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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 ; Online: Intraoperative indocyanine green imaging as an adjunctive technique to reduce any circumflex artery damage during mitral valve surgery: a feasibility study.

Savini, Carlo / Costantino, Antonino / Fiorentino, Mariafrancesca / Zucchetta, Fabio / Cavallucci, Andrea / Mikus, Elisa

European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery

2024 Volume 65, Issue 2

Abstract: Iatrogenic injuries to the circumflex coronary artery during mitral valve surgery are probably underestimated (reported rates of 0.3-1.8%). This complication arises from the artery's close proximity to the mitral annulus, particularly at the ... ...

Abstract	Iatrogenic injuries to the circumflex coronary artery during mitral valve surgery are probably underestimated (reported rates of 0.3-1.8%). This complication arises from the artery's close proximity to the mitral annulus, particularly at the anterolateral commissure. The study aimed to assess this risk in a patient group prone to such injury. The surgical procedure utilized a minimally invasive approach and indocyanine green-based fluorescence imaging. This technique allows a real-time visualization of the circumflex artery, aiding precise placement of annular sutures and minimizing the risk of injury. The method, applied in 6 patients, integrates preoperative assessments with intraoperative fluorescence imaging, ensuring accurate arterial depiction and preventing iatrogenic damage. The study highlights the safety and efficacy of fluorescence imaging, especially in identifying vessel anomalies, indicating potential applications in various cardiac procedures.
MeSH term(s)	Humans ; Coronary Vessels/diagnostic imaging ; Coronary Vessels/surgery ; Mitral Valve/diagnostic imaging ; Mitral Valve/surgery ; Indocyanine Green ; Feasibility Studies ; Mitral Valve Insufficiency/surgery ; Iatrogenic Disease
Chemical Substances	Indocyanine Green (IX6J1063HV)
Language	English
Publishing date	2024-02-07
Publishing country	Germany
Document type	Journal Article
ZDB-ID	639293-3
ISSN	1873-734X ; 1010-7940 ; 1567-4258
ISSN (online)	1873-734X
ISSN	1010-7940 ; 1567-4258
DOI	10.1093/ejcts/ezae043
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Zs.A 2303: Show issues

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Article ; Online: La terapia antitrombotica dopo chirurgia riparativa della valvola mitrale: revisione delle evidenze e suggerimenti aggiornati.

Rubboli, Andrea / Fiorentino, Maria Francesca / Lisi, Matteo / Arioti, Manfredi / Galvani, Marcello / Savini, Carlo

Giornale italiano di cardiologia (2006)

2024 Volume 25, Issue 3, Page(s) 157–161

Abstract: Surgical mitral valve repair (SMVR) is performed with various techniques that involve the implantation of non-biological material, such as the prolene of the suture threads, the polytetrafluoroethylene of the neo-chordae or the prosthetic ring for the ... ...

Title translation	Antithrombotic therapy after surgical mitral valve repair: review of the evidence and updated proposals.
Abstract	Surgical mitral valve repair (SMVR) is performed with various techniques that involve the implantation of non-biological material, such as the prolene of the suture threads, the polytetrafluoroethylene of the neo-chordae or the prosthetic ring for the remodeling of the valve annulus, whose exposure to the bloodstream is capable of triggering the blood coagulation cascade and consequently the development of thrombotic/thromboembolic events. The indications of the literature on the use of antithrombotic drugs after SMVR are weak and not univocal given the absence of randomized data and the availability of only small observational case series, which are generally contaminated by the lack of homogeneity of the populations examined. Indeed in these studies, patients not only undergoing SMVR, but also transcatheter repair of the mitral valve or surgical implantation of a biological valve prosthesis (not only in the mitral position) are included. In addition, the indication for antithrombotic therapy, and in particular anticoagulation, is often conditioned by the concomitant presence of atrial fibrillation that either preexists or develops postoperatively. In this review, the current evidence regarding antithrombotic therapy in patients undergoing SMVR, both in the presence or absence of atrial fibrillation, is summarized and updated treatment algorithms are proposed.
MeSH term(s)	Humans ; Mitral Valve/surgery ; Fibrinolytic Agents ; Heart Valve Prosthesis Implantation/methods ; Atrial Fibrillation/surgery ; Treatment Outcome ; Mitral Valve Insufficiency/etiology
Chemical Substances	Fibrinolytic Agents
Language	Italian
Publishing date	2024-02-23
Publishing country	Italy
Document type	Review ; English Abstract ; Journal Article
ZDB-ID	2272414-X
ISSN	1972-6481 ; 1827-6806
ISSN (online)	1972-6481
ISSN	1827-6806
DOI	10.1714/4209.42001
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Zs.A 6738: Show issues

