Background: Surgical ventricular reshaping (SVR) is a treatment option for patients with severe ischaemic heart failure (HF). Recently, a new minimally invasive, hybrid technique named "less invasive ventricular enhancement" (LIVE), has been developed adopting the Reviven™ Myocardial Anchoring System (BioVentrix Inc., San Ramon, CA, USA).
View Article and Find Full Text PDFPeripheral extracorporeal membrane oxygenation (ECMO) setting remains a valid option to treat cardiogenic shock (CS). We investigated a percutaneous approach to unload the left ventricle (LV) while on veno-arterial (v-a) peripheral ECMO support. Between 2017 and 2018, eight patients (three females, mean age: 49.
View Article and Find Full Text PDFRight ventricular failure after continuous-flow left ventricular assist device (LVAD) implantation is still an unsolved issue and remains a life-threatening event for patients. We undertook this study to determine predictors of the patients who are candidates for isolated LVAD therapy as opposed to biventricular support (BVAD). We reviewed demographic, echocardiographic, hemodynamic, and laboratory variables for 258 patients who underwent both isolated LVAD implantation and unplanned BVAD because of early right ventricular failure after LVAD insertion, between 2006 and 2017 (LVAD = 170 and BVAD = 88).
View Article and Find Full Text PDFExpert Rev Med Devices
December 2017
Right ventricular failure (RVF) still results as the major cause of morbidity and mortality after left ventricular assist device (LVAD) implantation. Despite overall improved outcomes and lower rates of RVF with the use of the newer, continuous-flow (CF) LVADs over pulsatile-flow devices, and development of clinical prediction scores to facilitate preoperative identification of patients at risk for RVF after implantation, RVF occurs in 13% to 40% of continuous-flow device. Areas covered: In this article, a review has been carried out on the current evidence for preoperative assessment of RV function and RVF risk for appropriate patient selection mainly focusing on current imaging and invasive assessment tools.
View Article and Find Full Text PDFBackground: Primary graft dysfunction (P-GD) is the leading cause of early mortality after heart transplantation (HT). In this 2-center study we analyze outcomes and risk factors of P-GD according to the recent consensus conference classification endorsed by International Society for Heart and Lung Transplantation.
Methods: We included all adult HTs performed between 1999 and 2013.
Early graft failure (EGF) is a major risk factor for death after heart transplantation (Htx). We investigated the predictive risk factors for moderate-to-severe EGF requiring an intra-aortic balloon pump (IABP) or extracorporeal membrane oxygenation (ECMO) circulatory support as treatment after Htx. Between January 2000 and December 2014, 412 consecutive adult patients underwent isolated Htx at our institution.
View Article and Find Full Text PDFObjectives: Aortic root replacement using a composite graft is the treatment of choice for a large variety of aortic root conditions with a diseased aortic valve. The objective of the current study was to evaluate the long-term results of this procedure.
Methods: Between 1978 and 2010, 1045 patients aged 58.
Background: Acute fulminant myocarditis (AFM) may represent a life-threatening event, characterized by rapidly progressive cardiac compromise that ultimately leads to refractory cardiogenic shock or cardiac arrest. Venoarterial extracorporeal membrane oxygenation (VA-ECMO) provides effective cardiocirculatory support in this circumstance, but few clinical series are available about early and long-term results. Data from a multicenter study group are reported which analyzed subjects affected by AFM and treated with VA-ECMO during a 5-year period.
View Article and Find Full Text PDFCombined orthotopic heart and liver transplantation (CHLT) is a lifesaving procedure for patients with end-stage heart-liver disease. We reviewed the long-term outcome of patients who have undergone CHLT at the University of Bologna, Italy. Fifteen patients with heart and liver failure were placed on the transplant list between November 1999 and March 2012.
View Article and Find Full Text PDFBackground: RotaFlow and Levitronix CentriMag veno-arterial extracorporeal membrane oxygenation (ECMO) support systems have been investigated as treatment for refractory cardiogenic shock (CS).
Methods: Between 2004 and 2012, 119 consecutive adult patients were supported on RotaFlow (n = 104) or CentriMag (n = 15) ECMO at our institution (79 men; age 57.3 ± 12.
Background: The RotaFlow (Maquet, Jostra Medizintechnik AG, Hirrlingen, Germany) and Levitronix CentriMag (Levitronix LCC, Waltham, MA, USA) veno-arterial extracorporeal membrane oxygenation (ECMO) support systems have been investigated as treatment for refractory cardiogenic shock.
Methods: Between 2004 and 2012, 119 consecutive adult patients were supported on RotaFlow (n=104) or CentriMag (n=15) ECMO at our Institution (79 men; mean age 57.3 ± 12.
