Publications by authors named "Giuseppe Sangiorgi"

Background: Mitral annular calcification (MAC) is characterized by severe calcification of mitral annulus and might be associated with both mitral regurgitation and stenosis. It is technically challenging for both surgical and percutaneous approach and is burdened by high mortality.

Case Summary: The present case report describes a complex case of mitral steno-insufficiency (baseline transvalvular gradient = 5 mmHg, effective regurgitant orifice area 0.

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Background: Prompt reperfusion is critical for patients with ST-segment elevation myocardial infarction (STEMI) to improve outcomes. Yet, variability in regional healthcare delivery may influence treatment times and patient outcomes. We thus aimed at evaluating differences in management and outcomes of STEMI patients across Northern, Central, and Southern Italy, focusing on time-dependent reperfusion and in-hospital logistics.

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Background: Data on the predictors of percutaneous stellate ganglion block (PSGB) efficacy in electrical storm are scanty.

Objective: We aimed to assess whether PSGB efficacy is influenced by the arrhythmia type and cycle length before the procedure.

Methods: This is a subanalysis of the multicenter STAR study.

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: This study aimed to compare the effects and safety of boldine combined with and plus tamsulosin vs. tamsulosin alone in medical expulsive therapy (MET) for distal ureteral calculi. : This retrospective cohort study was conducted on 159 renal colic patients with distal ureteric stones (≤10 mm).

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Article Synopsis
  • Electrical Storm (ES) is a critical condition that can be managed effectively using a technique called Percutaneous Stellate Ganglion Block (PSGB), which has shown positive results when used alongside standard therapy.
  • In a study analyzing 180 patients, those who received PSGB early experienced a significant reduction in arrhythmic events within the hour following the block compared to the hour before, although the overall effectiveness was similar to those who received PSGB later.
  • The findings suggest that early use of PSGB could help reduce the frequency of defibrillations and potentially lessen the risk of a more severe, refractory ES, demonstrating its effectiveness in early treatment settings.
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Background: Using three-dimensional (3D) modalities for optimal pre-procedure planning in transcatheter aortic valve replacement (TAVR) is critical for procedural success. However, current methods rely on visualizing images on a two-dimensional screen, using shading and colors to create the illusion of 3D, potentially impeding the accurate comprehension of the actual anatomy structures. In contrast, a new Mixed Reality (MxR) based software enables accurate 3D visualization, imaging manipulation, and quantification of measurements.

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Following the introduction in the latest European and American guidelines, transcatheter edge-to-edge repair has become a valid alternative to surgery for ineligible patients. Among the available technologies, MitraClip (Abbott) was the first to be introduced for the percutaneous treatment of mitral regurgitation with the edge-to-edge technique. Although its safety and effectiveness has been widely demonstrated, the optimal procedural results are highly dependent from operators' experience.

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Article Synopsis
  • - Renal denervation (RDN) is a safe and effective treatment option for hard-to-treat hypertension, showing blood pressure reductions similar to many common antihypertensive medications.
  • - RDN is best considered alongside lifestyle changes and traditional medical therapies, highlighting the importance of a comprehensive approach to manage hypertension effectively.
  • - Ongoing research is essential to understand RDN's impact on overall health outcomes and to pinpoint which patients are most likely to benefit from the procedure.
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Background: Acute kidney injury (AKI) is common in patients with acute coronary syndromes (ACS) treated by percutaneous coronary intervention.

Objectives: Contrast media (CM) volume minimization has been advocated for prevention of AKI. The DyeVert CM diversion system (Osprey Medical, Inc) is designed to reduce CM volume during coronary procedures.

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Background And Aims: An electrical storm (ES) is a clinical emergency with a paucity of established treatment options. Despite initial encouraging reports about the safety and effectiveness of percutaneous stellate ganglion block (PSGB), many questions remained unsettled and evidence from a prospective multicentre study was still lacking. For these purposes, the STAR study was designed.

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Article Synopsis
  • - Interest in transcatheter treatment for tricuspid regurgitation (TR) has increased due to its link to mortality and the scarcity of surgical options for high-risk patients.
  • - The transcatheter approach includes edge-to-edge repair and direct annuloplasty, the latter using an adjustable band to reduce TR and enhance heart failure symptoms.
  • - Successful procedures rely on careful patient selection and advanced imaging techniques, with challenges in imaging due to device shadowing, requiring precise alignment and monitoring during the procedure.
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  • - The study aimed to determine the most effective intravenous volume expansion method to prevent contrast-associated acute kidney injury (CA-AKI) in patients with chronic kidney disease (CKD) undergoing cardiovascular procedures.
  • - Analyzed data from 1927 CKD patients revealed that CA-AKI occurred in 11% of cases, with those affected receiving less volume expansion and experiencing higher rates of acute pulmonary edema.
  • - Findings suggest that to prevent CA-AKI, an absolute volume expansion of at least 1430 mL and a volume-to-contrast media ratio of 17 or greater should be considered, warranting further testing in future trials.
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Background: Transcatheter aortic valve implantation (TAVI)-related conduction system disorders are dynamic and may resolve over time. The purpose of this study was to investigate predictive factors of PM dependency among patients receiving permanent PM implantation after TAVI.

