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  1. Article: Outcomes of Emergent Isolated Coronary Bypass Grafting in Heart Failure Patients.

    Bianchi, Giacomo / Zancanaro, Edoardo / Margaryan, Rafik / Concistré, Giovanni / Varone, Egidio / Simeoni, Simone / Solinas, Marco

    Life (Basel, Switzerland)

    2022  Volume 12, Issue 12

    Abstract: Patients with previously diagnosed HF are at greater risk for subsequent morbidity and mortality when hospitalized for an Acute Myocardial Infarction (AMI). The purpose of our study was to describe the time trend of the incidence of emergent CABG in ... ...

    Abstract Patients with previously diagnosed HF are at greater risk for subsequent morbidity and mortality when hospitalized for an Acute Myocardial Infarction (AMI). The purpose of our study was to describe the time trend of the incidence of emergent CABG in patients with and without HF, the clinical characteristics, outcomes, and the risk factors for mortality of surgical revascularization in the short and medium term. This was a single-center retrospective observational study of patients who underwent isolated emergency CABG from January 2009 to January 2020. A propensity-score matching analysis yielded two comparable groups (n = 430) of patients without (n = 215) and with (n = 215) heart failure. In-hospital mortality did not differ in the two groups (2.8%; p > 0.9); the patients with heart failure presented more frequently with cardiogenic shock, and there was an association with mortality and mechanical circulatory support (OR 16.7−95% CI 3.31−140; p = 0.002) and postoperative acute renal failure (OR 15.9−95% CI 0.66−203; p = 0.036). In the early- and mid-term, heart failure and NSTEMI were associated with mortality (HR 3.47−95% CI 1.15−10.5; p = 0.028), along with age (HR 1.28−95% CI 1.21−1.36; p < 0.001). Surgical revascularization offers an excellent solution for patients with acute coronary syndrome, leading to a good immediate prognosis even in those with chronic heart failure.
    Language English
    Publishing date 2022-12-16
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2662250-6
    ISSN 2075-1729
    ISSN 2075-1729
    DOI 10.3390/life12122124
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  2. Article ; Online: Ten-year experience with sutureless Perceval bioprosthesis: single-centre analysis in 1157 implants.

    Concistrè, Giovanni / Bianchi, Giacomo / Margaryan, Rafik / Zancanaro, Edoardo / Chiaramonti, Francesca / Kallushi, Enkel / Gasbarri, Tommaso / Murzi, Michele / Varone, Egidio / Simeoni, Simone / Leone, Alessandro / Santarelli, Filippo / Farneti, Pierandrea / Solinas, Marco

    Journal of cardiovascular medicine (Hagerstown, Md.)

    2023  Volume 24, Issue 8, Page(s) 506–513

    Abstract: Aims: We describe long-term clinical and echocardiographic outcomes in the largest single-centre cohort of patients who underwent aortic valve replacement (AVR) with sutureless Perceval (CorCym, Italy) bioprosthesis.: Methods: Between March 2011 and ... ...

