, which in this patient respected the shape of the aorta and prevented the formation of wrinkles in the prosthesis and possible complications such as wall erosion.
Keywords	Diseases of the circulatory (Cardiovascular) system ; RC666-701 ; Specialties of internal medicine ; RC581-951 ; Internal medicine ; RC31-1245 ; Medicine ; R ; DOAJ:Cardiovascular ; DOAJ:Medicine (General) ; DOAJ:Health Sciences ; Surgery ; RD1-811 ; DOAJ:Surgery
Language	English
Publishing date	2007-02-01T00:00:00Z
Publisher	BioMed Central
Document type	Article ; Online
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Article ; Online: Left ventricle remodelling by double-patch sandwich technique

Nocchi Andrea / Manfredi Jacopo / Pederzolli Nicola / Fiorani Vinicio / Tappainer Ernesto / Zogno Mario

Journal of Cardiothoracic Surgery, Vol 2, Iss 1, p

2007 Volume 10

Abstract: Abstract Background The sandwich double-patch technique was adopted as an alternative method for reconstruction of the left ventricle after excision of postinfarction dysfunctional myocardium to solve technical problems due to the thick edges of the ... ...

Abstract	Abstract Background The sandwich double-patch technique was adopted as an alternative method for reconstruction of the left ventricle after excision of postinfarction dysfunctional myocardium to solve technical problems due to the thick edges of the ventricular wall. Methods Over a 5-year period, 12 of 21 patients with postinfarction antero-apical left ventricular aneurysm had thick wall edges after wall excision. It was due to akinetic muscular thick tissue in 6 cases, while in the other 6 with classic fibrous aneurysm, thick edges remained after the cut of the border zone. The ventricular opening was sandwiched between two patches and this is a technique which is currently used for the treatment of the interventricular septum rupture. In our patients the patches are much smaller than the removed aneurysm and they were sutured simply by a single row of single stitches. However, in contrast to interventricular septum rupture where the patches loosen the tension of the tissues, in our patients the patches pull strongly and restrain the walls by fastening their edges and supporting tight stitches. In this way they could narrow the cavity and close the ventricle. Results The resected area varied from 5 × 4 to 8 × 8 cm. Excision was extended into the interventricular septum in 5 patients, thus opening the right ventricle. CABG was performed on all patients but two. Left ventricular volumes and the ejection fraction changed significantly: end-systolic volume 93.5 ± 12.4 to 57.8 ± 8.9 ml, p < 0.001; end-diastolic volume 157.2 ± 16.7 to 115.3 ± 14.9 ml, p < 0.001; ejection fraction 40.3 ± 4.2 to 49.5 ± 5.7%, p < 0.001. All patients did well. One patient suffered from bleeding, which was not from the wall suture, and another had a left arm paresis. The post-operative hospital stay was 5 to 30 days with a mean 10.5 ± 7.5 days/patient. At follow-up, 9 to 60 months mean 34, all patients were symptom-free. NYHA class 2.5 ± 0.8 changed to 1.2 ± 0.4, p < 0.001. Conclusion The double-patch sandwich technique (bi-patch closure) offers some advantages and does not result in increased morbidity and mortality. In the case of excising a left ventricular aneurysm, this technique in no way requires eversion of the edges, felt strips, buttressed and multiple sutures, all of which are needed for longitudinal linear closure. Moreover, it does not require purse string sutures, endocardial scar remnant to secure the patch or folding the excluded non-functional tissue, all of which are needed for endoventricular patch repair.
Keywords	Diseases of the circulatory (Cardiovascular) system ; RC666-701 ; Specialties of internal medicine ; RC581-951 ; Internal medicine ; RC31-1245 ; Medicine ; R ; DOAJ:Cardiovascular ; DOAJ:Medicine (General) ; DOAJ:Health Sciences ; Surgery ; RD1-811 ; DOAJ:Surgery
Subject code	616
Language	English
Publishing date	2007-01-01T00:00:00Z
Publisher	BioMed Central
Document type	Article ; Online
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Article: La cardiochirurgia nell'ultraottantenne: cinque anni di esperienza.

