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  1. Artikel: 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  Band 23, Heft Suppl E, Seite(n) 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.
    Sprache Englisch
    Erscheinungsdatum 2021-10-08
    Erscheinungsland England
    Dokumenttyp 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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  2. Artikel ; 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  Band 38, Heft 4, Seite(n) 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-Begriff(e) Humans ; Corpus Callosum ; Coronary Artery Bypass/adverse effects ; Extracorporeal Circulation/adverse effects ; Ischemia/etiology ; Infarction/etiology
    Sprache Englisch
    Erscheinungsdatum 2022-03-09
    Erscheinungsland England
    Dokumenttyp 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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  3. Artikel ; 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  Band 39, Heft 2, Seite(n) 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-Begriff(e) Humans ; Aortic Valve/surgery ; Retrospective Studies ; Heart Valve Prosthesis Implantation/adverse effects ; Treatment Outcome ; Sternotomy/adverse effects ; Obesity/complications ; Obesity/surgery ; Length of Stay
    Sprache Englisch
    Erscheinungsdatum 2024-03-01
    Erscheinungsland Brazil
    Dokumenttyp 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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  4. Artikel ; Online: Clinical impact of multiple resheathing during transcatheter aortic valve implantation with Evolut self-expanding valves.

    Aurigemma, Cristina / Busco, Marco / Bianchini, Francesco / Bianchini, Emiliano / Di Brango, Claudio / Marchetta, Michele / Bruno, Piergiorgio / Nesta, Marialisa / Romagnoli, Enrico / Burzotta, Francesco / Trani, Carlo

    International journal of cardiology

    2024  Band 410, Seite(n) 132218

    Abstract: Background: The possibility to resheath some transcatheter heart valves (THV) facilitates the optimization of self-expandable devices implantation. However, resheating manoeuvres (expecially when repeated) increase the interaction between the ... ...

    Abstract Background: The possibility to resheath some transcatheter heart valves (THV) facilitates the optimization of self-expandable devices implantation. However, resheating manoeuvres (expecially when repeated) increase the interaction between the transcatheter prosthesis and the patient's tissues potentially causing side-effects.
    Aims: To assess the clinical outcomes of resheathing at midterm follow-up with a focus on the safety of multiple resheathing.
    Methods: This retrospective observational study included all consecutive patients who underwent TAVI with a self-expandable supra-annular THV between December 2018 and December 2022. Primary endpoint was a composite of cardiovascular (CV) mortality, neurological events, non-fatal acute myocardial infarction and CV rehospitalizations. All clinical endpoints were assessed according to VARC-3 criteria.
    Results: 469 TAVI procedures with self-expandable supra-annular THV were included in the study. The attempt to resheath and the resheath manoeuvres number was prospectively recorded into an electronic database. Resheating was attempted in 253 (53.9%) cases; 1, 2 and ≥ 3 resheathing were performed in respectively 122 (26.0%), 63 (13.4%) and 68 (14.5%) procedures. At a median follow-up of 640 days (interquartile range 340-1033 days), the incidence of the primary endpoint did not differ between 0 vs. ≥1 (22.7 vs. 26.1%, LogRank p = 0.584) and < 3 vs. ≥3 resheathing groups (24.2 vs. 26.5% LogRank p = 0.963). Furthermore, no significant differences in the primary endpoint were observed between 0, 1-2 and ≥ 3 resheathing (p = 0.84).
    Conclusions: Our study found that resheathing of self-expandable THVs during TAVI did not result in worse clinical outcomes compared with no resheathing at mid-term follow-up. These results are independent from the number of resheathing, underling the safety of multiple resheathing in terms of peri-procedural and mid-term outcome.
    Condensed abstract: In this retrospective observational study of 469 patients undergoing transcatheter aortic valve implantation (TAVI) for symptomatic severe aortic stenosis with self-expanding valves, we investigated the influence of resheathing on mid-term clinical outcomes. Specifically, we focused on the safety of multiple resheathing procedures. Our findings revealed no significant impact of resheathing on medium-term outcomes. The primary endpoint, a composite of cardiovascular mortality, neurological events, non-fatal acute myocardial infarction, and cardiovascular rehospitalizations, did not show statistically significant differences between no resheathing, single resheathing and multiple resheathing groups. Our study suggests that resheathing, even when performed multiple times, does not appear to significantly affect clinical outcomes at mid-term follow-up.
    Sprache Englisch
    Erscheinungsdatum 2024-05-28
    Erscheinungsland Netherlands
    Dokumenttyp Journal Article
    ZDB-ID 779519-1
    ISSN 1874-1754 ; 0167-5273
    ISSN (online) 1874-1754
    ISSN 0167-5273
    DOI 10.1016/j.ijcard.2024.132218
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  5. Artikel ; Online: Anatomical Annulus Predictors of New Permanent Pacemaker Implantation Risk after Balloon-expandable Trans-catheter Aortic Valve Implantation.