    Abstract Aims: We describe long-term clinical and echocardiographic outcomes in the largest single-centre cohort of patients who underwent aortic valve replacement (AVR) with sutureless Perceval (CorCym, Italy) bioprosthesis.
    Methods: Between March 2011 and March 2021, 1157 patients underwent AVR with Perceval bioprosthesis implantation. Mean age was 77 ± 6 years (range: 46-89 years) and mean EuroSCORE II was 6.7 ± 3.2% (range: 1.7-14.2%). Concomitant procedures were performed in 266 patients (23%).
    Results: Thirty-day mortality was 1.38% (16/1157). Eight hundred and twenty of 891 (92%) isolated AVRs underwent minimally invasive surgery with a ministernotomy ( n  = 196) or right minithoracotomy ( n  = 624) approach. Cardiopulmonary bypass and aortic cross-clamp times were 81.1 ± 24.3 and 50.6 ± 11.7 min for isolated AVR and 144.5 ± 34.7 and 96.4 ± 21.6 min for combined procedures. At mean follow-up of 53.08 ± 6.7 months (range: 1-120.5 months), survival was 96.5% and mean transvalvular pressure gradient was 13.7 ± 5.8 mmHg. Left ventricular mass decreased from 152.8 to 116.1 g/m 2 ( P  < 0.001) and moderate paravalvular leakage occurred in three patients without haemolysis not requiring any treatment. Freedom from reoperation was 97.6%. Eight patients required surgical reintervention and 19 patients transcatheter valve-in-valve procedure for structural prosthesis degeneration at a mean of 5.6 years after first operation (range: 2-9 years).
    Conclusion: AVR with a Perceval bioprosthesis is associated with good clinical results and excellent haemodynamic performance in our 10-year experience. Structural degeneration rate of Perceval is comparable with other bioprosthetic aortic valves. Sutureless technology may reduce operative time especially in combined procedures and enable minimally invasive AVR.
    MeSH term(s) Humans ; Aged ; Aged, 80 and over ; Bioprosthesis ; Heart Valve Prosthesis Implantation/methods ; Aortic Valve Stenosis/diagnostic imaging ; Aortic Valve Stenosis/surgery ; Aortic Valve Stenosis/complications ; Prosthesis Design ; Treatment Outcome ; Heart Valve Prosthesis ; Aortic Valve/diagnostic imaging ; Aortic Valve/surgery
    Language English
    Publishing date 2023-04-25
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2223461-5
    ISSN 1558-2035 ; 1558-2027
    ISSN (online) 1558-2035
    ISSN 1558-2027
    DOI 10.2459/JCM.0000000000001475
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  3. Article: Transcatheter Aortic Valve Replacement in Degenerated Perceval Bioprosthesis: Clinical and Technical Aspects in 32 Cases.

    Concistrè, Giovanni / Gasbarri, Tommaso / Ravani, Marcello / Al Jabri, Anees / Trianni, Giuseppe / Bianchi, Giacomo / Margaryan, Rafik / Chiaramonti, Francesca / Murzi, Michele / Kallushi, Enkel / Varone, Egidio / Simeoni, Simone / Leone, Alessandro / Farneti, Andrea / Berti, Sergio / Solinas, Marco

    Journal of clinical medicine

    2023  Volume 12, Issue 19

    Abstract: Background: Sutureless aortic bioprostheses are increasingly being used to provide shorter cross-clamp time and facilitate minimally invasive aortic valve replacement. As the use of sutureless valves has increased over the past decade, we begin to ... ...

    Abstract Background: Sutureless aortic bioprostheses are increasingly being used to provide shorter cross-clamp time and facilitate minimally invasive aortic valve replacement. As the use of sutureless valves has increased over the past decade, we begin to encounter their degeneration. We describe clinical outcomes and technical aspects in patients with degenerated sutureless Perceval (CorCym, Italy) aortic bioprosthesis treated with valve-in-valve transcatheter aortic valve replacement (VIV-TAVR).
    Methods: Between March 2011 and March 2023, 1310 patients underwent aortic valve replacement (AVR) with Perceval bioprosthesis implantation. Severe bioprosthesis degeneration treated with VIV-TAVR occurred in 32 patients with a mean of 6.4 ± 1.9 years (range: 2-10 years) after first implantation. Mean EuroSCORE II was 9.5 ± 6.4% (range: 1.9-35.1%).
    Results: Thirty of thirty-two (94%) VIV-TAVR were performed via transfemoral and two (6%) via transapical approach. Vascular complications occurred in two patients (6%), and mean hospital stay was 4.6 ± 2.4 days. At mean follow-up of 16.7 ± 15.2 months (range: 1-50 months), survival was 100%, and mean transvalvular pressure gradient was 18.7 ± 5.3 mmHg.
    Conclusion: VIV-TAVR is a useful option for degenerated Perceval and appears safe and effective. This procedure is associated with good clinical results and excellent hemodynamic performance in our largest single-center experience.
    Language English
    Publishing date 2023-09-28
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2662592-1
    ISSN 2077-0383
    ISSN 2077-0383
    DOI 10.3390/jcm12196265
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  4. Article: Right anterior mini-thoracotomy and sutureless valves: the perfect marriage.

    Solinas, Marco / Bianchi, Giacomo / Chiaramonti, Francesca / Margaryan, Rafik / Kallushi, Enkel / Gasbarri, Tommaso / Santarelli, Filippo / Murzi, Michele / Farneti, Pierandrea / Leone, Alessandro / Simeoni, Simone / Varone, Egidio / Marchi, Federica / Glauber, Mattia / Concistrè, Giovanni

    Annals of cardiothoracic surgery

    2020  Volume 9, Issue 4, Page(s) 305–313

    Abstract: Background: A minimally invasive approach (MIA) reduces mortality and morbidity in patients referred for aortic valve replacement (AVR). Sutureless technology facilitates a MIA. We describe our experience with the sutureless Perceval (LivaNova, Italy) ... ...

