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  1. Article: Early-Staged Carotid Artery Stenting Prior to Coronary Artery Bypass Grafting: Analysis of the Early and Mid-Term Results in Comparison with a Consecutive Cohort of Isolated Coronary Artery Surgery Patients.

    Nardi, Paolo / Altieri, Claudia / Pisano, Calogera / Oddi, Fabio Massimo / Ranucci, Alessandro / Fresilli, Mauro / Salvati, Alessandro Cristian / Buioni, Dario / Scognamiglio, Mattia / Ajello, Valentina / Bassano, Carlo / Ascoli Marchetti, Andrea / Ippoliti, Arnaldo / Ruvolo, Giovanni

    Journal of clinical medicine

    2024  Volume 13, Issue 2

    Abstract: Aim: The aim of the present study was to analyze retrospectively the results of patients who underwent early-staged, i.e., within 24-48 h, carotid artery stenting (e-s CAS) before coronary artery bypass grafting (CABG).: Methods: Between December ... ...

    Abstract Aim: The aim of the present study was to analyze retrospectively the results of patients who underwent early-staged, i.e., within 24-48 h, carotid artery stenting (e-s CAS) before coronary artery bypass grafting (CABG).
    Methods: Between December 2014 and December 2022, 1046 consecutive patients underwent CABG; 31 of these patients (3%) were subjected to e-s CAS prior to CABG (e-s CAS + CABG group). Preoperative and intraoperative variables and early and mid-term results of the e-s CAS + CABG group were compared with those of patients who underwent isolated CABG (CABG group).
    Results: As compared with the CABG group, the e-s CAS + CABG group showed a worse clinical risk profile due to higher Euroscore-2 values and incidence of obstructive pulmonary disease and bilateral carotid artery and peripheral artery diseases (
    Conclusions: CABG preceded by e-s CAS appears to be associated with satisfactory early outcomes while limiting the risk of myocardial infarction to a very short time interval between the two procedures. Freedom from late all-causes death, cardiac death, and MACCEs were comparable and equally satisfactory, underscoring the positive protective effects of CAS and CABG on the carotid and coronary territories over time.
    Language English
    Publishing date 2024-01-15
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2662592-1
    ISSN 2077-0383
    ISSN 2077-0383
    DOI 10.3390/jcm13020480
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: The role of the female gender on mid-term outcome after coronary artery bypass grafting: a retrospective study.

    Nardi, Paolo / Pisano, Calogera / Bassano, Carlo / Bertoldo, Fabio / Buioni, Dario / Labriola, Vincenzo / Salvati, Alessandro Cristian / Scognamiglio, Mattia / Altieri, Claudia / Ruvolo, Giovanni

    Journal of thoracic disease

    2024  Volume 16, Issue 2, Page(s) 862–874

    Abstract: Background: Data on female gender differences on clinical prognosis after coronary artery bypass grafting (CABG) are still controversial. We evaluated retrospectively the impact of women patients in comparison with men undergoing CABG on mid-term ... ...

    Abstract Background: Data on female gender differences on clinical prognosis after coronary artery bypass grafting (CABG) are still controversial. We evaluated retrospectively the impact of women patients in comparison with men undergoing CABG on mid-term outcome.
    Methods: Between December 2014 and March 2022, 1,044 consecutive patients (162 females, 15.5%, 882 males, 84.5%) underwent isolated CABG. The mean follow-up was 40±27 (median 38) months. Logistic and Cox model analysis regressions were used to assess the risk of female gender and other variables, Kaplan-Meier estimates to assess survival rates.
    Results: Women did not have a significant higher operative mortality than men (3.09%
    Conclusions: Women undergoing CABG with the same surgical techniques currently adopted for men, do not appear to be associated with worse early prognosis. Freedom from late all-causes mortality, cardiac death and adverse cardiac events are comparable and equally satisfactory, highlighting the positive protective effect of CABG over time also in women.
    Language English
    Publishing date 2024-02-04
    Publishing country China
    Document type Journal Article
    ZDB-ID 2573571-8
    ISSN 2077-6624 ; 2072-1439
    ISSN (online) 2077-6624
    ISSN 2072-1439
    DOI 10.21037/jtd-23-932
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Association of sex with major bleeding risks in sub-Saharian anticoagulated patients with mechanical heart valves: A cohort study from the Khartoum Emergency Salam Centre.

    Erba, Nicoletta / Tosetto, Alberto / Abdallah, Suha Abdelwahab / Langer, Martin / Giovanella, Elena / Lentini, Salvatore / Masini, Franco / Mocini, Alessandro / Portella, Gennarina / Salvati, Alessandro Cristian / Squizzato, Alessandro / Testa, Sophie / Lip, Gregory Y H / Poli, Daniela

    International journal of cardiology

    2023  Volume 394, Page(s) 131398

    Abstract: Background: Rheumatic heart disease (RHD) with mechanical heart valve (MHV) replacement is common in Africa. However, MHV requires lifelong anticoagulation that could have a particular impact in women in reproductive age.: Methods: We report data of ... ...

