A pilot study on the efficacy and safety of a minimally invasive surgical and anesthetic approach for ventricular assist device implantation.

Background: The aim of our study was to compare 2 surgical and anesthetic approaches during ventricular assist device implantation.

Methods: 68 patients (50.4 ± 17.

Impact of Changes in Left Ventricular Ejection Fraction on Survival After Transapical Aortic Valve Implantation.

Background: This single-center retrospective study assessed the variation of left ventricular ejection fraction (LVEF) after transapical transcatheter aortic valve implantation and its effect on survival. We also evaluated the effect of sheath diameter on LVEF.

Methods: We analyzed data of all consecutive patients who underwent transapical transcatheter aortic valve implantation with the Sapien (Edwards Lifesciences, Irvine, CA) device (and its evolutions) between 2009 and 2015.

Early and Midterm Clinical and Hemodynamic Outcomes of Transcatheter Valve-in-Valve Implantation: Results From a Multicenter Experience.

Background: Transcatheter valve-in-valve (VIV) implantation is an alternative option in inoperable or high-risk patients with prosthetic valve dysfunction. Aim of this retrospective multicenter study was to evaluate early and midterm clinical and hemodynamic outcomes of patients undergoing aortic (VIV-A) and mitral VIV (VIV-M).

Methods: We analyzed data of 66 procedures performed in 65 patients who underwent VIV procedures in the VIV-A and VIV-M position at 5 Italian institutions from January 2008 to May 2015.

Single vs double antiplatelet therapy in acute coronary syndrome: Predictors of bleeding after coronary artery bypass grafting.

Aim: To investigate the contribution of anti-platelet therapy and derangements of pre-operative classical coagulation and thromboelastometry parameters to major bleeding post-coronary artery bypass grafting (CABG).

Methods: Two groups of CABG patients were studied: Group A, treated with aspirin alone (n = 50), and Group B treated with aspirin and clopidogrel (n = 50). Both had similar preoperative, clinical, biologic characteristics and operative management.

Conventional surgery, sutureless valves, and transapical aortic valve replacement: what is the best option for patients with aortic valve stenosis? A multicenter, propensity-matched analysis.

Objective: Although surgical aortic valve replacement (SAVR) is the treatment of choice for patients with aortic valve stenosis, transcatheter aortic valve replacement (TAVR) and sutureless aortic valve replacement (SU-AVR) have shown good results. The aim of our multicenter, propensity-matched study was to compare the clinical and hemodynamic outcomes of surgical SAVR, transapical TAVR (TA-TAVR), and SU-AVR.

Methods: We analyzed data from 566 TA-TAVR, 349 SAVR, and 38 SU-AVR patients treated from January 2009 to March 2012.

Aortic valve hydrodynamics: considerations on the absence of sinuses of Valsalva.

Background And Aim Of The Study: The study aim was to compare the hydrodynamics of the Carpentier-Edwards Magna 21 (CEM) and St. Jude Medical Biocor-Epic-Supra 21 (SJME) valves at increasing stroke volume and pulse rate in two different aortic conduits, namely straight and with sinuses of Valsalva present.

Methods: Both valve types were tested in the aortic chamber of the Sheffield pulse duplicator, at rates of 70, 80 and 90 beats/min, and stroke volumes of 50 and 60 ml.

The impact of transcatheter aortic valve implantation on patients' profiles and outcomes of aortic valve surgery programmes: a multi-institutional appraisal.

Objectives: The aim of this retrospective multicenter study was to assess how the development of transcatheter aortic valve implantation (TAVI) influenced the characteristics and outcomes of patients undergoing aortic valve procedures.

Methods: We reviewed 1395 patients who underwent isolated surgical aortic valve replacement (SAVR) or TAVI in three centres with a high-volume TAVI programme. Patients were divided into two groups: 'Pre-TAVI' (395 patients, 28.

Gender differences and role of pregnancy in the history of post-surgical women affected by tetralogy of Fallot.

Background: The aim of this study was to describe gender differences in patients operated on for TOF and to define the impact of pregnancy in late post-surgical follow-up in women.

Methods: In this research, we studied 145 patients after correction of TOF: 66 male, 79 women, 41 of which reported history of 68 pregnancies, means age 37±10 years, age at operation 7±8 years, mean duration of post-surgical follow-up 30±7 years. Selected variables were compared according to sex and according to history of pregnancy with statistical tests.

Carpentier-Edwards Magna ease versus Magna valves: a comparison of in-vitro valve hydrodynamic performance.

Background And Aim Of The Study: Previous studies have shown that the Carpentier-Edwards Magna (CEM) valve is an excellent bioprosthesis in terms of its systolic performance; indeed, it has been described as 'a stented valve with stentless performance'. However, valve performance is not only a matter of gradients; it is also necessary to evaluate the diastolic-phase performance. Previous in-vitro studies have shown that the CEM has an excessive total regurgitant volume.

In vitro comparison of different mechanical prostheses suitable for replacement of the systemic atrioventricular valve in children.

Objective: The aim of the present study was to compare the hydrodynamics of 4 different mechanical prostheses fitting the atrioventricular annulus in children.

Methods: We tested different inverted aortic prostheses with a prosthesis-annulus relationship in the mitral chamber of the Sheffield pulse duplicator (Department of Medical Physics and Clinical Engineering, Royal Hallamshire Hospital, Sheffield, UK), analyzed by comparing the prosthetic housing diameter and the predicted annulus diameter based on body surface area (0.8 and 1 m(2) corresponding to an annulus diameter of 18.

The changing hydrodynamic performance of the decellularized intact porcine aortic root: considerations on in-vitro testing.

