Publications by authors named "Angelo Dell Aquila"
Objective: To evaluate the benefits of surgical repair acute type A aortic dissection (ATAAD) on survival of octogenarians.
Methods: Patients who underwent surgery for acute ATAAD from the multicenter European Registry of Type A Aortic Dissection (ERTAAD) were the subjects of the present analysis.
Results: 326 (8.
: Type A aortic dissection (TAAD) is a life-threatening condition which requires prompt diagnosis and surgical treatment. When TAAD involves the aortic root, aortic valve-sparing or Bentall procedures are the main surgical treatment options. The subjects of this analysis were 3735 patients included in the European Registry of Type A Aortic Dissection (ERTAAD).
View Article and Find Full Text PDFBackground: The current study aims to report the presentation of the malperfusion syndrome in patients with acute type A aortic dissection admitted to surgery and its impact on mortality.
Methods: Data were retrieved from the multicenter European Registry of Type A Aortic Dissection. The Penn classification was used to categorize malperfusion syndromes.
Article Synopsis
- The study investigated the outcomes for patients who had surgery for Stanford type A aortic dissection (TAAD) and spent time in the intensive care unit (ICU), analyzing data from 3,538 patients.
- Average ICU stays were around 9.9 days, with associated costs averaging €24,086, and observed in-hospital mortality was 14.8%, while five-year mortality was 30.5%.
- The analysis found that longer ICU stays (>5 days) linked to better survival rates, with lower in-hospital mortality (8.9% vs. 17.4%) and lower five-year mortality (28.2% vs. 30.7%) when compared to shorter stays (2-
Article Synopsis
- The study investigates gender differences in outcomes after type A aortic dissection (TAAD) surgery, focusing on both short- and long-term results.
- Data was collected from a multicenter European registry including 3902 TAAD surgery patients from 2005-2021, with a gender breakdown of 30.4% females.
- Results showed no significant early postoperative differences between genders, although males had a slightly better ten-year relative survival rate compared to females, despite advancements in surgical techniques over time.
Aims: Technological advances and the current shortage of donor organs have contributed to an increase in the number of left ventricular assist device (LVAD) implantations in patients with end-stage heart failure. Demographic change and medical progress might raise the number of these patients, resulting in a further increase in the number of LVAD implantations. The aim of this study was to evaluate the long-term costs of LVAD therapy and identify diagnoses resulting in expensive stays.
View Article and Find Full Text PDFArticle Synopsis
- Extended aortic repair is essential for maintaining long-term surgical success in young patients with DeBakey type 1 aortic dissection, as they face higher risks of aortic degeneration due to their longer life expectancy.
- A study analyzed 1,199 patients under 60 who had aortic repair surgeries across Europe from 2005 to 2021, comparing outcomes between ascending aortic repair and total aortic arch repair techniques.
- Results showed no significant difference in the need for additional surgeries after 5 years between the two techniques, but total aortic arch repair had higher rates of postoperative complications like stroke and dialysis, while overall mortality rates were similar.
Article Synopsis
- The study investigates the effects of different arterial cannulation methods (femoral, supra-aortic, and direct aortic) on outcomes for patients undergoing surgery for acute Stanford type A aortic dissection (TAAD).
- Results show that in-hospital mortality rates for patients using femoral or supra-aortic cannulation are similar, while direct aortic cannulation yields lower mortality rates compared to femoral cannulation.
- Additionally, switching cannulation sites during surgery increases the risk of in-hospital mortality, while long-term outcomes (10-year mortality) remain consistent across the groups.
Article Synopsis
- Surgery for type A aortic dissection (TAAD) often leads to neurological complications, which were analyzed in a study of 3,902 patients from the European Registry of Type A Aortic Dissection.
- Out of these patients, 18.5% experienced strokes or global brain ischemia during hospitalization, with significant increases in in-hospital mortality linked to these complications: 25.6% for ischemic stroke, 48.7% for hemorrhagic stroke, and 74.0% for global brain ischemia.
- Although neurologic complications sharply increased early and midterm mortality, this negative impact on survival tended to diminish about one year post-surgery.
Article Synopsis
- Surgery for type A aortic dissection (TAAD) has a high early mortality risk, with in-hospital mortality rates increasing based on the urgency of the procedure, ranging from 10% for urgent surgeries to over 57% for the most critical salvage procedures.
- A multicenter study using data from the European Registry of TAAD (ERTAAD) found that preoperative arterial lactate levels correlate with procedure urgency, indicating that more critical cases are associated with poorer outcomes.
- The urgency classification enhances the ability to predict patient risk, suggesting that despite high mortality in severe cases, salvage surgeries are often justified as many patients can still survive to discharge.
Background: Surgery for type A aortic dissection (TAAD) is associated with high risk of mortality. Current risk scoring methods have a limited predictive accuracy.
Methods: Subjects were patients who underwent surgery for acute TAAD at 18 European centers of cardiac surgery from the European Registry of Type A Aortic Dissection (ERTAAD).