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Article ; Online: Images in cardiovascular medicine voluminous left main stem to pulmonary artery fistula: A conservative approach.

Botta, Luca / Amodio, Ciro / Savini, Carlo / Pacini, Davide

Journal of cardiac surgery

2020 Volume 35, Issue 5, Page(s) 1098–1099

Abstract: The presence of a coronary arteriovenous fistula is almost rare in the adult population, even rare when associated with aortic valve insufficiency. Management and treatment options can vary and depend on a single patient. In our case, a large fistula ... ...

Abstract	The presence of a coronary arteriovenous fistula is almost rare in the adult population, even rare when associated with aortic valve insufficiency. Management and treatment options can vary and depend on a single patient. In our case, a large fistula with a rounded origin started from the roof of the left main stem, just attached to the wall of the aortic root, and finished with a very narrowed end in the pulmonary trunk. Due to its anatomical position and to the potential complications related to a proximal surgical closure as well as the incidental discovery in adult age (without signs or symptoms until the operation), we decided to have a conservative approach, leaving untouched the fistula. No intraoperative, perioperative, and follow-up signs of myocardial ischemia were observed.
MeSH term(s)	Arteriovenous Fistula/therapy ; Computed Tomography Angiography ; Conservative Treatment ; Coronary Vessel Anomalies ; Humans ; Male ; Middle Aged ; Pulmonary Artery/abnormalities ; Rare Diseases ; Tomography, X-Ray Computed
Language	English
Publishing date	2020-03-16
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.14483
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Zs.A 2221: Show issues

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Article: Less Is More? Combined Approaches to Improve Mortality and Morbidity after Aortic Valve Replacement.

Mikus, Elisa / Fiorentino, Mariafrancesca / Sangiorgi, Diego / Calvi, Simone / Tenti, Elena / Cavallucci, Andrea / Tremoli, Elena / Tripodi, Alberto / Pin, Maurizio / Savini, Carlo

Biomedicines

2023 Volume 11, Issue 11

Abstract: Background: Nowadays, one of the main goals of aortic valve surgery is to reduce the biological impact, mortality, and complications. It is well-known that long operative times in terms of the extracorporeal circulation, but above all, of the aortic ... ...

Abstract	Background: Nowadays, one of the main goals of aortic valve surgery is to reduce the biological impact, mortality, and complications. It is well-known that long operative times in terms of the extracorporeal circulation, but above all, of the aortic cross-clamp time (ACC), represent a risk factor for mortality in patients undergoing cardiac surgery. In order to shorten the aortic cross-clamp time, many technological improvements, such as sutureless prostheses, have been introduced, but their actual effectiveness has not been proven yet. The aim of this study was to assess the 30-day outcomes of patients undergoing aortic valve replacement surgery, focusing on the ACC length. Methods: All 3139 patients undergoing aortic valve replacement between January 2013 and July 2022 at our institution were enrolled. The data were retrospectively collected and the baseline characteristics and intraoperative variables were recorded. In order to adjust the results according to the differences in the baseline characteristics, propensity score matching was performed and four groups of 351 patients were obtained based on the first, second, third, and fourth quartile of the ACC time. Results: The patient population included 132 redo surgeries (9.4%) and 61 cases of active endocarditis (4.3%), with an overall median EuroSCORE II of 1.8 (IQR 1.2-3.1). An increase across the groups was observed in terms of the acute kidney failure ( Conclusions: Shortening the operative times resulted in marked improvements of the patients' outcomes. The combined use of minimally invasive approaches and sutureless aortic valve prostheses allows for a lower 30-day events rate. New technologies should be assessed to obtain the best results with the least risk.
Language	English
Publishing date	2023-11-07
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2720867-9
ISSN	2227-9059
ISSN	2227-9059
DOI	10.3390/biomedicines11112989
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Article ; Online: Transcatheter Aortic Valve Replacement Without On-Site Cardiac Surgery: Ready for Prime Time?