Interact Cardiovasc Thorac Surg
November 2014
Objectives: Lung transplantation (LTx) is the only effective treatment for end-stage lung disease. In rapidly deteriorating patients awaiting transplant, supportive strategies for lung function allow only a short period of support and lung transplantation remains the definitive therapy. An urgent transplant programme may reduce the waiting time, allowing lung transplantation in these patients.
View Article and Find Full Text PDFBackground: Mechanical circulatory support (MCS) is the standard therapy for the management of acute or chronic end-stage heart failure. We report on our two-center experience with MCS therapy.
Methods: Between January 2000 and December 2012, 116 adult patients (mean age 56.
Two centrifugal pumps, the RotaFlow (Maquet, Jostra Medizintechnik AG, Hirrlingen, Germany) and Levitronix CentriMag (Levitronix LCC, Waltham, MA, USA), used in central or peripheral veno-arterial extracorporeal membrane oxygenation (ECMO) support systems have been investigated, in terms of double-center experience, as treatment for patients with refractory cardiogenic shock (CS). Between January 2006 and December 2012, 228 consecutive adult patients were supported on RotaFlow (n=213) or CentriMag (n=15) ECMO, at our institutions (155 men; age 58.3±10.
View Article and Find Full Text PDFBackground And Aim Of The Study: During recent years, pericardial bioprostheses have gained widespread acceptance as cardiac valve substitutes. The study aim was to evaluate the early clinical and hemodynamic performance of the Sorin SopranoTM supra-annular aortic bioprosthesis, as used for aortic valve replacement (AVR).
Methods: Between January 2004 and August 2006, a total of 501 patients (55% males; mean age 75 +/- 6.
Objectives: Primary heart tumours are rare lesions with variegated histological types. We reviewed our 35 years experience with a significant number of primary benign cardiac tumour cases.
Methods: The patient database at University of Bologna was searched to identify patients with primary cardiac tumours between 1974 and 2009.
Interact Cardiovasc Thorac Surg
September 2003
Atrial fibrillation (AF) is associated with a significant mortality and morbidity. Microwave (MW) ablation is a new technology for surgical treatment of this arrhythmia. We present our preliminary experience with MW ablation in patients with AF who underwent a concomitant open-heart surgery.
View Article and Find Full Text PDFInteract Cardiovasc Thorac Surg
February 2007
Objectives: Atrial fibrillation (AF) is very common in patients undergoing open heart surgery. AF ablation with different sources of energy, enables the surgeon to create linear lesions rapidly and safely. However, results of these technologies need examination.
View Article and Find Full Text PDFMitral valve myxomas are extremely uncommon, and their presence raises differential diagnosis with other pathologic conditions. We report on the case of a patient with an unspecific clinical presentation and an equivocal echocardiographic finding: mass prolapsing through the mitral valve into the left ventricle. The tumor was strongly attached by a wide pedicle, involving both the anterior and posterior mitral valve leaflets.
View Article and Find Full Text PDFEur J Cardiothorac Surg
April 2007
Objective: Preprocedural levels of C-reactive protein predict mid-term mortality after percutaneous coronary intervention for the treatment of unprotected left main coronary artery stenosis. However, there are no data regarding the impact of C-reactive protein on mid-term mortality in patients with unprotected left main coronary artery stenosis treated with coronary artery bypass graft.
Methods: The predictive value of preoperative C-reactive protein levels, leukocyte counts, and fibrinogen levels were evaluated in a series of 108 patients who underwent coronary artery bypass graft surgery at our Institution from 1st January 2002 to 31st April 2005.
Although great interest exists in the relative efficacy of coronary artery bypass grafting (CABG) versus percutaneous coronary intervention (PCI) for the treatment of unprotected left main coronary artery stenosis, data comparing the 2 strategies are scant. Furthermore, no comparison has ever been performed between CABG and drug-eluting stents in this setting. From January 2002 to June 2005, 154 patients with unprotected left main coronary artery stenosis underwent CABG and 157 underwent PCI.
View Article and Find Full Text PDFBackground: Thyroid nodules and thyroid cancer occur more frequently in people exposed to radiation for therapeutic purposes, and to nuclear fallout. Furthermore, it is known that a moderate degree of iodine deficiency may be responsible for an increased prevalence of thyroid nodules, while it is suspected that radiation exposure could induce changes in thyroid autoimmunity. The iodine intake of people resident in Bari, S.
View Article and Find Full Text PDFBackground: Patients suffering from a concomitant coronary and carotid artery occlusive disease represent a high-risk population whose management remains controversial.
Methods: Between April 1979 and June 2002, 202 patients (163 men and 39 women, mean age 65 +/- 7 years) were admitted at the Department of Cardiovascular Surgery of the University of Bologna for coronary artery bypass graft and carotid endarterectomy (CEA). In Group 1 (140 patients) coronary artery bypass graft and carotid endarterectomy were performed simultaneously while in Group 2 (62 patients) they were performed as two-staged procedures.