    Abstract Background: A minimally invasive approach (MIA) reduces mortality and morbidity in patients referred for aortic valve replacement (AVR). Sutureless technology facilitates a MIA. We describe our experience with the sutureless Perceval (LivaNova, Italy) aortic bioprosthesis through a right anterior mini-thoracotomy (RAMT) approach.
    Methods: Between March 2011 and October 2019, 1,049 patients underwent AVR with Perceval bioprosthesis. Five hundred and three patients (48%) were operated through a RAMT approach in the second intercostal space. Considering only isolated AVR (881), 98% of patients were operated with MIA, and Perceval in RAMT approach was performed in 57% of these patients. Eight patients (1.6%) had previously undergone cardiac surgery. The prosthesis sizes implanted were: S (n=91), M (n=154), L (n=218) and XL (n=40). Concomitant procedures were mitral valve surgery (n=6), tricuspid valve repair (n=1), mitral valve repair and tricuspid valve repair (n=1) and miectomy (n=2). Mean age was 78±4 years (range, 65-89 years), 317 patients were female (63%) and EuroSCORE II was 5.9%±8.4%.
    Results: The 30-day mortality was 0.8% (4/503). Cardiopulmonary bypass (CPB) and aortic cross-clamp times were 81.6±30.8 and 50.3±24.5 minutes respectively for stand-alone procedures. In two patients, early moderate paravalvular leakage appeared as a result of incomplete expansion of the sutureless valve due to oversizing of the bioprosthesis, requiring reoperations at two and nine postoperative days with sutured aortic bioprosthesis implantation. Permanent pacemaker implantation within the first thirty days was necessary in 26 (5.2%) patients. At the mean follow-up of 4.6 years (range, 1 month to 8.6 years), survival was 96%, freedom from reoperation was 99.2%, and mean transvalvular pressure gradient was 11.9±4.3 mmHg.
    Conclusions: AVR with the Perceval bioprosthesis in a RAMT approach is a safe and feasible procedure associated with low mortality and excellent hemodynamic performance. Sutureless technology facilitates a RAMT approach.
    Language English
    Publishing date 2020-07-29
    Publishing country China
    Document type Journal Article
    ZDB-ID 2713627-9
    ISSN 2304-1021 ; 2225-319X
    ISSN (online) 2304-1021
    ISSN 2225-319X
    DOI 10.21037/acs-2019-surd-172
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  5. Article ; Online: Aortic valve decalcification for severe aortic valve stenosis in the elderly: medium-term results.

    Garatti, Andrea / Canziani, Alberto / Menicanti, Lorenzo / Tripepi, Sonia / Simeoni, Simone / Mossuto, Eugenio / Santoro, Tiberio / Montericcio, Vincenzo / Pelissero, Gabriele

    Journal of cardiovascular medicine (Hagerstown, Md.)

    2016  Volume 17, Issue 2, Page(s) 130–136

    Abstract: Aims: To present the results of a novel technique of aortic valve decalcification (AVD) in a consecutive population of elderly patients with severe aortic valve stenosis (AVS) and small aortic annulus.: Methods: Between January 2008 and December 2012, ...

