Publications by authors named "Cosimo Angelo Greco"
Aortic valve replacement (AVR) in a patient with a bio-Bentall conduit can be very challenging, especially if there was a previous endocarditis process for significant morbidity and mortality. We report a case of sutureless AVR in an old patient with a bio-Bentall conduit (Carpentier-Edwards Perimount Magna Ease 25 aortic valve and Hemashield 30 aortic conduit), who developed an endocarditis on aortic prosthesis valve. We believe that sutureless AVR is the best option for redo-operation in older patients with a high surgical risk because it allows for easy rapid deployment implantation, avoids anchoring sutures on a fragile aortic anulus, and reduces cardiopulmonary and aortic cross-clamp times.
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- * Echocardiography is the primary and recommended imaging technique for diagnosing IE, particularly when time is critical, and should be conducted immediately upon suspicion of the disease.
- * While repeated echocardiography is advised for patients with persistent suspicion of IE despite negative initial results, systematic screening should only occur when there are clear clinical indicators to avoid false positives and unnecessary complications.
Article Synopsis
- The Italian Society of Echography and Cardiovascular Imaging (SIECVI) conducted a national survey to investigate stress echocardiography (SE) practices across Italy, collecting data from 228 laboratories in November 2022.
- The survey revealed that out of 179 centers performing SE, most were located in northern Italy, and the study categorized them into low, moderate, and high volume of activity based on the number of SE examinations.
- Key findings indicated differences in the use of stressors, with a tendency for high-volume centers to employ multiple stress techniques and incorporate advanced evaluations like coronary flow velocity reserve (CFVR) more frequently than low and moderate volume centers.
Background: The Italian Society of Echocardiography and Cardiovascular Imaging (SIECVI) conducted a national survey to understand better how different echocardiographic modalities are used and accessed in Italy.
Methods: We analyzed echocardiography laboratory activities over a month (November 2022). Data were retrieved via an electronic survey based on a structured questionnaire, uploaded on the SIECVI website.
Article Synopsis
- Internuclear ophthalmoplegia (INO) is a condition related to eye movement issues caused by brainstem lesions, often associated with acute ischemic strokes (AIS), but it's rarely the main symptom that leads to treatment.
- This study details a unique case of a patient who experienced INO upon waking and highlights the use of magnetic resonance imaging (MRI) to confirm the stroke's nature and ensure the patient was eligible for intravenous thrombolysis (IVT).
- Post-treatment, the patient fully recovered with complete resolution of INO and follow-up MRI showed no ischemic lesions, underscoring the effectiveness of IVT in such cases and advocating for MRI to be performed promptly in similar situations.
Article Synopsis
- Left atrial intramural hematoma (LAIH) is a rare but serious condition that requires quick diagnosis to make treatment decisions.
- Causes of LAIH can include cardiac procedures, and while advanced imaging techniques like CT and MRI are effective, they're not always accessible.
- This case study showcases how echocardiography can be helpful in diagnosing LAIH in critically ill patients, highlighting a particular instance where LAIH occurred after a catheter ablation, leading to serious complications that necessitated surgery.
Article Synopsis
- This study investigates how echocardiographic laboratories in Italy were organized and operated during the second wave of the COVID-19 pandemic, comparing it to the same period in 2019.
- Findings show significant reductions in both hospital and outpatient echocardiographic activities, with many labs partially or fully interrupted during the pandemic.
- Safety measures improved for operators, with a widespread use of personal protective equipment, and the study noted an increase in outpatient waiting times for echocardiograms and a rise in the use of point-of-care cardiac ultrasound during the pandemic.
Congenital double orifice mitral valve or surgical Alfieri stich?
Eur Heart J Cardiovasc Imaging
February 2021
Article Synopsis
- Takotsubo syndrome involves a temporary malfunction of the left ventricle that isn't linked to typical heart artery issues and often occurs after stress.
- A case study discusses this syndrome in a newborn experiencing acute heart failure and severe mitral regurgitation after stress during delivery due to a twisted umbilical cord.
- The dysfunction observed was regional and could be related to stress at birth leading to a surge in stress hormones, affecting heart function.
[More risks and fewer treatments: the paradox about elderly patients with acute coronary syndromes].
Ital Heart J Suppl
February 2002
Article Synopsis
- The majority of patients experiencing acute coronary syndromes are elderly, who face a significantly higher short-term mortality rate compared to younger individuals, often due to delays in hospital arrival that negate the benefits of timely reperfusion treatment.
- Despite their high-risk status, elderly patients receive critical treatments like thrombolytics and beta-blockers less frequently than younger patients; concerns about bleeding risks from these therapies contribute to their limited use.
- Effective management of elderly patients involves careful risk assessment to determine suitability for thrombolytic therapy versus alternative interventions, with an emphasis on prioritizing invasive procedures for those with manageable bleeding risk, ultimately improving their quality of life.