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Article: Implantable ventricular assistance systems (VAD) as a bridge to transplant or as 'destination therapy'.

Nesta, Marialisa / Cammertoni, Federico / Bruno, Piergiorgio / Massetti, Massimo

European heart journal supplements : journal of the European Society of Cardiology

2021 Volume 23, Issue Suppl E, Page(s) E99–E102

Abstract: Heart failure is a complex clinical syndrome associated with a high mortality and morbidity rate. Despite the extensive pharmacological armamentarium, a non-negligible percentage of patients develop advanced heart failure and require further therapies. ... ...

Abstract	Heart failure is a complex clinical syndrome associated with a high mortality and morbidity rate. Despite the extensive pharmacological armamentarium, a non-negligible percentage of patients develop advanced heart failure and require further therapies. In these circumstances, heart transplantation remains the treatment of choice, but the limited number of donors and the reduction of potential candidates have made necessary to develop new technologies. Since the 1980s, left ventricular assist devices (LVADs) have been introduced and have completely revolutionized the landscape of advanced heart failure treatments. This article has identified the categories of patients who can benefit from the implantation of an LVAD and summarized the new classifications. In addition, the main LVADs are described, analysing the results of the main clinical studies, with particular reference to adverse events. Although there is no perfect LVAD, a multidisciplinary team approach, dedicated to the treatment of advanced heart failure, can guide the choices on the best device to implant, in order to minimize complications and improve the patient's quality of life.
Language	English
Publishing date	2021-10-08
Publishing country	England
Document type	Journal Article
ZDB-ID	1463769-8
ISSN	1554-2815 ; 1520-765X
ISSN (online)	1554-2815
ISSN	1520-765X
DOI	10.1093/eurheartj/suab101
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Article ; Online: Extensive corpus callosum ischemia after coronary artery bypass grafting on extracorporeal circulation.

Colò, Francesca / Cammertoni, Federico / Nesta, Marialisa / Caliandro, Pietro / Bruno, Piergiorgio / Massetti, Massimo / Broccolini, Aldobrando

Perfusion

2022 Volume 38, Issue 4, Page(s) 872–875

Abstract: Introduction: Heart surgery can be associated with adverse ischemic brain events.: Case report: Here, we describe two patients who presented extensive infarction of the corpus callosum and of other brain watershed areas following coronary artery ... ...

Abstract	Introduction: Heart surgery can be associated with adverse ischemic brain events. Case report: Here, we describe two patients who presented extensive infarction of the corpus callosum and of other brain watershed areas following coronary artery bypass grafting (CABG) on extracorporeal circulation (ECC). Discussion: Infarction of the corpus callosum is an extremely rare condition due to its abundant blood supply. Our findings are noteworthy since they diverge from classical brain watershed infarcts and from other cases of corpus callosum involvement. This suggests that in some cases, CABG surgery on ECC may be associated to a profound impairment of intracerebral circulation. However, it is also possible that the corpus callosum is particularly vulnerable to yet unknown metabolic modifications connected to ECC. Conclusions: Further studies are needed in order to investigate the complex response of brain circulation and metabolism during heart surgery with ECC.
MeSH term(s)	Humans ; Corpus Callosum ; Coronary Artery Bypass/adverse effects ; Extracorporeal Circulation/adverse effects ; Ischemia/etiology ; Infarction/etiology
Language	English
Publishing date	2022-03-09
Publishing country	England
Document type	Case Reports ; Journal Article
ZDB-ID	645038-6
ISSN	1477-111X ; 0267-6591
ISSN (online)	1477-111X
ISSN	0267-6591
DOI	10.1177/02676591221082920
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Zs.A 2424: Show issues

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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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Article: Pledget-assisted hemostasis to fix residual access-site bleedings after double pre-closure technique.

Burzotta, Francesco / Aurigemma, Cristina / Kovacevic, Mila / Romagnoli, Enrico / Cangemi, Stefano / Bianchini, Francecso / Nesta, Marialisa / Bruno, Piergiorgio / Trani, Carlo

World journal of cardiology

2022 Volume 14, Issue 5, Page(s) 297–306

Abstract: Background: The use of pre-closure suture-based devices represents a widely access-site hemostasis technique in percutaneous transfemoral transcatheter-aortic-valve-replacement (TF-TAVR); yet this technique is associated with the risk of a device ... ...