    Bianchini, Francesco / Bianchini, Emiliano / Romagnoli, Enrico / Aurigemma, Cristina / Zito, Andrea / Busco, Marco / Nesta, Marialisa / Bruno, Piergiorgio / Laezza, Domenico / Giambusso, Nicole / Natale, Luigi / Pelargonio, Gemma / Burzotta, Francesco / Trani, Carlo

    The American journal of cardiology

    2024  

    Abstract: New-generation transcatheter-heart-valves (THV) have significantly improved technical success and procedural safety of transcatheter-aortic-valve-implantation (TAVI) procedures, but incidence of permanent pacemaker implantation (PPI) remains a concern ... ...

    Abstract New-generation transcatheter-heart-valves (THV) have significantly improved technical success and procedural safety of transcatheter-aortic-valve-implantation (TAVI) procedures, but incidence of permanent pacemaker implantation (PPI) remains a concern.The study aimed to assess the role of anatomical annulus features in determining peri-procedural conduction disturbances leading to new-PPI following TAVI with the last generation Edwards Sapien balloon-expandable valves (BEV). In the context of a prospective single-center registry, we integrated clinical and procedural predictors of PPI with anatomical data derived from multi-slice-computed-tomography (MSCT). A total of 210 consecutive patients treated with balloon expandable Edwards THV were included in the study from 2015 to 2023. Technical success was achieved in 197 (93.8%) procedures, and 26 patients (12.4%) required new-PPI at 30-day follow-up (median time-to-implantation 3 days). At the univariable logistic-regression analysis, pre-procedural right bundle branch block (RBBB; OR:2.24 [95%CI:1.01-4.97], p=0.047), annulus eccentricity ≥0.25 (OR:5.43 [95%CI:2.21-13.36], p<0.001), calcium volume at annulus of the right coronary cusp (RCC) >48 mm
    Sprache Englisch
    Erscheinungsdatum 2024-06-04
    Erscheinungsland United States
    Dokumenttyp Journal Article
    ZDB-ID 80014-4
    ISSN 1879-1913 ; 0002-9149
    ISSN (online) 1879-1913
    ISSN 0002-9149
    DOI 10.1016/j.amjcard.2024.05.034
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  6. Artikel: 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  Band 14, Heft 5, Seite(n) 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.
    Sprache Englisch
    Erscheinungsdatum 2022-06-09
    Erscheinungsland United States
    Dokumenttyp Journal Article
    ZDB-ID 2573665-6
    ISSN 1949-8462
    ISSN 1949-8462
    DOI 10.4330/wjc.v14.i5.297
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  7. Artikel ; Online: Progression of the ascending aorta diameter after surgical or transcatheter bicuspid aortic valve replacement.