Pederzolli, Nicola / Fiorani, Vinicio / Maizza, Anna / Tappainer, Ernesto / Zogno, Mario

Italian heart journal. Supplement : official journal of the Italian Federation of Cardiology

2005 Volume 6, Issue 11, Page(s) 710–715

Abstract: Background: Cardiac surgery in octogenarians is increasing in industrialized countries and therefore represents a growing population. The aim of this study was to evaluate characteristics and outcomes of octogenarian patients undergoing cardiac surgery.! ...

Title translation	Cardiac surgery in octogenarians: a five-year experience.
Abstract	Background: Cardiac surgery in octogenarians is increasing in industrialized countries and therefore represents a growing population. The aim of this study was to evaluate characteristics and outcomes of octogenarian patients undergoing cardiac surgery. Methods: We reviewed all consecutive octogenarians operated on during the last 5 years. Among 1912 patients operated on between April 2000 and December 2004, we identified 223 patients (11.6%) aged > 80 years. Median age was 82.17 +/- 2.11 years, and 52.5% were males. The mean EuroSCORE score was 9.4 +/- 1.8. Among them 43 patients (19.3%) had isolated aortic valve replacement, 127 patients (57%) had isolated coronary artery bypass graft, 40 patients (17.9%) had aortic valve replacement combined with coronary artery bypass graft, 11 patients (4.9%) had mitral valve repair, and 2 patients (0.9%) had ventricular septal rupture repair. Results: The overall hospital mortality was 5.4%; cumulative actuarial survival at 4 years was 77.6%. Conclusions: We conclude that for unselected octogenarians the operative mortality is acceptable and only slightly increased than in younger age groups; the late survival rate is good.
MeSH term(s)	Actuarial Analysis ; Aged, 80 and over ; Aging ; Cardiac Surgical Procedures/mortality ; Coronary Artery Bypass/mortality ; Female ; Heart Valve Diseases/mortality ; Heart Valve Diseases/surgery ; Heart Valve Prosthesis Implantation/mortality ; Humans ; Italy/epidemiology ; Male ; Retrospective Studies ; Risk Assessment ; Survival Analysis ; Ventricular Septal Rupture/mortality ; Ventricular Septal Rupture/surgery
Language	Italian
Publishing date	2005-11
Publishing country	Italy
Document type	English Abstract ; Journal Article
ZDB-ID	2012387-5
ISSN	1972-6465 ; 1129-4728 ; 1129-471X
ISSN (online)	1972-6465
ISSN	1129-4728 ; 1129-471X
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Article ; Online: A rare case of anterior chest closure only with omental flap after devastating mediastinitis: case report.

Fiorani, Vinicio / Memishaj, Sabjan / Nocchi, Andrea / Tappainer, Ernesto / Pederzolli, Nicola / Manfredi, Jacopo / Zogno, Mario

Journal of cardiac surgery

2008 Volume 23, Issue 5, Page(s) 586–589

Abstract: We describe a case of 73-year-old patient who has been operated in emergency on triple coronary artery bypass graft (CABG), which was complicated with respiratory insufficiency and devastating mediastinitis. The anterior mediastinum was closed with an ... ...

Abstract	We describe a case of 73-year-old patient who has been operated in emergency on triple coronary artery bypass graft (CABG), which was complicated with respiratory insufficiency and devastating mediastinitis. The anterior mediastinum was closed with an omental flap that was allowed to epithelize spontaneously. The patient was discharged after 110 days. Despite the large number of cases with mediastinitis described in the literature, the chest closure with only an omental flap without closure of subcutaneous tissue and skin is rare.
MeSH term(s)	Aged ; Angina, Unstable/etiology ; Coronary Artery Bypass/adverse effects ; Humans ; Male ; Mediastinitis/complications ; Mediastinitis/drug therapy ; Mediastinitis/microbiology ; Mediastinitis/surgery ; Methicillin-Resistant Staphylococcus aureus ; Omentum/transplantation ; Respiratory Insufficiency/etiology ; Risk Factors ; Surgical Flaps ; Thoracic Surgical Procedures/methods
Language	English
Publishing date	2008-09
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	639059-6
ISSN	1540-8191 ; 0886-0440
ISSN (online)	1540-8191
ISSN	0886-0440
DOI	10.1111/j.1540-8191.2008.00575.x
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