Publications by authors named "Francesco Soriano"
Article Synopsis
- Tricuspid insufficiency used to be thought of as not very important, but new research shows it actually plays a big role in causing problems with the right side of the heart.
- New technology is making it possible to treat patients who were too risky for regular surgery, helping them feel better and live better lives.
- The focus now is on getting patients the right care by sending them to specialized centers that know how to diagnose and treat this condition effectively.
Background: There is a growing need for percutaneous coronary intervention (PCI) to be performed within the same transcatheter aortic valve implantation (TAVI) procedure. In such cases, cangrelor, a fast-acting intravenous P2Y12-inhibitor with a short offset, is potential clinical utility to minimize bleeding and vascular complications during large-bore arterial access (LBAA) as well as the thrombotic risk associated with concomitant PCI.
Case Summary: We report two cases of TAVI with an indication to concomitant, high-risk PCI.
Article Synopsis
- * Triple therapy with oral anticoagulants and dual antiplatelet therapy is recommended initially for optimal protection against stroke and stent thrombosis, typically starting for seven days and potentially extending to thirty for high-risk patients.
- * Treatment must be personalized based on drug characteristics and patient specifics, considering factors like the complexity of the procedure, anticoagulant dosing, and management of atrial fibrillation to effectively balance risks of bleeding and ischemic events.
Article Synopsis
- - The study focused on evaluating the performance of the ACURATE Neo2 transcatheter heart valve (THV) in patients with a horizontal aorta (HA), which is linked to worse outcomes after heart valve procedures.
- - Results showed that while both ACURATE Neo and Neo2 valves had similar success rates, the Neo2 valve significantly reduced the occurrence of moderate or severe paravalvular leak (PVL) compared to the Neo valve (5% vs. 15%).
- - The findings suggest that the Neo2 valve is a better option for patients with HA, offering improved PVL rates without compromising device success in the shorter term follow-up.
Article Synopsis
- The study aimed to evaluate the prognosis and clinical impact of moderate aortic stenosis, as its mortality risk was previously unclear, with a focus on how patient characteristics affect survival.* -
- Researchers analyzed 15 studies involving over 11,500 patients and found significantly higher all-cause mortality rates in those with moderate aortic stenosis compared to controls, regardless of other factors like left ventricular ejection fraction and sex.* -
- The results indicated that age significantly influenced mortality risk, suggesting that older patients with moderate aortic stenosis face a greater risk, and called for further research on the potential benefits of aortic valve replacement.*
Severe tricuspid regurgitation is associated with the occurrence of right failure and increased morbidity and mortality. Transcatheter heterotopic bi-caval valve implantation might offer symptom relief in these patients that are often at prohibitive surgical risk.
View Article and Find Full Text PDFBackground: Patients with severe aortic stenosis (AS) and complex coronary artery disease with a clinical indication to both transcatheter aortic valve implantation (TAVI) and percutaneous coronary intervention (PCI) pose a clinical dilemma since it is unclear which lesion should be treated first and careful planning is required.
Case Summary: We report two cases of AS with complex PCI (ASCoP) features. In the first one, easy coronary cannulation with an Acurate Neo2 valve and commissural alignment was predicted; therefore, TAVI was performed first, and subsequently complex high-risk PCI of the left main was performed in the same procedure but without the burden of ongoing severe AS.
Background Acute kidney injury (AKI) after transcatheter aortic valve replacement (TAVR) is associated with increased mortality. However, it is controversial whether AKI affects prognosis per se, being linked to baseline chronic kidney disease (CKD) and bleeding complications. The aim of this study was to disentangle, applying mediation analysis, the association between AKI and clinical outcome, considering CKD and bleedings.
View Article and Find Full Text PDFAims: As the indications to transcatheter aortic valve replacement (TAVR) expand to patients at increasingly lower risk, procedure-related vascular and bleeding complications events must be minimized. We aimed to evaluate the impact of different large-bore arterial access closure devices on clinical outcomes after TAVR.
