Publications by authors named "Antonio Salsano"
Article Synopsis
- * A network meta-analysis of various studies found that coronary artery bypass grafting (CABG) had the lowest late mortality rate, while the combination of subvalvular repair and annuloplasty showed promising results for reducing early death and hospital readmissions.
- * Although the combination treatment displayed potential benefits, the authors emphasize the need for more research to confirm these findings and ensure proper assessment of outcomes.
Article Synopsis
- Type A acute aortic dissection (TAAAD) is a serious medical emergency requiring immediate surgical intervention, and understanding treatment options is crucial for improving patient outcomes.
- A multicenter observational registry called AoArch has been established, combining data from four cardiac surgery centers in Europe to analyze the effects of hemiarch repair (HAR) versus extended arch repair (EAR) on patient outcomes following TAAAD surgery.
- The study will assess various factors, such as patient co-morbidities and surgical strategies, to measure both early and late adverse events, with a focus on defining mortality rates and complications related to TAAAD treatments.
Article Synopsis
- * It included 100 patients, finding that 38% experienced POAF, which was associated with increased levels of fibrosis, inflammation, and specific gene expression related to fibrosis in the heart tissue.
- * The research identified elevated TMAO levels (≥61.8 ng/mL), low preoperative hemoglobin, and impaired right ventricular function as independent risk factors for developing POAF, highlighting the significance of TMAO in cardiac health post-surgery.
Introduction: In the absence of clinical trials, the benefit of endovascular therapy (EVT) on the treatment of acute ischemic stroke (AIS) with primary distal and medium vessel occlusions (DMVO) is still not well defined. The aim of the study is to evaluate EVT with or without intravenous thrombolysis (EVT ± IVT) in primary DMVO stroke in comparison with a control cohort treated with IVT alone.
Methods: We analysed all consecutive AIS with proven primary DMVO.
[Choice of the prosthetic valve in patients aged between 55 and 70 years].
G Ital Cardiol (Rome)
April 2024
Article Synopsis
- * Prosthetic valves fall into two main types: biological valves, which can degrade over time, and mechanical valves, which last longer but require ongoing anticoagulation medication.
- * Choosing between biological and mechanical valves is particularly tough for patients aged 55 to 70, so discussions with surgeons about individual preferences and specific health conditions are crucial for making the best decision.
Article Synopsis
- Previous studies on enhanced recovery after surgery (ERAS) protocols in cardiac surgery showed positive outcomes, but comprehensive data from randomized studies were lacking, prompting this analysis of randomized controlled trials (RCTs) comparing ERAS-like protocols to standard care.* -
- The meta-analysis included 13 RCTs with 1,704 participants, finding no significant difference in in-hospital mortality between ERAS and standard groups, but ERAS was linked to shorter ICU and hospital stays and lower overall complication rates, particularly stroke.* -
- The results indicate that while ERAS-like protocols do not affect short-term survival, they facilitate quicker recovery and discharge from the hospital while potentially reducing complications.*
Background: While surgery is almost always indicated for acute type A aortic dissections (ATAADs), the extent of surgery is often debated, with some surgeons preferring a conservative option and others preferring a more radical option This study aims to assess the outcome after surgery for ATAAD and the prognostic impact of surgical strategy (with without aortic arch replacement).
Methods: Data was gathered between 1 January 2005 and 31 December 2021 and retrospectively analyzed with multivariable logistic and Cox regression to ascertain risk factors and survival respectively.
Results: A total of 601 patients underwent type A aortic dissection repair across the recruiting centers with an operative mortality of 24.
Background: Infective endocarditis (IE) is a serious disease, and in many cases, surgery is necessary. Whether the type of prosthesis implanted for aortic valve replacement (AVR) for IE impacts patient survival is a matter of debate. The aim of the present study is to quantify differences in long-term survival and recurrence of endocarditis AVR for IE according to prosthesis type among patients aged 40 to 65 years.