    Chiariello, Giovanni Alfonso / Di Mauro, Michele / Pasquini, Annalisa / Bruno, Piergiorgio / Nesta, Marialisa / Fabiani, Ludovica / Mazza, Andrea / Meloni, Martina / Baldo, Elisabetta / Ponzo, Myriana / Ferraro, Francesco / Conserva, Antonio Davide / D'Acierno, Edoardo / Villa, Emmanuel / Trani, Carlo / Burzotta, Francesco / Massetti, Massimo

    Interdisciplinary cardiovascular and thoracic surgery

    2024  Band 38, Heft 5

    Abstract: Objectives: Ascending aorta (AA) dilatation in patients with bicuspid aortic valve (AV) is related both to genetic and haemodynamic factors. The aim of this study is to compare late progression of AA dilatation in bicuspid AV patients undergoing ... ...

    Abstract Objectives: Ascending aorta (AA) dilatation in patients with bicuspid aortic valve (AV) is related both to genetic and haemodynamic factors. The aim of this study is to compare late progression of AA dilatation in bicuspid AV patients undergoing surgical aortic valve replacement (SAVR) versus transcatheter aortic valve implantation (TAVI).
    Methods: Data of 189 consecutive patients who underwent AV replacement for severe bicuspid AV stenosis were prospectively collected. Patients who underwent SAVR were compared to patients who underwent TAVI. Indication to the procedure was validated by the institutional Heart Team. Aortic diameters were evaluated by transthoracic echocardiogram. Differences between preoperative and long-term follow-up AA diameters were compared in the 2 groups.
    Results: Between January 2015 and December 2021, 143 (76%) patients underwent SAVR and 46 (24%) patients underwent TAVI. At 4.6 (standard deviation 1.7) years follow-up, patients in the TAVI group showed significantly lower survival (P = 0.00013) and event-free survival (P < 0.0001). AA diameter progression was lower in surgical compared to transcatheter patients, 0.95 (0.60, 1.30) vs 1.65 (0.67, 2.63) mm, P = 0.02. AA diameter progression indexed for body surface area and height was lower in the surgical group: 0.72 (0.38, 1.05) vs 1.05 (0.39, 1.71) mm/m2, P = 0.02, and 0.59 (0.36, 0.81) vs 1.11 (0.44, 1.78) mm/m, P = 0.001, respectively. At multivariable linear regression analysis transcatheter procedure, baseline aortic diameter and paravalvular leak were significantly associated with increased postoperative AA dilatation.
    Conclusions: Bicuspid AV patients who underwent SAVR, showed significantly less long-term AA diameter progression than patients who underwent transcatheter procedure.
    Sprache Englisch
    Erscheinungsdatum 2024-04-18
    Erscheinungsland England
    Dokumenttyp Journal Article
    ISSN 2753-670X
    ISSN (online) 2753-670X
    DOI 10.1093/icvts/ivae100
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  8. Artikel ; 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  , Seite(n) e016151

    Sprache Englisch
    Erscheinungsdatum 2024-04-11
    Erscheinungsland United States
    Dokumenttyp 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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  9. Artikel ; Online: Potential Life-Threatening Complication After Transacatheter Aortic Valve Replacement: A Pseudoaneurysm of the Interventricular Septum.

    Nesta, Marialisa / Bruno, Piergiorgio / Gambardella, Rosanna / Filice, Monica / Olimpieri, Alessandro / Pasquini, Annalisa / Pavone, Natalia / Cammertoni, Federico / Chiariello, Giovanni Alfonso / Grandinetti, Maria / Burzotta, Francesco / Romagnoli, Enrico / Aurigemma, Cristina / Muciaccia, Massimo / Costa, Federico / Trani, Carlo / Massetti, Massimo

    Circulation. Cardiovascular imaging

    2024  , Seite(n) e016193

    Sprache Englisch
    Erscheinungsdatum 2024-06-05
    Erscheinungsland United States
    Dokumenttyp Journal Article
    ZDB-ID 2435045-X
    ISSN 1942-0080 ; 1941-9651
    ISSN (online) 1942-0080
    ISSN 1941-9651
    DOI 10.1161/CIRCIMAGING.123.016193
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  10. Artikel ; 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  Band 64, Heft 4, Seite(n) 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-Begriff(e) 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
    Sprache Englisch
    Erscheinungsdatum 2023-07-04
    Erscheinungsland Italy
    Dokumenttyp 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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