Background And Aim Of The Study: The most effective method for decellularization of the intact porcine aortic root remains controversial. Additionally, the hydrodynamic effect that such treatment may have on aortic roots has never been previously investigated. The study aim was to compare the in-vitro hydrodynamic performances of intact porcine aortic roots, both before and after decellularization treatment.

The fate of Hancock II porcine valve recipients 25 years after implant.

Objective: The Hancock II (HII) is a second-generation porcine bioprosthesis introduced into clinical use in 1982. This study aimed to evaluate very long-term outcomes for the HII valve in a large patient population.

Methods: Between May 1983 and November 1993, 517 consecutive patients (pts) (309 male, mean age: 64+/-9 years) underwent valve replacement (VR) surgery with HII, with 302 (58.

Valve surgery in octogenarians: does it prolong life?

Objectives: Age-related degenerative heart-valve disease is a health issue in the present era. Octogenarians are frequently affected by concomitant diseases and, with the present lack of resources, the risk/benefit of valvular replacement therapy poses serious medical, economical and political challenge. We analysed the long-term survival of 346 octogenarians who underwent 352 operations between 1 January 1987 and 1 January 2009 and we compared it with the survival of the general population, matched for age, sex and operative year.

The changing spectrum of bioprostheses hydrodynamic performance: considerations on in-vitro tests.

The aims of the present study were to compare hydrodynamics of three pericardial and two porcine valves while performing at different stroke volume (SV) and increasing pulse rate (PR). Carpentier-Edwards Magna-21 (CEM), Sorin Soprano-20 (SS), Mitroflow-23 (MF), SJM-Biocor-Epic-Supra-21 (SJME), and Medtronic Mosaic Ultra-23 (MMU) were tested in the aortic chamber (23-mm in diameter) of the Sheffield-Pulse-Duplicator. The tests were carried out at increasing pulse-rate and at each pulse-rate the valve was tested at different SV.

In-vitro testing of three totally supra-annular bileaflet mechanical valves: hydrodynamics in the Sheffield pulse duplicator.

Background And Aim Of The Study: In-vivo echocardiographic studies are limited by several confounding factors and technical pitfalls, and consequently the hypothetical differential hydraulic behavior between different prosthetic heart valves has not been identified. However, for surgeons it is essential to know the functional and geometric characteristics of the prostheses to be used. Herein, the in-vitro performance of two new supra-annular bileaflet prostheses--the Medtronic Advantage Supra and Sorin Bicarbon Overline--was compared with that of the 21-mm St.

Infective endocarditis in bicuspid aortic valve: atrioventricular block as sign of perivalvular abscess.

A 46-year-old man presenting with fever, peripheral edema, and chest pain was admitted to the emergency department. Electrocardiogram showed sinus tachycardia and first-degree atrioventricular block. Transesophageal echocardiogram showed infective endocarditis in bicuspid aortic valve, complicated with severe aortic regurgitation, ring abscess, and sinus-of-Valsalva aneurysm extending to mitroaortic fibrous continuity.

Midterm results of surgical intervention for congenital heart disease in adults: an Italian multicenter study.

Objective: We have analyzed, in a clinical multicenter study, the effect of cardiac surgery in adults with congenital heart disease in Italy.

Methods: We collected clinical data from 856 patients aged 19 years or older who underwent surgical intervention from January 1, 2000, to December 31, 2004. Patients were divided into 3 surgical groups: group 1, palliation (3.

Commissural dehiscence: a rare and peculiar cause of porcine valve structural deterioration.

Objective: Calcification is the main cause of structural valve deterioration; however, other causes of failure have been identified, and among them, dehiscence of a commissure from the stent has been reported in several models of porcine valves. The aim of this study was to analyze the rate and mode of occurrence of this complication in first- and second-generation porcine bioprosthetic explants.

Methods: Among 586 porcine xenografts explanted and analyzed at the Institute of Pathological Anatomy of the University of Padua, 17 (2.

Fifteen-year results with the Hancock II valve: a multicenter experience.

Objectives: The purpose of this multi-institutional study was to review the 15-year outcome of patients who received isolated aortic or mitral valve replacement with the Hancock II bioprosthesis.

Methods: From 1983 through 2002, 1274 patients underwent 1293 isolated valve replacements, 809 aortic valve replacements and 484 mitral valve replacements, at hospitals in the Venetian area (Padova, Treviso, and Venice). Mean age was 68 +/- 8 years in patients undergoing aortic valve replacement and 66 +/- 9 years in patients undergoing mitral valve replacement; 52% of patients undergoing aortic valve replacement and 63% of patients undergoing mitral valve replacement were in New York Heart Association class III or greater.

Clinical results of Hancock II versus Hancock Standard at long-term follow-up.

Objective: We performed a multi-institutional study to compare the long-term structural valve deterioration of isolated Hancock Standard versus Hancock II bioprostheses.

Methods: From 1983 to 2002, 714 Hancock Standard and 1293 Hancock II bioprostheses were implanted at hospitals of the Venetian territory (Padova, Treviso, and Venice). Follow-up on January 1, 2003, included 14,749 patient-years with a median of 12 years and was 96% complete: 115 Hancock Standard and 53 Hancock II bioprostheses were at risk at 15 years.

How to deal with recipients of valves prone to structural failure in the 2000s: Padua experience with the TRI Technologies valve.

Background: TRI Technologies (TT) valves evidenced a propensity to structural failure, consisting in fracture of the pivoting system, leading to leaflet escape. At our institution, between 2000 and 2002, 36 TT valves were implanted in 34 patients. Here we report the final results of the Tritech survey program.