Compagnone, Miriam / Dall'Ara, Gianni / Grotti, Simone / Santarelli, Andrea / Balducelli, Marco / Savini, Carlo / Tarantino, Fabio Felice / Galvani, Marcello

JACC. Cardiovascular interventions

2023 Volume 16, Issue 24, Page(s) 3026–3030

MeSH term(s)	Humans ; Transcatheter Aortic Valve Replacement/adverse effects ; Treatment Outcome ; Aortic Valve/diagnostic imaging ; Aortic Valve/surgery ; Aortic Valve Stenosis/diagnostic imaging ; Aortic Valve Stenosis/surgery ; Risk Factors ; Heart Valve Prosthesis
Language	English
Publishing date	2023-12-26
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2452157-7
ISSN	1876-7605 ; 1936-8798
ISSN (online)	1876-7605
ISSN	1936-8798
DOI	10.1016/j.jcin.2023.09.020
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Zs.A 6669: Show issues

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Article: Long-Term Atrioventricular Block Following Valve Surgery: Electrocardiographic and Surgical Predictors.

Farina, Jacopo / Biffi, Mauro / Folesani, Gianluca / Di Marco, Luca / Martin, Sofia / Zenesini, Corrado / Savini, Carlo / Ziacchi, Matteo / Diemberger, Igor / Martignani, Cristian / Pacini, Davide

Journal of clinical medicine

2024 Volume 13, Issue 2

Abstract: Background: Bradyarrhythmia requiring pacemaker implantation among patients undergoing valve surgery may occur even after several years, with unclear predictors. Our aim was to investigate the incidence of pacemaker implantation at different follow-up ... ...

Abstract	Background: Bradyarrhythmia requiring pacemaker implantation among patients undergoing valve surgery may occur even after several years, with unclear predictors. Our aim was to investigate the incidence of pacemaker implantation at different follow-up times and identify associated predictors. Methods: We conducted a retrospective study evaluating 1046 consecutive patients who underwent valve surgery at the Cardiac Surgery Division of Bologna University Hospital from 2005 to 2010. Results: During 10 ± 4 years of follow-up, 11.4% of these patients required pacemaker implantation. Interventions on both atrioventricular valves independently predicted long-term pacemaker implantation (SHR 2.1, 95% CI 1.2-3.8, Conclusion: Patients undergoing valvular surgery have a continuing risk of atrioventricular block late after surgery until the 12-month follow-up, which was clearly superior to the rate of atrioventricular block observed at long-term. Pre-operative atrioventricular conduction disease and combined surgery on both atrioventricular valves are strong predictors of atrioventricular block requiring pacemaker implantation.
Language	English
Publishing date	2024-01-17
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm13020538
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Article: Surgical Treatment of Active Endocarditis Pre- and Post-COVID-19 Pandemic Onset.

Mikus, Elisa / Fiorentino, Mariafrancesca / Sangiorgi, Diego / Fiaschini, Costanza / Tenti, Elena / Tremoli, Elena / Calvi, Simone / Costantino, Antonino / Tripodi, Alberto / Zucchetta, Fabio / Savini, Carlo

Biomedicines

2024 Volume 12, Issue 1

Abstract: Background: Despite advanced diagnosis and treatment, infective endocarditis (IE) is a potentially life-threatening condition. The impact of COVID-19 on the diagnosis and outcome of the surgical treatment of IE is uncertain. The aim of this study was to ...