View Article and Find Full Text PDFUnlabelled: Type A acute aortic dissection (TAAAD) is a serious condition within the acute aortic syndromes that demands immediate treatment. Despite advancements in diagnostic and referral pathways, the survival rate post-surgery currently sits at almost 20%. Our objective was to pinpoint clinical indicators for mortality and morbidity, particularly raised arterial lactate as a key factor for negative outcomes.
View Article and Find Full Text PDFType A acute aortic dissection is associated with significant morbidity and mortality, with prompt referral imaging and management to tertiary referral centers needed urgently. Surgery is usually needed emergently, but the choice of surgery often varies depending on the patient and the presentation. Staff and center expertise also play a major role in determining the surgical strategy employed.
View Article and Find Full Text PDFArticle Synopsis
- - The study focused on octogenarian patients undergoing minimally invasive valve surgery to evaluate early mortality, major complications, and mid-term mortality predictors, given the increasing average age of patients with valve diseases.
- - Out of 130 patients analyzed, the operative mortality rate was 6%, with one-year and five-year survival rates at 86% and 64%, respectively; age and creatinine levels were identified as significant predictors of mid-term mortality.
- - The findings suggest that age should not be a strict barrier to performing minimally invasive valve surgery, and it's important to identify which patients may benefit most for better outcomes.
Article Synopsis
- The study investigates sex-specific differences in patients undergoing Type A Acute Aortic Dissection (TAAAD) repair, revealing that women tend to be older and have poorer pre-operative health compared to men.
- Data was gathered from three cardiac surgery departments over a 16-year period, and statistical methods were used to analyze the influence of gender on surgical outcomes.
- Despite significant differences in patient profiles, the study found no notable difference in long-term survival rates or postoperative complications between male and female patients, although women with high preoperative arterial lactate levels faced higher operative mortality.
Article Synopsis
- The study aimed to assess the effectiveness of subvalvular repair (SV-r) combined with restrictive annuloplasty (RA-r) for treating ischemic mitral regurgitation (IMR), as current guidelines lack specific recommendations on this approach.
- Researchers analyzed data from 96 patients with severe IMR undergoing either SV-r + RA-r or just RA-r, focusing on treatment failure rates and the long-term outcomes related to recurrent mitral regurgitation (MR) and heart remodeling.
- Results showed that patients receiving the SV-r + RA-r combination had a significantly lower treatment failure rate and better outcomes at 5 years compared to those who only had RA-r, highlighting that SV-r enhances the durability of the surgical repair and
Article Synopsis
- The study aimed to assess the outcomes of isolated coronary artery bypass grafting (CABG) in patients with or without revascularization of the occluded right coronary artery (RCA).
- Based on a large European registry, the analysis included 724 patients with RCA occlusion, revealing that one-third did not undergo revascularization, showing variability among medical centers.
- Results indicated that patients without RCA revascularization had a higher 5-year all-cause mortality rate (17.7%) and an increased risk of major adverse cardiovascular and cerebrovascular events (MACCE) compared to those who had the procedure (24.7% vs. 15.7%).
Article Synopsis
- The study aimed to evaluate how the experience of surgeons and the volume of surgeries performed at hospitals affect early results in patients undergoing off-pump coronary artery bypass (OPCAB) surgery.
- A total of 1,549 patients from a larger registry were analyzed, comparing outcomes between experienced OPCAB surgeons and non-OPCAB surgeons, as well as between high and low volume centres.
- Results indicated that surgeries by experienced surgeons and at high volume centres led to shorter procedure times, fewer complications, lower 30-day mortality rates, and shorter hospital stays, highlighting their importance for better patient outcomes.
Objectives: The aim of the present study was to evaluate the risk of late mortality and major adverse cardiovascular and cerebral events after coronary artery bypass grafting (CABG) in patients with prior percutaneous coronary intervention (PCI).
Methods: A total of 2948 patients undergoing isolated CABGs were included in a prospective multicenter registry. Outcomes were adjusted for multiple covariates in logistic regression, Cox proportional hazards analysis and competing risk analysis.