Methods: We included 37 consecutive patients who underwent PPM implantation within six days after TAVI and who completed a 12-month follow-up.

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Arterial hypertension is the most prevalent cardiovascular risk factor worldwide. Despite the availability of many and effective antihypertensive medications, the prevalence of uncontrolled blood pressure (BP) remains high. As sympathetic hyperactivity has long been recognized as a major contributor to resistant hypertension, catheter-based renal denervation (RDN) has emerged as a new strategy to reduce BP.

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Middle-aged adults can start to be affected by some arterial diseases (ADs), such as abdominal aortic or popliteal artery aneurysms, lower extremity arterial disease, internal carotid, or renal artery or subclavian artery stenosis. These vasculopathies are often asymptomatic or paucisymptomatic before manifesting themselves with dramatic complications. Therefore, early detection of ADs is fundamental to reduce the risk of major adverse cardiovascular and limb events.

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Atherosclerotic cardiovascular disease is the most common cause of morbidity and death worldwide. Recent studies have demonstrated that this chronic inflammatory disease of the arterial wall can be controlled through the modulation of immune system activity. Many patients with cardiovascular disease remain at elevated risk of recurrent events despite receiving current, state-of-the-art preventive medical treatment.

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Evaluation of the right ventricle (RV) in patients with acute myocarditis (MY) remains challenging with both 2D transthoracic echocardiography (TTE) and cardiovascular magnetic resonance (CMR). We examined the incremental diagnostic value of CMR feature tracking (FT) to evaluate RV involvement in patients with myocarditis. We enrolled 54 patients with myocarditis and preserved left ventricle (LV) ejection fraction (EF).

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In a patient who previously developed left bundle branch block after transcatheter aortic valve replacement, intermittent narrow QRS complexes were recorded on ambulatory electrocardiography monitoring. The peculiar distribution of wide and narrow QRS complexes suggested the presence of a window of supernormality in the refractory period of a branch block that on other occasions exhibited the Wenckebach phenomenon. ().

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Article Synopsis
  • Debulking lesions with severe coronary artery calcification (CAC) is crucial for successful procedures, and the study evaluates the use of coronary intravascular lithotripsy (IVL) after rotational atherectomy (RA).
  • Conducted in 23 international centers, the study enrolled 160 patients with symptomatic coronary artery disease to assess the effectiveness and safety of IVL using the Shockwave Coronary Rx Lithotripsy System.
  • Results showed that 96.9% of procedures were successful, with 90.6% free from serious complications, indicating that IVL is a safe and effective option for treating severe CAC lesions post-RA.
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(1) Introduction: Cancer and atrial fibrillation (AF) are increasingly coexisting medical challenges. These two conditions share an increased thrombotic and bleeding risk. Although optimal regimens of the most suitable anti-thrombotic therapy are now affirmed in the general population, cancer patients are still particularly understudied on the matter; (2) Aims And Methodology: This metanalysis (11 studies (incl.

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Background: Although the pathogenesis of acute kidney injury (AKI) in patients with acute coronary syndrome (ACS) undergoing invasive treatment is multifactorial, the role of iodinated contrast media (CM) has been well established. The DyeVert system (Osprey Medical) is designed to reduce the CM volume during invasive coronary procedures while maintaining fluoroscopic image quality.

Objective: The aim of the Renal Insufficiency Following Contrast Media Administration Trial IV (REMEDIAL IV) is to test whether the use of the DyeVert system is effective in reducing contrast-associated acute kidney injury (CA-AKI) rate in patients with ACS undergoing urgent invasive procedures.

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Introduction And Objectives: The incidence of device infection has increased over time and is associated with increased mortality in patients with cardiac implantable electronic devices (CIEDs). Gentamicin-impregnated collagen sponges (GICSs) are useful in preventing surgical site infection (SSI) in cardiac surgery. Nevertheless, to date, there is no evidence concerning their use in CIED procedures.

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Background: Identifying sex-related differences/variables associated with 30 day/1 year mortality in patients with chronic limb-threatening ischemia (CLTI).

Methods: Multicenter/retrospective/observational study. A database was sent to all the Italian vascular surgeries to collect all the patients operated on for CLTI in 2019.

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Background: Pulmonary embolism (PE) is an acute cardiovascular syndrome characterized by high incidence and mortality. The therapy of this condition is based on anticoagulation and hemodynamic support, but in case of high-risk mortality, the European Society of Cardiology (ESC) guidelines recommend systemic thrombolytic therapy and surgical embolectomy if thrombolysis is contraindicated or has failed; nowadays several percutaneous catheter-directed treatments for local thrombolysis or mechanical embolectomy are available, but they have IIa class of recommendation, because of lack of robust scientific evidence favoring their use.

Case Description: We described a case of high-risk PE treated with a novel percutaneous system for mechanical embolectomy, which consists of a large aspiration catheter that was advanced in the pulmonary artery, capturing and removing a vast thrombus, of 15 centimeters in length.

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