Background: Acute type A aortic dissection (TAAD) is associated with significant mortality and morbidity. In this study we evaluated the prognostic significance of preoperative arterial lactate concentration on the outcome after surgery for TAAD.
Methods: The ERTAAD registry included consecutive patients who underwent surgery for acute type A aortic dissection (TAAD) at 18 European centers of cardiac surgery.
Background: The use of venoarterial extracorporeal membrane oxygenation (VA-ECMO) after coronary artery bypass grafting (CABG) is associated with high in-hospital mortality rates. The pRedicting mortality in patients undergoing venoarterial Extracorporeal MEMBrane oxygenation after coronary artEry bypass gRafting (REMEMBER) score has been created to predict in-hospital mortality in this subgroup of patients. The aim of this study is to externally validate the REMEMBER score.
View Article and Find Full Text PDFSurgical Considerations for Treatment of Fungal Homograft Endocarditis in Re-re-re-re-do.
Thorac Cardiovasc Surg Rep
January 2023
Fungal endocarditis is associated with high surgical mortality rates. Advanced expertise is required for surgical treatment of this serious condition. In the present report, we describe the homograft replacement in a beating heart during re-re-re-re-do in a 29-year-old female patient with fungal endocarditis.
View Article and Find Full Text PDFArticle Synopsis
- A study compared direct aortic cannulation to supra-aortic cannulation methods during surgery for type A aortic dissection to see which leads to better patient outcomes.
- Data from 3,902 patients in the European registry showed that direct aortic cannulation resulted in lower in-hospital mortality (12.7% vs. 18.1%) and fewer postoperative complications, including issues like paralysis and infections.
- The findings suggest that direct aortic cannulation is a safer option for patients undergoing surgery for acute type A aortic dissection.
Objective: The aim of this study was to evaluate the outcomes of different surgical strategies for acute Stanford type A aortic dissection (TAAD).
Summary Background Data: The optimal extent of aortic resection during surgery for acute TAAD is controversial.
Methods: This is a multicenter, retrospective cohort study of patients who underwent surgery for acute TAAD at 18 European hospitals.
Purpose: To evaluate the impact of individual institutions on the outcome after surgery for Stanford type A aortic dissection (TAAD).
Methods: This is an observational, multicenter, retrospective cohort study including 3902 patients who underwent surgery for TAAD at 18 university and non-university hospitals.
Results: Logistic regression showed that four hospitals had increased risk of in-hospital mortality, while two hospitals were associated with decreased risk of in-hospital mortality.
Objective. Available evidence suggests that a minimally invasive approach with the use of sutureless bioprostheses has a favorable impact on the outcome of patients undergoing aortic valve replacement (AVR). Methods.
View Article and Find Full Text PDF(1) Background: Acute Stanford type A aortic dissection (TAAD) may complicate the outcome of cardiovascular procedures. Data on the outcome after surgery for iatrogenic acute TAAD is scarce. (2) Methods: The European Registry of Type A Aortic Dissection (ERTAAD) is a multicenter, retrospective study including patients who underwent surgery for acute TAAD at 18 hospitals from eight European countries.
View Article and Find Full Text PDFHeterotopic heart transplantation (HHT) is an alternative to the orthotopic technique in selected patients with terminal heart failure. We report the case of the longest survival after HHT, with an uneventful follow-up for over three decades after transplantation. At the age of 25 years, endomyocardial fibrosis following myocarditis rendered the patient's native heart unable to maintain the body's needs.
View Article and Find Full Text PDFObjective: The aim of this study was to evaluate the early and mid-term results after the frozen elephant trunk (FET) procedure for the treatment of complex arch and proximal descending aortic disease in a single-center institution.
Methods: From April 2015 to July 2021, 72 patients (25 women, 60.4 ± 10.
Targeting Procalcitonin Protects Vascular Barrier Integrity.
Am J Respir Crit Care Med
August 2022
Capillary leakage frequently occurs during sepsis and after major surgery and is associated with microvascular dysfunction and adverse outcome. Procalcitonin is a well-established biomarker in inflammation without known impact on vascular integrity. We determined how procalcitonin induces endothelial hyperpermeability and how targeting procalcitonin protects vascular barrier integrity.
View Article and Find Full Text PDFBackground: Orthotopic heart transplantation (OHT) is associated with a high incidence of conduction disturbances (CD) leading to permanent pacemaker (PPM) implantation. However, the improved posttransplant survival raises the question about the pacemaker dependence (PD) in a prolonged follow-up.
Hypothesis: The prevalence of PPM in OHT is high but not all patients are PD in a very long-term follow-up.
Background: The extent of aortic replacement for aneurysms of the distal ascending aorta remains controversial and opinions vary between standard cross-clamp resection and open hemiarch anastomosis in circulatory arrest and selective cerebral perfusion. As the deleterious effects of extended circulatory arrest are well-known, borderline indication for distal ascending aorta aneurysm repair must be outweighed against the potential risk of complications related to the open anastomosis. In the present study, we describe our own approach consisting of "transversal arch clamping" for exhaustive resection of aneurysms of the distal ascending aorta without open anastomosis and we present the postoperative outcomes.
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