Microbial biofilm correlates with an increased antibiotic tolerance and poor therapeutic outcome in infective endocarditis.

Background: Infective endocarditis (IE) is associated with high rates of mortality. Prolonged treatments with high-dose intravenous antibiotics often fail to eradicate the infection, frequently leading to high-risk surgical intervention. By providing a mechanism of antibiotic tolerance, which escapes conventional antibiotic susceptibility profiling, microbial biofilm represents a key diagnostic and therapeutic challenge for clinicians.

Surgical treatment of isolated tricuspid valve infective endocarditis: 25-year results from a multicenter registry.

Background: To assess early and late mortality in patients with isolated acute tricuspid valve infective endocarditis (TVIE) using data from a multicenter registry.

Methods: From 1983 to 2018, isolated acute TVIE was surgically treated in 157 (3.8%) patients [mean age 47 ± 16 years (range 15-86 years), 25% females].

Use of Dithiothreitol to Dislodge Bacteria From the Biofilm on an Aortic Valve in the Operating Theatre: A Case of Infective Endocarditis Caused by Staphylococcus aureus and Proteus mirabilis.

This is the first reported case of 2 biofilm-producing bacteria, Staphylococcus aureus and Proteus mirabilis, identified from an aortic valve using an innovative device with dithiothreitol solution, able to dislodge bacterial biofilm. The method is usable in the operating theatre and recommended in infective endocarditis nonresponders to empiric therapy.

Can Drainage Using a Negative-Pressure Wound Therapy Device Replace Traditional Sample Collection Methods?

Background: In 2015 a new device for the collection of mediastinal fluid from patients with deep sternal wound infection (DSWI) in the presence of negative-pressure wound therapy (NPWT) became available. The present study was designed to evaluate whether changing sample collection devices increased micro-organism detection in patients undergoing NPWT.

Methods: During 2013-2014, 207 samples were collected and cultured from NPWT patients (n = 23) to demonstrate the presence of DSWI using reticulated polyurethane sponge culture, a swab, and blood culture.

Chronic histological transmurality of high-intensity focused ultrasound ablation.

We evaluated histologic results for surgical left maze with an high-intensity focused ultrasound (HIFU) energy source. Two patients came to our attention 6 and 48 months, respectively, after ablation concomitant to a valve procedure. Tissue specimens, obtained from the lesion site on the mitral isthmus and from the "box lesion" around the pulmonary veins were analyzed histologically.

Endovascular repair of ascending aortic pseudoaneurysm in a high-risk patient.

Mycotic ascending aortic pseudoaneurysm (AAP) is an uncommon but surgically challenging problem with high morbidity and mortality rates. We describe endovascular repair of an acute mycotic AAP in a high-risk patient. A 45-year old man, HIV serum positive, chronic hepatitis HBV and HCV related, presented, after two sternotomies, with a fast growing 11 6 cm AAP that was sealed with two Gore Exluder aortic cuffs, inserted from the left axillary artery.

The use of magnetic resonance in myocardial ischaemia.

Despite the efforts that have been made at an international level to identify and control cardiovascular risk factors, cardiopathies and, in particular, coronary artery disease (CAD), remain the principal cause of death in Europe and the United States. These data confirm the importance and necessity of noninvasive, reliable diagnostic imaging of early CAD. Coronary angiography is still the hinge, around which all instrumental and laboratory investigations turn, for cardiac ischaemia today.

Mitral valve annuloplasty and myocardial revascularization in the treatment of ischemic dilated cardiomyopathy.

The aim of this study was to examine perioperative mortality and morbidity and midterm results in patients undergoing coronary bypass graft and mitral valve annuloplasty with advanced dilated cardiomyopathy. Sixty-one patients with ischemic dilated cardiomyopathy underwent coronary artery bypass grafting and mitral valve annuloplasty between January 1998 and December 2003. Patients eligible for revascularization that presented a mild or more severe mitral valve regurgitation at echocardiography (effective regurgitant orifice > 0.

Acute coronary syndromes without persistent st-segment elevation: advances in surgical revascularization.

Coronary artery bypass grafting (CABG) still plays a fundamental role in the management of acute coronary syndromes. The aim of this study is to report the experience of our center in the treatment of patients with acute coronary sindromes without persistent ST elevation urgently operated on with CABG, and to discuss surgical problems related. Two-hundred and six patients were urgently operated on for CABG for acute coronary syndromes without persistent ST-segment elevation from January 2001 to February 2003.