Publications by authors named "Marco Totaro"

Pseudoaneurysm of the mitral-aortic intervalvular fibrosa (P-MAIVF) can be a rare but life-threatening complication of infective endocarditis, cardiac surgery, or blunt chest trauma. Congenital heart diseases especially in young patients are reported as additionally predisposing factors. We present the case of an asymptomatic 52 years-old male with bicuspid aortic valve and gastrointestinal polyposis syndrome in whom a P-MAIVF was incidentally detected.

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The coronavirus disease 2019 (COVID-19) pandemic outbreak, caused by severe acute respiratory syndrome coronavirus-2 (SARS-Cov-2) is affecting people worldwide representing a public health emergency. The effect of concomitant COVID-19 on patients who underwent cardiac surgery using cardiopulmonary bypass (CPB) is still undefined. Both SARS-Cov-2 infection and CPB can develop a cytokines storm and haemostatic disarrangements leading to acute respiratory distress syndrome (ARDS) and post-perfusion lung syndrome, respectively.

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Background: We report a rare case of delayed, symptomatic thoracic endograft thrombosis after the initial thoracic endovascular aortic repair (TEVAR) for blunt thoracic aortic injury which was successfully retreated with a redo TEVAR, followed by open conversion due to recurrent partial occlusion of the distal edge of the endografts.

Methods: Two years ago, a 22-year-old man had undergone an emergency TEVAR for blunt thoracic aortic injury. A Zenith Cook 22 × 100 mm (Cook Incorporated, Bloomington, IN) endograft was used.

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Background: There are few long-term mortality prediction studies after acute aortic dissection (AAD) Type A and none were performed using new models such as neural networks (NN) or support vector machines (SVM) which may show a higher discriminatory potency than standard multivariable models.

Methods: We used 32 risk factors identified by Literature search and previously assessed in short-term outcome investigations. Models were trained (50%) and validated (50%) on 2 random samples from a consecutive 235-patient cohort.

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Background: There are few comparative reports on the overall accuracy of neural networks (NN), assessed only versus multiple logistic regression (LR), to predict events in cardiovascular surgery studies and none has been performed among acute aortic dissection (AAD) Type A patients.

Objectives: We aimed at investigating the predictive potential of 30-day mortality by a large series of risk factors in AAD Type A patients comparing the overall performance of NN versus LR.

Methods: We investigated 121 plus 87 AAD Type A patients consecutively operated during 7 years in two Centres.

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We report a case of unusual origin of cardiac angiosarcoma rising from the pulmonary trunk. The tumor caused severe obstruction of the right ventricular outflow tract with serious symptoms of right ventricular failure and tricuspid insufficiency. The angiosarcoma was surgically unresectable because of infiltration of the pulmonary artery and cardiac structures.

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Purpose: To describe an extension of type B dissection into type A during endoluminal treatment of acute type B dissection.

Case Report: A 57-year-old man with acute type B dissection underwent endovascular repair using 2 Excluder stent-grafts. Before releasing the second stent-graft, the patient complained of mild central chest pain, headache, and visual flashes, but no hemodynamic changes were noticed.

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Background: The timing and optimal therapy for descending thoracic aortic diseases still remain a challenging problem for surgeons. Nowadays endovascular treatment is becoming more and more popular both for acute as well as chronic cases. This technique is more respectful of the tissue integrity and avoids major and demolitive surgery for the patient.

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