Abstract	Background: Despite advanced diagnosis and treatment, infective endocarditis (IE) is a potentially life-threatening condition. The impact of COVID-19 on the diagnosis and outcome of the surgical treatment of IE is uncertain. The aim of this study was to analyze the incidence, characteristics, and outcomes of surgically treated IE before and after the COVID-19 pandemic. Methods: This study retrospectively analyzed the data of 535 patients who underwent valve surgical procedures for IE between January 2010 and December 2022 in a single cardiac surgery center. Patients were divided into two groups depending on the date of their operation: before ( Results: Patients from the post-COVID-19 cohort (after 11 March 2020) had a greater number of comorbidities such as diabetes (29.6% vs. 16.3% Conclusions: The incidence of surgically treated IE significantly increases after the COVID-19 pandemic with a higher incidence of mitral valve involvement with respect to the aortic valve. Although a delay in surgical timing occurred during the COVID-19 pandemic, data in terms of mortality and outcomes were largely unaffected.
Language	English
Publishing date	2024-01-19
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2720867-9
ISSN	2227-9059
ISSN	2227-9059
DOI	10.3390/biomedicines12010233
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Article: Risks of Stroke After Coronary Artery Bypass Graft - Recent Insights and Perspectives.

Palmerini, Tullio / Savini, Carlo / Di Eusanio, Marco

Interventional cardiology (London, England)

2018 Volume 9, Issue 2, Page(s) 77–83

Abstract: Stroke is one of the most devastating complications after coronary artery bypass graft (CABG) surgery, entailing permanent disability, a 3-6 fold increased risk of mortality, an incremental hospital resource consumption and a longer length of hospital ... ...

Abstract	Stroke is one of the most devastating complications after coronary artery bypass graft (CABG) surgery, entailing permanent disability, a 3-6 fold increased risk of mortality, an incremental hospital resource consumption and a longer length of hospital stay. Notwithstanding advances in surgical, anaesthetic and medical management across the last 10 years, the risk of stroke after CABG has not significantly declined, likely because an older and sicker population is now deemed suitable to undergo CABG. The pathogenesis of stroke is multifactorial, but two variables are believed to play a major role - cerebral embolisation of atheromatous debris arising from the ascending aorta during surgical manipulation and hypoperfusion during surgery. Identification of vulnerable patients at increased risk of stroke before CABG is of paramount importance for the surgical decision-making approach and informed consent. Several models including demographic, clinical and procedural variables have been developed to risk-stratify the hazard of stroke in patients undergoing CABG, but identification of severe atherosclerosis of the ascending aorta and pre-existing cerebrovascular disease are key determinants for appropriate risk stratification and decision-making. Atherosclerotic disease of the ascending aorta can be identified before surgery using transoesophageal echocardiography, computed tomography and magnetic resonance imaging. However, intra-operative ultrasound scanning of the ascending aorta is the diagnostic tool with the best sensitivity and specificity for the detection of atheromatous debris in the ascending aorta. Although many investigators have advocated the use of off-pump CABG to minimise the risk of peri-operative stroke, results from randomised trials and meta-analyses have been inconsistent. Anaortic approaches, including total arterial revascularisation with
Language	English
Publishing date	2018-03-23
Publishing country	England
Document type	Journal Article
ZDB-ID	2813989-6
ISSN	1756-1485 ; 1756-1477
ISSN (online)	1756-1485
ISSN	1756-1477
DOI	10.15420/icr.2011.9.2.77
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Article: Sutureless aortic valve replacement and direct Sapien 3 valve-in-valve implantation: a challenging case.

Savini, Carlo / Gliozzi, Gregorio / Mariani, Carlo / Votano, Daniela / Leone, Alessandro / Pacini, Davide

Annals of cardiothoracic surgery

2020 Volume 9, Issue 4, Page(s) 341–343

Language	English
Publishing date	2020-07-29
Publishing country	China
Document type	Editorial
ZDB-ID	2713627-9
ISSN	2304-1021 ; 2225-319X
ISSN (online)	2304-1021
ISSN	2225-319X
DOI	10.21037/acs.2020.02.13
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