Publications by authors named "Marco Vola"
Article Synopsis
- * It analyzed data from 533 adult patients divided into two groups based on different CPB flow rate targets: a low group (>2.2 L/min/m²) and a high group (>2.4 L/min/m²).
- * Results showed significant reduction in major adverse kidney events (MAKE) at 30 days in the high flow rate group, which included lower mortality and fewer instances of renal replacement therapy compared to the low flow rate group.
Article Synopsis
- Type 2 diabetes (T2D) negatively impacts left ventricular (LV) remodeling and function in patients with severe aortic stenosis (AS), leading to worse cardiac outcomes despite similar AS severity compared to non-diabetics.
- The study combined clinical assessments and biological analyses between T2D and non-diabetic patients undergoing valve replacement, revealing significant differences in gene expression related to inflammation, cardiac hypertrophy, and mitochondrial function.
- Findings indicated that T2D is associated with reduced mitochondrial function and calcium signaling, contributing to adverse cardiac remodeling, which may inform future treatment strategies for these patients.
Totally endoscopic non-robotic excision of aortic valve fibroelastoma: a case report.
J Cardiothorac Surg
November 2022
Article Synopsis
- - Papillary fibroelastomas (PFEs) are rare, benign tumors usually found on the aortic valve, with both traditional and minimally invasive removal methods being explored.
- - This report details a case where a PFE on the aortic valve was successfully removed using a totally endoscopic, non-robotic technique.
- - The findings suggest that this endoscopic approach leads to positive intra and post-operative results, along with quicker recovery times for patients.
Robotic assisted aortic valve surgery is still challenging and debatable. We retrospectively reviewed our cases of robotic assisted aortic valve replacement utilizing sutureless aortic valve with following surgical technique: 3 ports, 1 for endoscope and 2 for the robotic arms were inserted in the right chest and da Vinci Si robotic system (Intuitive Surgical, Sunnyvale, CA, USA) was adapted to these ports. Cardiopulmonary bypass was initiated through peripheral cannulations.
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- Minimally invasive mitral valve surgery without aortic cross-clamp (MIMVS-WAC) shows promising outcomes for patients with secondary mitral regurgitation, particularly those with low ejection fraction or previous heart surgeries.
- In a study involving 46 patients, the procedure involved right minithoracotomy and hypothermic cardiopulmonary bypass, with no conversions to sternotomy and a postoperative echocardiography revealing good preservation of left ventricular function in most cases.
- The technique is deemed safe for high-risk patients, with significant improvements in heart function and minimal complications reported in both short and long-term follow-up.
Article Synopsis
- - The study aimed to assess changes in health-related quality of life (HRQOL) 6 months after elective cardiac surgery and identify predictors of poor HRQOL.
- - A total of 326 patients participated, with 26.6% showing a decline in physical HRQOL and 28.2% in mental HRQOL post-surgery; factors like acute renal failure and prolonged mechanical ventilation were linked to these declines.
- - Overall, while most patients experienced improved HRQOL after surgery, over a quarter faced deterioration, highlighting the need for clinicians to better inform patients about potential outcomes.
Background: Percutaneous coronary intervention (PCI) for bifurcation lesions (BL) using 2 stents technique is known to be associated with high rates of procedural failure especially on the side branch (SB) mainly due to stent incomplete apposition. Stent deployment at very high pressure (SDHP) may lead to better stent expansion and apposition. However, SDHP may also be at the origin of deeper wall injury resulting into major cardiac adverse events.
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- The paper introduces an endoscopic expandable sizer designed for thoracoscopic aortic valve replacement using a sutureless prosthesis, allowing for dynamic sizing of the aortic annulus.
- In experiments with ten aortic torsos, the feasibility of the sizing tool was confirmed, and subsequent successful implantation of sutureless valves was achieved.
- The study concludes that the endoscopic expandable sizer is technically viable, with satisfactory valve size selection observed, although further testing with fluid dynamics is necessary before clinical trials.
Interest is growing in the clinical use of sutureless (SU) valves. However, indications in some anatomical sub-settings, like bicuspid aortic valves (BAV), have been so far limited. We discuss herein our initial experience with the implantation of the 3f Enable SU bioprosthesis in patients with a BAV.
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- Tissue perfusion issues significantly contribute to organ dysfunction, which can lead to worse outcomes after cardiac surgery.
- A study analyzed 220 patients post-cardiac surgery, measuring central venous-arterial difference in CO tension (ΔCO) at various time points to evaluate its relation to outcomes.