Abstract	Background: The use of pre-closure suture-based devices represents a widely access-site hemostasis technique in percutaneous transfemoral transcatheter-aortic-valve-replacement (TF-TAVR); yet this technique is associated with the risk of a device failure that may result in clinically relevant residual bleeding. Thus, a bailout intervention is needed. So far, the best management of pre-closure device failure has not been recognized. Aim: To report the first clinical results obtained using a novel bailout hemostasis technique for patients with double suture-based vascular closure device failure in the setting of TF-TAVR. Methods: We developed a "pledget-assisted hemostasis" technique to manage residual access-site bleeding. This consists of the insertion of a surgical, non-absorbable, polytetrafluoroethylene pledget over the sutures of the two ProGlide (Abbott Vascular, CA, United States). The ProGlide's knot-pushers are used to push down the pledget and the hand-made slipknot to seal the femoral artery leak. This technique was used as a bailout strategy in patients undergoing TF-TAVR with a systematic double pre-closure technique. Post-procedural access-site angiography was systematically performed. In-hospital complications were systematically detected and classified according to Valve Academic Research Consortium-2 criteria. Results: Out of 136 consecutive patients who underwent TF-TAVR, 15 patients (mean age 80.0 ± 7.2 years, 66.7% female) with access-site bleeding after double pre-closure technique failure were treated by pledget-assisted hemostasis. In the majority of patients, 16F sheath was used ( Conclusion: The "pledget assisted hemostasis" might be considered as a possible bailout technique to treat patients with residual access site bleeding. Further studies are needed to compare this approach with other bail-out techniques.
Language	English
Publishing date	2022-06-09
Publishing country	United States
Document type	Journal Article
ZDB-ID	2573665-6
ISSN	1949-8462
ISSN	1949-8462
DOI	10.4330/wjc.v14.i5.297
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Article ; Online: Unrecognized Hole in the Aortic Stenosis Heart: Acquired Gerbode Defect Detected During Pretransfemoral Aortic Valve Implantation Evaluation.

Nesta, Marialisa / Bruno, Piergiorgio / d'Acierno, Edoardo Maria / Cutrone, Gessica / Rovere, Giuseppe / Burzotta, Francesco / Trani, Carlo / Romagnoli, Enrico / Aurigemma, Cristina / Infusino, Fabio / Locorotondo, Gabriella / Chiariello, Giovanni A / Cammertoni, Federico / Grandinetti, Maria / Pavone, Natalia / Massetti, Massimo

Circulation. Cardiovascular imaging

2024 , Page(s) e016151

Language	English
Publishing date	2024-04-11
Publishing country	United States
Document type	Journal Article
ZDB-ID	2435045-X
ISSN	1942-0080 ; 1941-9651
ISSN (online)	1942-0080
ISSN	1941-9651
DOI	10.1161/CIRCIMAGING.123.016151
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Zs.A 6743: Show issues

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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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Zs.A 469: Show issues

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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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Article: Transcatether Aortic Valve Implantation to Treat Degenerated Surgical Bioprosthesis: Focus on the Specific Procedural Challenges.

Aurigemma, Cristina / Burzotta, Francesco / Vergallo, Rocco / Farina, Piero / Romagnoli, Enrico / Cangemi, Stefano / Bianchini, Francesco / Nesta, Marialisa / Bruno, Piergiorgio / D'Amario, Domenico / Leone, Antonio Maria / Trani, Carlo

Frontiers in cardiovascular medicine

2022 Volume 9, Page(s) 895477

Abstract: Actually transcatheter aortic valve implantation within failed surgically bioprosthetic valves (VIV-TAVI) is an established procedure in patients at high risk for repeat surgical aortic valve intervention. Although less invasive than surgical ... ...

Abstract	Actually transcatheter aortic valve implantation within failed surgically bioprosthetic valves (VIV-TAVI) is an established procedure in patients at high risk for repeat surgical aortic valve intervention. Although less invasive than surgical reintervention, VIV-TAVI procedure offers potential challenges, such as higher rates of prosthesis-patient mismatch and coronary obstruction. Thus, optimal procedural planning plays an important role to minimize the risk of procedure complications. In this review, we describe the key points of a VIV-TAVI procedure to optimize outcomes and reduce the risk of procedure complications.
Language	English
Publishing date	2022-05-31
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2781496-8
ISSN	2297-055X
ISSN	2297-055X
DOI	10.3389/fcvm.2022.895477
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Article ; Online: Acute haemodynamic impact of transcatheter aortic valve implantation in patients with severe aortic stenosis.