Methods And Results: We searched for papers that reported outcomes according to the type of vascular closure device/technique used after TAVR and performed a Bayesian network meta-analysis (NMA).
Background: The first-generation ACURATE neo transcatheter heart valve (THV) (Boston Scientific) was associated with a non-negligible occurrence of moderate or greater paravalvular aortic regurgitation (AR) following transcatheter aortic valve replacement. To overcome this issue, the ACURATE neo2 iteration, which incorporates a taller outer skirt aimed at reducing the occurrence of paravalvular AR, has recently been developed.
Objectives: The aim of this study was to assess the efficacy and safety of the ACURATE neo2 (Boston Scientific) THV in patients with severe aortic valve stenosis.
Background: Transcatheter Aortic Valve Implantation (TAVI) is beneficial in patients with symptomatic severe Aortic Stenosis (AS). There is no consensus about the best anticoagulation strategy for patients with a recent TAVI and with atrial fibrillation (AF). Direct oral anticoagulants (DOACs) are effective to prevent embolic events with a significant lower incidence of bleeding.
View Article and Find Full Text PDFArticle Synopsis
- Acute myocarditis (AM) is recognized as a rare but serious cardiovascular complication in COVID-19 patients, with a study analyzing data from 112 suspected cases in hospitalized patients across the U.S. and Europe.
- The prevalence of definite/probable AM was found to be 2.4 per 1000 hospitalizations, with common symptoms including chest pain and dyspnea, particularly in younger adults averaging 38 years of age.
- The study revealed significant challenges, such as 20.4% experiencing in-hospital mortality or requiring advanced support, with a notably higher mortality rate in patients who also had pneumonia.
Background: Cardiovascular complications of severe acute respiratory distress syndrome coronavirus 2 (SARS-CoV2) are known to be associated with poor outcome. A small number of case series and reports have described cases of myocarditis and ischaemic events, however, knowledge on the aetiology of acute cardiac failure in SARS-CoV2 remains limited. We describe the occurrence and risk stratification imaging correlates of 'takotsubo' stress cardiomyopathy presenting in a patient with Coronavirus Disease 2019 (COVID-19) in the intensive care unit.
View Article and Find Full Text PDFThe Publisher regrets that this article is an accidental duplication of an article that has already been published, https://doi.org/10.1016/j.
View Article and Find Full Text PDFBackground And Aims: Uric Acid (UA) has been related to the development of Cardio-Vascular (CV) events in patients affected by Chronic Coronary Syndromes (CCS). Among various hypothesis, two arise: UA may negatively act on coronary artery determining a higher degree of atherosclerotic disease, and/or on heart determining a higher prevalence of diastolic dysfunction. Both the above hypothesized effects are object of our investigation.
View Article and Find Full Text PDFWe report a 55-year-old woman with a history of hypothyroidism and type 2 diabetes mellitus who consulted at the emergency room because of intermittent oppressive chest discomfort. At admission, electrocardiogram showed a complete atrioventricular block. A transthoracic echocardiogram disclosed severe left ventricular dysfunction.
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- Radiation Induced Heart Disease (RIHD) is a serious condition that can develop in cancer patients who have undergone chest radiation, leading to increased mortality by affecting various heart structures.
- A study compared 115 patients who had chest irradiation without traditional cardiovascular risk factors to a control group of 135 patients with risk factors, evaluating their heart health using exercise stress electrocardiography.
- Despite the irradiated group being younger and having fewer traditional risk factors, there was no significant difference in the rate of ischemia detected through stress tests between the two groups, highlighting that radiation itself is a significant cardiovascular risk.
We report a 65-years old woman with a history of permanent atrial fibrillation with high risk for ischemic and bleeding events. She developed a heart failure with severely impaired left ventricular ejection fraction and severe secondary mitral regurgitation. Given her high surgical risk, using transesophageal echocardiography guidance, a concomitant deployment of two MitraClip devices using a high-posterior septal puncture and a left atrial appendage closure with an Amplatzer Amulet occluder were performed through the same access.
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