- The findings revealed that a low ΔCO (below 6 mmHg) was linked to higher SOFA scores and mortality rates; however, ΔCO had a low predictive value for outcomes in cardiac surgery, contrary to other surgical contexts.
Totally endoscopic cardiac operations for coronary procedures and atrial septal defect repair have demonstrated improved quality of life, but they have required longer cross-clamp times compared with open operations. Although transcatheter valve implantation remains appropriate for inoperable patients, the totally endoscopic approach could be an effective treatment for lower risk patients, including complete removal of the stenotic aortic valve, while minimizing surgical chest wall trauma, and providing excellent early quality of life. Totally endoscopic aortic valve replacement procedures were previously performed with the 3f Enable bioprosthesis.
View Article and Find Full Text PDFBackground: Ischemic mitral regurgitation (IMR) is a common complication of coronary artery disease and represents an independent predictor of mortality. In the IMR the pattern of mitral valve annular dilatation is asymmetrical: this can explain the long-term incidence of recurrent mitral regurgitation after surgical annular size reduction with a symmetrical ring. The aim of this study is to analyze early and mid-term results of mitral valve repair (MVR) with the CMA IMR ETlogix ring, specifically developed for the surgical correction of IMR.
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- Researchers developed a new testing method using bulge inflation and optical measurements to study the rupture properties of ascending thoracic aortic aneurysms (ATAAs), which are typically not covered by current literature.
- The study analyzed data from 31 patients, finding that younger patients (under 55) had stronger tissues, and established that rupture occurs when the tissue reaches maximum extensibility.
- The findings indicate that the risk of rupture is closely linked to the tissue's elastic modulus, regardless of patient age, aneurysm size, or aortic valve type, aiding in identifying patients at higher risk for surgical repair.
Article Synopsis
- The case report discusses the unique migration of a stent that was already placed under high pressure in a main artery during a procedure involving two stents for a bifurcation lesion.
- It suggests that the use of a Kissing balloon was inadequate, risking an insufficient opening of the stent's struts/cells, which contributed to the stent being pulled back into the artery.
- The report emphasizes the critical role of an effective Kissing Balloon technique in ensuring successful outcomes during bifurcation stenting procedures.
An aorta to right atrium fistula is rare. We report a case of idiopathic aortic root to right atrial fistula with right heart failure and review the literature. doi: 10.
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- Minimally invasive aortic valve replacement usually requires small chest incisions, but this study introduces the first series of totally endoscopic aortic valve replacement (TEAVR) as a potential alternative.
- Over two years, 14 patients underwent TEAVR successfully, with a high success rate of 92.8% for the thoracoscopic approach; only one needed conversion to traditional surgery.
- The procedure was found to be safe, with no major complications or leakage, suggesting that TEAVR could be a viable option for low-risk patients, although further research is needed to improve the technique and patient outcomes.
Background: In this article we present a consecutive single-center experience of implantation of the Medtronic 3f Enable aortic valve (Medtronic Inc, Minneapolis, MN).
Methods: Between March 2011 and October 2014, 200 consecutive patients (mean age, 76.4 ± 5.
Article Synopsis
- * The heart team considered a transcatheter valve-in-valve method but chose to implant a sutureless 3f Enable valve instead, after removing the damaged leaflets.
- * This surgical decision not only simplified the procedure but also resulted in excellent blood flow and heart function post-surgery during follow-up.
Article Synopsis
- * From 167 total patients, the average age was 72 years, and all had successful sutureless valve implantations using various surgical approaches, with manageable cross-clamping and bypass times.
- * Follow-up at around 11 months revealed stable outcomes, including low pressure gradients and no new cases of paravalvular leakage, suggesting that this method holds promise, but further research across multiple centers is needed for more conclusive results.
Background: Sutureless valves have recently enabled closed chest aortic valve replacement. This paper evaluates the feasibility of a robotic telemanipulation during thoracoscopic sutureless aortic valve implantation in cadavers.
Methods: Cadavers were prepared with a five thoracosopic trocar setting, with a transthoracic clamp inserted in the first right intercostal space and the optics inserted in the second.
Article Synopsis
- The study focuses on the implantation of sutureless 3f Enable prostheses in patients with Sievers type 0 bicuspid valves between 2011 and 2014.
- Five patients were selected based on specific criteria, excluding those with larger aortic annulus sizes or lower left ventricle ejection fractions.
- The results showed that two patients developed moderate paravalvular leakages after receiving larger prostheses, highlighting concerns about the valve's performance in this patient group, particularly regarding the acceptance of any residual leakage during surgery.