    Abstract Background: Rheumatic heart disease (RHD) with mechanical heart valve (MHV) replacement is common in Africa. However, MHV requires lifelong anticoagulation that could have a particular impact in women in reproductive age.
    Methods: We report data of a prospective observational cohort study conducted between August 2018 and September 2019 in MHV patients in the Salam Centre for Cardiac Surgery built in Khartoum by Emergency, an Italian Non-Governmental Organization, to evaluate bleeding risk, its associated determinants, and the impact of lifelong anticoagulation in fertile women.
    Results: We studied 3647 patients (median age 25.1 years; 53.9% female). During follow-up [median time 1.1 (0.1-1.2) years], we recorded 85 major bleedings (rate 2.16 × 100 pt-years), Major bleedings occurred more frequently among women (64/85 cases, 75.3%; rate 3.0 × 100 pt-years), compared to men (21/85 cases, 24.7%; rate 1.16 × 100 pt-years) (RR 2.6; 95% CI 1.6-4.5; p = 0.0001). Multivariate analysis was performed to identify variables associated with major bleeding, and female sex was the only risk factor significantly associated, whereas aspirin treatment and higher INR target showed a non-significant trend for higher bleeding risk. Thirty-two/85 (37.6%) of major bleedings were metrorrhagias. When we calculate the incidence of major bleedings after the exclusion of gynecological events, no sex differences in the bleeding risk were found (HR 1.3, 95% CI 0.8-2.3; p = 0.3).
    Conclusions: Bleeding risk of young MHV patients on oral anticoagulant therapy is higher among women, mainly due to metrorrhagia. Women in the reproductive life are at high risk for gynecological bleeding when treated with anticoagulants.
    MeSH term(s) Male ; Humans ; Female ; Adult ; Warfarin/adverse effects ; Cohort Studies ; Prospective Studies ; Thromboembolism/epidemiology ; Anticoagulants/adverse effects ; Hemorrhage/chemically induced ; Hemorrhage/diagnosis ; Hemorrhage/epidemiology ; Heart Valve Prosthesis/adverse effects ; Risk Factors ; Heart Valves
    Chemical Substances Warfarin (5Q7ZVV76EI) ; Anticoagulants
    Language English
    Publishing date 2023-09-27
    Publishing country Netherlands
    Document type Observational Study ; Journal Article
    ZDB-ID 779519-1
    ISSN 1874-1754 ; 0167-5273
    ISSN (online) 1874-1754
    ISSN 0167-5273
    DOI 10.1016/j.ijcard.2023.131398
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 1673: 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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  4. 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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  5. Article ; Online: Simple open-heart surgery protocol for sickle-cell disease patients: a retrospective cohort study comparing patients undergoing mitral valve surgery.

    Epis, Francesco / Chatenoud, Liliane / Somaschini, Alberto / Bitetti, Ilaria / Cantarero, Fulvio / Salvati, Alessandro Cristian / Rocchi, Daniela / Lentini, Salvatore / Giovanella, Elena / Portella, Gina / Langer, Martin

    Interactive cardiovascular and thoracic surgery

    2022  Volume 35, Issue 3

    Abstract: Objectives: Sickle-cell disease (SCD) patients are considered to be at high risk from open-heart surgery. This study assessed the role of a simple sickling-prevention protocol.: Methods: Perioperative non-specific and SCD-specific morbidity and 30- ... ...