    Abstract Aims: To present the results of a novel technique of aortic valve decalcification (AVD) in a consecutive population of elderly patients with severe aortic valve stenosis (AVS) and small aortic annulus.
    Methods: Between January 2008 and December 2012, a consecutive series of 34 patients (mean age 80 ± 13 years) with severe AVS were operated on using AVD. They were compared with a matched population of 68 patients (mean age 82 ± 7 years) submitted to aortic valve replacement (AVR) with bioprosthesis. The two groups were comparable for cardiac risk factors and admission symptoms. Preoperatively, all patients presented with severe AVS, small aortic annulus (19 mm) and preserved left ventricular function.
    Results: Thirty-day mortality was 8.8 vs. 7.5% in the AVD and AVR groups, respectively (P = 0.88). Actuarial 2 and 5-year survival rates were 80 vs. 82% and 64 vs. 78% in the AVD and AVR groups, respectively (P = 0.27). Long-term valve-related events incidence was significantly higher in the AVD group (12%) compared with that in the AVR group (4%; P = 0.01). However, in the AVD group, patients with no or mild residual AR experienced 2 and 5 years of freedom from valve-related events, which is not significantly different from the patients submitted to the AVR group (P = 0.76). After AVD, a significant increase in the aortic valve area (from 0.8 to 1.9 cm) and a parallel reduction in the mean gradient (from 40 to 12 mmHg) was observed in all patients (P = 0.01). Postoperative aortic valve area (1.9 vs. 1.26 cm), as well as mean gradient (12 vs. 21 mmHg), were significantly better in the AVD group compared with that in the AVR group (P = 0.01).
    Conclusion: In this preliminary experience, AVD seems a good therapeutic option for elderly patients with severe AVS. Further studies with longer follow-up are needed in order to confirm these preliminary results and to ascertain the valve durability over time.
    MeSH term(s) Aged ; Aged, 80 and over ; Aortic Valve Stenosis/surgery ; Cardiac Surgical Procedures/methods ; Case-Control Studies ; Female ; Follow-Up Studies ; Humans ; Male
    Language English
    Publishing date 2016-02
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2223461-5
    ISSN 1558-2035 ; 1558-2027
    ISSN (online) 1558-2035
    ISSN 1558-2027
    DOI 10.2459/JCM.0000000000000281
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  6. Article ; Online: Impact of pulmonary hypertension on mortality after operation for isolated aortic valve stenosis.

    Miceli, Antonio / Varone, Egidio / Gilmanov, Danyiar / Murzi, Michele / Simeoni, Simone / Concistrè, Giovanni / Marchi, Federica / Solinas, Marco / Glauber, Mattia

    International journal of cardiology

    2013  Volume 168, Issue 4, Page(s) 3556–3559

    Abstract: Background: Pulmonary hypertension (PH) is a well-known independent risk factor for mortality and morbidity after cardiac surgery. However, no weight is given to PH in the current guidelines for the management of patients with aortic stenosis (AS) ... ...

    Abstract Background: Pulmonary hypertension (PH) is a well-known independent risk factor for mortality and morbidity after cardiac surgery. However, no weight is given to PH in the current guidelines for the management of patients with aortic stenosis (AS) undergoing aortic valve replacement (AVR). The aim of our study was to evaluate the impact of preoperative PH on early and five-year survival in patients with severe AS undergoing isolated AVR.
    Methods: From January 2005 to July 2010, 422 consecutive patients with severe AS underwent isolated AVR. According to systolic pulmonary artery pressure (sPAP), PH was classified as none (sPAPS<35 mmHg, N=224), mild-moderate (35≤sPAP<50 mmHg, N=159) and severe (sPAP≥50 mmHg, N=39).
    Results: Overall in-hospital mortality was 2.8%. Unadjusted mortality was 0.9%, 3.8% and 10.2% for patients with normal, mild-moderate and severe PH (p=0.003). In multivariable analysis, severe PH (OR 4.1, 95 CI 1.1-15.3, p=0.04) and New York Heart Association class III-IV (OR 14.9, 95% CI 1.8-117.8, p=0.01) were independent risk factors of in-hospital mortality. Multivariable predictors of five-year survival were extracardiac arteriopathy (HR 2.8, 95%CI 1.6-4.9, p<0.0001), severe PH (HR 2.4, 95%CI 1.2-4.6 p=0.01), NHYA III-IV class (HR 2.3, 95% CI 1.3-4, p=0.003), preoperative serum creatinine (HR 2.2, 95%CI, 1.6-3.1,p<0.0001) and age (HR 1.08, 95%CI 1.03-1.13, p=0.01). Five-year survival was 86%±3% with normal sPAP, 81%±4% with mild-moderate PH and 63±10% with severe PH (p<0.001).
    Conclusions: In patients undergoing isolated AVR with severe AS, severe PH is an independent predictor of in-hospital mortality and five-year survival.
    MeSH term(s) Aged ; Aged, 80 and over ; Aortic Valve Stenosis/diagnosis ; Aortic Valve Stenosis/mortality ; Aortic Valve Stenosis/surgery ; Cohort Studies ; Female ; Hospital Mortality/trends ; Humans ; Hypertension, Pulmonary/diagnosis ; Hypertension, Pulmonary/mortality ; Male ; Middle Aged ; Postoperative Complications/diagnosis ; Postoperative Complications/mortality ; Prospective Studies ; Retrospective Studies ; Survival Rate/trends
    Language English
    Publishing date 2013-10-09
    Publishing country Netherlands
    Document type Journal Article ; Observational Study
    ZDB-ID 779519-1
    ISSN 1874-1754 ; 0167-5273
    ISSN (online) 1874-1754
    ISSN 0167-5273
    DOI 10.1016/j.ijcard.2013.05.001
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    Zs.A 1673: Show issues Location:
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  7. Article ; Online: Root replacement with stentless Freestyle bioprostheses for active endocarditis: a single centre experience.