Graziani, Francesca / Cialdella, Pio / Lillo, Rosa / Locorotondo, Gabriella / Genuardi, Lorenzo / Ingrasciotta, Gessica / Cangemi, Stefano / Nesta, Marialisa / Bruno, Piergiorgio / Aurigemma, Cristina / Romagnoli, Enrico / Calabrese, Michele / Giambusso, Nicole / Lombardo, Antonella / Burzotta, Francesco / Trani, Carlo

ESC heart failure

2022 Volume 9, Issue 3, Page(s) 1721–1730

Abstract: Aims: There are limited data about the intraprocedural haemodynamic study performed immediately before and after transcatheter aortic valve implantation (TAVI) in patients with severe aortic stenosis (AS). We aimed to evaluate the acute haemodynamic ... ...

Abstract	Aims: There are limited data about the intraprocedural haemodynamic study performed immediately before and after transcatheter aortic valve implantation (TAVI) in patients with severe aortic stenosis (AS). We aimed to evaluate the acute haemodynamic impact of TAVI in patients with severe AS and to investigate invasive and non-invasive parameters predicting all-cause mortality. Methods and results: A total of 245 consecutive AS patients (43% male, mean age 80.3 ± 7.3 years) undergoing TAVI were enrolled. Intraprocedural left heart catheterization (LHC) and echocardiogram before and after TAVI were performed. The clinical endpoint was the death for any cause. LHC after TAVI revealed significant changes in aortic and left ventricular (LV) pressures, including indexes of intrinsic myocardial contractility and diastolic function such as positive dP/dT (1128.9 ± 398.7 vs. 806.3 ± 247.2 mmHg/s, P ˂ 0.001) and negative dP/dT (1310.7 ± 431.1 vs. 1075.1 ± 440.8 mmHg/s, P ˂ 0.001). Post-TAVI echo showed a significant reduction in LV end-diastolic (P = 0.036) and end-systolic (P ˂ 0.001) diameters, improvement in LV ejection fraction (from 55 ± 12% to 57.2 ± 10.5%, P ˂ 0.001), and pulmonary artery systolic pressure (42.1 ± 14.2 vs. 33.1 ± 10.7 mmHg, P < 0.001). After a mean follow-up time interval of 24 months, 47 patients died. Post-TAVI significant aortic regurgitation at echocardiography was the only independent predictor of mortality (hazard ratio 5.592, confidence interval 1.932-16.184, P = 0.002). Conclusions: Left heart catheterization performed immediately before and after prosthesis release offers a unique insight in the assessment of LV adaptation to severe AS and the impact of TAVI on LV, catching changes in indexes of intrinsic contractility and myocardial relaxation. Aortic regurgitation assessed by echocardiography was the only independent predictor of mortality in patients undergoing TAVI.
MeSH term(s)	Aged ; Aged, 80 and over ; Aortic Valve Insufficiency ; Aortic Valve Stenosis/complications ; Aortic Valve Stenosis/diagnosis ; Aortic Valve Stenosis/surgery ; Female ; Hemodynamics ; Humans ; Male ; Transcatheter Aortic Valve Replacement ; Treatment Outcome
Language	English
Publishing date	2022-03-29
Publishing country	England
Document type	Journal Article
ZDB-ID	2814355-3
ISSN	2055-5822 ; 2055-5822
ISSN (online)	2055-5822
ISSN	2055-5822
DOI	10.1002/ehf2.13846
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Article ; Online: Repair of Posterior Infarct Ventricular Septal Defect in a Patient with Dextrocardia and Situs Inversus.

Nesta, Marialisa / Mazza, Andrea / Perri, Gianluigi / Bruno, Piergiorgio / Massetti, Massimo

Journal of cardiac surgery

2016 Volume 31, Issue 3, Page(s) 147–149

Abstract: We report a patient with situs inversus who developed a large posterior interventricular septum pseudoaneurysm with a septal defect following a myocardial infarction. The ventricular septum was approached through the left ventricle and the entrance of ... ...

Abstract	We report a patient with situs inversus who developed a large posterior interventricular septum pseudoaneurysm with a septal defect following a myocardial infarction. The ventricular septum was approached through the left ventricle and the entrance of the pseudoaneurysm was repaired with a strip of equine pericardium.
MeSH term(s)	Abnormalities, Multiple ; Aneurysm, False/etiology ; Aneurysm, False/surgery ; Animals ; Cardiac Surgical Procedures/methods ; Dextrocardia ; Heart Aneurysm/etiology ; Heart Aneurysm/surgery ; Heart Septal Defects, Ventricular/etiology ; Heart Septal Defects, Ventricular/surgery ; Heart Septum/surgery ; Heart Ventricles/surgery ; Horses ; Humans ; Male ; Middle Aged ; Myocardial Infarction/complications ; Pericardium/transplantation ; Situs Inversus
Language	English
Publishing date	2016-03
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/jocs.12691
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