Article Synopsis
- - This study compares how treatments and outcomes for mechanical complications of acute myocardial infarction (MI) differed during the Covid-19 pandemic versus the period before it, using data from 1998 to 2020.
- - Early mortality rates showed significant differences; surgical treatment had a 15% mortality rate compared to 62.4% for conservative treatment during the pandemic, while pre-pandemic surgical treatment had a higher but not statistically significant mortality rate.
- - Despite an increase in MI complications possibly due to delayed hospital visits during Covid-19, the overall outcomes for surgical and clinical treatments of these complications did not significantly worsen during the pandemic.
Article Synopsis
- The diagnosis of infective endocarditis (IE) is complex and difficult due to various factors.
- Identifying the underlying cause of infections in the heart is crucial for effective treatment but often poses significant challenges.
- Ongoing research is necessary to improve diagnostic methods and enhance understanding of the disease.
Article Synopsis
- The study aimed to compare clinical features and outcomes between culture-positive infective endocarditis (CPIE) and culture-negative infective endocarditis (CNIE) patients, noting that CNIE has a higher mortality rate.
- Researchers analyzed data from 3,113 patients, finding 83.2% had CPIE and 16.8% had CNIE; one-year mortality was notably higher for CNIE patients receiving only medical therapy.
- The findings suggest that while patients with CNIE have poorer long-term outcomes, those who undergo surgery benefit from reduced mortality rates, highlighting the need for improved diagnosis and early identification of CNIE cases.
Article Synopsis
- The study aimed to compare early and late mortality rates in patients with acute isolated tricuspid valve infective endocarditis (TVIE) who underwent either valve repair or replacement.
- A total of 149 patients from a larger registry were evaluated, revealing a 9% early mortality rate and showing that valve repair had lower mortality and complication rates compared to replacement, although these differences were not statistically significant.
- The research concluded that both surgical options resulted in low recurrence rates and good long-term survival for TVIE patients, indicating that the type of surgery has minimal impact on overall outcomes.
Article Synopsis
- The study aimed to compare the clinical course and outcomes of patients with recurrent versus first-episode infective endocarditis (IE), using data from the EURO-ENDO registry.
- A total of 3106 patients were analyzed, revealing that while patients with recurrent IE had a different profile and valve involvement, there were no significant differences in mortality rates between the two groups.
- Both types of IE shared similar predictors for poor outcomes, suggesting that treatment approaches may need to be similarly aggressive regardless of the patient's history with the disease.
Article Synopsis
- A 74-year-old male developed a rare sternal wound infection with acid-fast bacilli after cardiac surgery, which was only identified post-mortem.* -
- The infection was complicated by a previous SARS-CoV-2 infection, worsening his clinical condition.* -
- It's important to maintain a high level of suspicion for such infections to prevent unnecessary treatments and serious health outcomes.*
Article Synopsis
- There is limited longitudinal data comparing quality of life (QoL) after full sternotomy aortic valve replacement (fsAVR) versus ministernotomy aortic valve replacement (msAVR).
- A study involved 1844 patients, with 187 pairs matched based on baseline characteristics, assessing QoL over time using the Short Form-36 scale.
- Results indicated that while the fsAVR group had a worse preoperative risk profile and longer ICU stays, both surgical methods resulted in similar QoL improvements after one year, with no significant differences between the two approaches.
Article Synopsis
- - *The study examines outcomes for cardiac surgery patients in Italy during the COVID-19 pandemic, specifically focusing on the impact of COVID-19 status on mortality rates.* - *Out of 1354 patients analyzed, 3.5% were positive for SARS-CoV-2, and those in the COVID-positive group had significantly higher in-hospital mortality rates (20.8% vs. 0.9%).* - *The findings suggest that being COVID-positive, older age, and low oxygen saturation at admission are key risk factors for increased in-hospital mortality among cardiac surgery patients.*