    Miceli, Antonio / Croccia, Mariagrazia / Simeoni, Simone / Varone, Egidio / Murzi, Michele / Farneti, Pier Andrea / Solinas, Marco / Glauber, Mattia

    Interactive cardiovascular and thoracic surgery

    2012  Volume 16, Issue 1, Page(s) 27–30

    Abstract: Objectives: Few studies have examined the use of stentless Freestyle bioprostheses in patients with active valve endocarditis (VE). The aim of this study was to evaluate outcomes of stentless Freestyle bioprostheses in patients undergoing full-root ... ...

    Abstract Objectives: Few studies have examined the use of stentless Freestyle bioprostheses in patients with active valve endocarditis (VE). The aim of this study was to evaluate outcomes of stentless Freestyle bioprostheses in patients undergoing full-root replacement.
    Methods: From February 2000 to June 2010, 180 patients with VE underwent cardiac surgery at our institution, of which 71 (39.5%) had prosthetic VE. Eighteen patients underwent full-root replacement with Freestyle bioprostheses: 3 patients (16%) had native aortic VE, 14 (78%) had aortic prosthetic VE and 1 (6%) had mitral and aortic prosthetic VE. Mean age was 66.7 ± 10.1, M/F: 6/12, mean logistic EuroSCORE 36.4 ± 21.6. Eight patients (42%) underwent concomitant procedures (two mitral valve replacements, three ascending aorta replacements, one coronary artery bypass grafting (CABG), one ventricular septal disease (VSD) repair, one CABG + ascending aorta + VSD repair).
    Results: Two patients (11%) died in-hospital. At the median follow-up of 24 months (range 1-113 months), no death occurred and freedom from reoperation was 87.5% (2 patients for aortic root pseudo-aneurysm at 1 and 23 months). All patients are in NYHA functional class I and have satisfactory echocardiographic data (EF 54.3 ± 8%, peak and mean trans-prosthetic gradients 12 ± 6.7 mmHg and 7.5 ± 3.6 mmHg) with 100% freedom recurrence of VE.
    Conclusions: Our experience shows that root replacement with Freestyle stentless bioprostheses in patient with VE, is associated with low rates of early and mid-term mortality, good haemodynamic performance and low rates of valve-related morbidity as well as low recurrence of infection.
    MeSH term(s) Adult ; Aged ; Aorta/diagnostic imaging ; Aorta/physiopathology ; Aorta/surgery ; Aortic Valve/diagnostic imaging ; Aortic Valve/microbiology ; Aortic Valve/physiopathology ; Aortic Valve/surgery ; Bioprosthesis ; Blood Vessel Prosthesis ; Blood Vessel Prosthesis Implantation/adverse effects ; Blood Vessel Prosthesis Implantation/instrumentation ; Blood Vessel Prosthesis Implantation/mortality ; Endocarditis, Bacterial/diagnosis ; Endocarditis, Bacterial/microbiology ; Endocarditis, Bacterial/mortality ; Endocarditis, Bacterial/physiopathology ; Endocarditis, Bacterial/surgery ; England ; Female ; Heart Valve Prosthesis ; Heart Valve Prosthesis Implantation/adverse effects ; Heart Valve Prosthesis Implantation/instrumentation ; Heart Valve Prosthesis Implantation/mortality ; Hemodynamics ; Hospital Mortality ; Humans ; Logistic Models ; Male ; Middle Aged ; Prosthesis Design ; Recurrence ; Risk Factors ; Time Factors ; Treatment Outcome ; Ultrasonography
    Language English
    Publishing date 2012-10-26
    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/ivs438
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    Zs.A 5730: Show issues Location:
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