    Abstract Objectives: Sickle-cell disease (SCD) patients are considered to be at high risk from open-heart surgery. This study assessed the role of a simple sickling-prevention protocol.
    Methods: Perioperative non-specific and SCD-specific morbidity and 30-day mortality are investigated in a retrospective cohort study on patients undergoing isolated mitral valve surgery. Patients with and without SCD were compared. In the SCD cohort, a bundle of interventions was applied to limit the risk of sickling: 'on-demand' transfusions to keep haemoglobin levels of around 7-8 g/dl, cardiopulmonary bypass (CPB) with higher blood flow and perfusion temperature, close monitoring of acid-base balance and oxygenation.
    Results: Twenty patients with and 40 patients without SCD were included. At baseline, only preoperative haemoglobin levels differed between cohorts (8.1 vs 11.8 g/dl, P < 0.001). Solely SCD patients received preoperative transfusions (45.0%). Intraoperative transfusions were significantly larger in SCD patients during CPB (priming: 300 vs 200 ml; entire length: 600 vs 300 ml and 20 vs 10 ml/kg). SCD patients had higher perfusion temperatures during CPB (34.7 vs 33.0°C, P = 0.01) with consequently higher pharyngeal temperature, both during cooling (34.1 vs 32.3°C, P = 0.02) and rewarming (36.5 vs 36.2°C, P = 0.02). No mortality occurred, and non-SCD-specific complications were comparable between groups, but one SCD patient suffered from perioperative cerebrovascular accident with seizures, and another had evident haemolysis.
    Conclusions: SCD patients may undergo open-heart surgery for mitral valve procedures with an acceptable risk profile. Simple but thoughtful perioperative management, embracing 'on-demand' transfusions and less-aggressive CPB cooling is feasible and probably efficacious.
    MeSH term(s) Anemia, Sickle Cell/surgery ; Cardiac Surgical Procedures/adverse effects ; Cardiopulmonary Bypass/adverse effects ; Clinical Protocols ; Hemoglobins ; Humans ; Mitral Valve/surgery ; Retrospective Studies
    Chemical Substances Hemoglobins
    Language English
    Publishing date 2022-08-26
    Publishing country England
    Document type Journal Article
    ZDB-ID 2095298-3
    ISSN 1569-9285 ; 1569-9293
    ISSN (online) 1569-9285
    ISSN 1569-9293
    DOI 10.1093/icvts/ivac205
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    In stock of ZB MED Cologne/Königswinter

    Zs.A 5730: 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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  6. Article ; Online: Oral anticoagulant management of patients with mechanical heart valves at the Salam Centre of Khartoum: Observations on quality of anticoagulation and thrombotic risk.

    Erba, Nicoletta / Tosetto, Alberto / Langer, Martin / Abdallah, Suha Abdelwahab / Giovanella, Elena / Lentini, Salvatore / Masini, Franco / Mocini, Alessandro / Portella, Gennarina / Salvati, Alessandro Cristian / Squizzato, Alessandro / Testa, Sophie / Lip, Gregory Y H / Poli, Daniela

    Thrombosis research

    2022  Volume 219, Page(s) 155–161

    Abstract: Introduction: Rheumatic heart disease with mechanical heart valve (MHV) replacement is common in Africa. However, MHV requires long-life anticoagulation and managing this can be challenging.: Methods and results: We report data of a prospective ... ...

    Abstract Introduction: Rheumatic heart disease with mechanical heart valve (MHV) replacement is common in Africa. However, MHV requires long-life anticoagulation and managing this can be challenging.
    Methods and results: We report data of a prospective observational study conducted between August 2018 and September 2019 in MHV patients in the Salam Centre for Cardiac Surgery built in Khartoum, by Emergency, an Italian Non-Governmental Organization, to evaluate the quality of anticoagulation control and the risk of thrombotic complications.
    Results: We studied 3647 patients (median age 25.1 years; 53.9 % female). Median Time in Therapeutic Range (TTR) was 53 % (interquartile range 37 % to 67 %) and 70 thrombotic events (rate 1.8 × 100 pt-years [95 % CI 1.38-2.23]) were recorded. Among patients in the first quartile of TTR (≤37 %), we recorded 34/70 (48.6 %) of all thrombotic events (rate 3.7 × 100 pt-years [95 % CI 2.5-5.1]), with a high mortality rate (2.2 × 100 pt-years [95 % CI 1.3-3.3]). In patients with guideline-recommended TTR (≥65 %) the event rate was 0.8 × 100 pt-years for thrombotic events [95 % CI 0.3-1.5] and 0.4 × 100 pt-years for mortality [95 % CI 0.1-0.9]. Multivariable analysis showed that having a TTR in the lowest quartile (≤37 %) and being noncompliant are significantly associated with increased thrombotic risk. Aspirin use or different valve type did not influence the thrombotic risk. Almost 40 % of all thromboembolic complications could have been potentially prevented by further improving VKA management to obtain a TTR > 37 %.
    Conclusion: The thrombotic risk of MHV patients on VKAs living in a low-income country like Sudan is associated with low quality of anticoagulation control. Efforts should be made to decrease the number of non-compliant patients and to reach a guideline-recommended TTR of ≥65 %.
    MeSH term(s) Adult ; Anticoagulants/adverse effects ; Aspirin/pharmacology ; Blood Coagulation ; Female ; Heart Valves ; Hemorrhage/chemically induced ; Humans ; Male ; Thrombosis/chemically induced ; Thrombosis/etiology
    Chemical Substances Anticoagulants ; Aspirin (R16CO5Y76E)
    Language English
    Publishing date 2022-09-21
    Publishing country United States
    Document type Journal Article ; Observational Study
    ZDB-ID 121852-9
    ISSN 1879-2472 ; 0049-3848
    ISSN (online) 1879-2472
    ISSN 0049-3848
    DOI 10.1016/j.thromres.2022.09.018
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 863: 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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