Publications by authors named "Perrotti A"
Background: Extensive surgical resection of the thoracic aorta in patients with type A aortic dissection (TAAD) is thought to reduce the risk of late aortic wall degeneration and the need for repeat aortic operations.
Objectives: We evaluated the early and late outcomes after aortic root replacement and supracoronary ascending aortic replacement in patients with TAAD involving the aortic root.
Design: Retrospective, multicenter cohort study.
Objective: To evaluate the benefits of surgical repair acute type A aortic dissection (ATAAD) on survival of octogenarians.
Methods: Patients who underwent surgery for acute ATAAD from the multicenter European Registry of Type A Aortic Dissection (ERTAAD) were the subjects of the present analysis.
Results: 326 (8.
The David Versus the Bentall Procedure for Acute Type A Aortic Dissection.
J Cardiovasc Dev Dis
November 2024
: Type A aortic dissection (TAAD) is a life-threatening condition which requires prompt diagnosis and surgical treatment. When TAAD involves the aortic root, aortic valve-sparing or Bentall procedures are the main surgical treatment options. The subjects of this analysis were 3735 patients included in the European Registry of Type A Aortic Dissection (ERTAAD).
View Article and Find Full Text PDFMultiproxy data collected from the largest inland wetland in Belize, Central America, demonstrate the presence of large-scale pre-Columbian fish-trapping facilities built by Late Archaic hunter-gatherer-fishers, which continued to be used by their Maya descendants during Formative times (approximately 2000 BCE to 200 CE). This is the earliest large-scale Archaic fish-trapping facility recorded in ancient Mesoamerica. We suggest that such landscape-scale intensification may have been a response to long-term climate disturbance recorded between 2200 and 1900 BCE.
View Article and Find Full Text PDFBackground: The current study aims to report the presentation of the malperfusion syndrome in patients with acute type A aortic dissection admitted to surgery and its impact on mortality.
Methods: Data were retrieved from the multicenter European Registry of Type A Aortic Dissection. The Penn classification was used to categorize malperfusion syndromes.
Background: The optimal strategy in prosthetic heart valve thrombosis (PVT) remains controversial, with no randomized trials and conflicting observational data. We performed a systematic review and meta-analysis of evidence comparing systemic thrombolysis and cardiac surgery in PVT.
Methods And Results: We searched PubMed, the Cochrane Library, and Embase for studies on treatment strategies in patients with left-sided PVT since 2000.
Article Synopsis
- The study investigated the outcomes for patients who had surgery for Stanford type A aortic dissection (TAAD) and spent time in the intensive care unit (ICU), analyzing data from 3,538 patients.
- Average ICU stays were around 9.9 days, with associated costs averaging €24,086, and observed in-hospital mortality was 14.8%, while five-year mortality was 30.5%.
- The analysis found that longer ICU stays (>5 days) linked to better survival rates, with lower in-hospital mortality (8.9% vs. 17.4%) and lower five-year mortality (28.2% vs. 30.7%) when compared to shorter stays (2-
Article Synopsis
- The study investigates gender differences in outcomes after type A aortic dissection (TAAD) surgery, focusing on both short- and long-term results.
- Data was collected from a multicenter European registry including 3902 TAAD surgery patients from 2005-2021, with a gender breakdown of 30.4% females.
- Results showed no significant early postoperative differences between genders, although males had a slightly better ten-year relative survival rate compared to females, despite advancements in surgical techniques over time.
Background: It remains unclear today whether risk scores created specifically to predict early mortality after cardiac operations for infective endocarditis (IE) outperform or not the European System for Cardiac Operative Risk Evaluation II (EuroSCORE II).
Methods: Perioperative data and outcomes from a European multicenter series of patients undergoing surgery for definite IE were retrospectively reviewed. Only the cases with known pathogen and without missing values for all considered variables were retained for analyses.
Article Synopsis
- Extended aortic repair is essential for maintaining long-term surgical success in young patients with DeBakey type 1 aortic dissection, as they face higher risks of aortic degeneration due to their longer life expectancy.
- A study analyzed 1,199 patients under 60 who had aortic repair surgeries across Europe from 2005 to 2021, comparing outcomes between ascending aortic repair and total aortic arch repair techniques.
- Results showed no significant difference in the need for additional surgeries after 5 years between the two techniques, but total aortic arch repair had higher rates of postoperative complications like stroke and dialysis, while overall mortality rates were similar.
Article Synopsis
- The study investigates the effects of different arterial cannulation methods (femoral, supra-aortic, and direct aortic) on outcomes for patients undergoing surgery for acute Stanford type A aortic dissection (TAAD).
- Results show that in-hospital mortality rates for patients using femoral or supra-aortic cannulation are similar, while direct aortic cannulation yields lower mortality rates compared to femoral cannulation.
- Additionally, switching cannulation sites during surgery increases the risk of in-hospital mortality, while long-term outcomes (10-year mortality) remain consistent across the groups.
Article Synopsis
- Surgery for type A aortic dissection (TAAD) often leads to neurological complications, which were analyzed in a study of 3,902 patients from the European Registry of Type A Aortic Dissection.
- Out of these patients, 18.5% experienced strokes or global brain ischemia during hospitalization, with significant increases in in-hospital mortality linked to these complications: 25.6% for ischemic stroke, 48.7% for hemorrhagic stroke, and 74.0% for global brain ischemia.
- Although neurologic complications sharply increased early and midterm mortality, this negative impact on survival tended to diminish about one year post-surgery.
Background: Surgery for Stanford type A aortic dissection (TAAD) is associated with an increased risk of late aortic reoperations due to degeneration of the dissected aorta.
Methods: The subjects of this analysis were 990 TAAD patients who survived surgery for acute TAAD and had complete data on the diameter and dissection status of all aortic segments.
Results: After a mean follow-up of 4.
Article Synopsis
- Surgery for type A aortic dissection (TAAD) has a high early mortality risk, with in-hospital mortality rates increasing based on the urgency of the procedure, ranging from 10% for urgent surgeries to over 57% for the most critical salvage procedures.
- A multicenter study using data from the European Registry of TAAD (ERTAAD) found that preoperative arterial lactate levels correlate with procedure urgency, indicating that more critical cases are associated with poorer outcomes.
- The urgency classification enhances the ability to predict patient risk, suggesting that despite high mortality in severe cases, salvage surgeries are often justified as many patients can still survive to discharge.
Background: Surgery for type A aortic dissection (TAAD) is associated with high risk of mortality. Current risk scoring methods have a limited predictive accuracy.
Methods: Subjects were patients who underwent surgery for acute TAAD at 18 European centers of cardiac surgery from the European Registry of Type A Aortic Dissection (ERTAAD).
Purpose: With application to the United States, this tutorial explores barriers in the American juvenile justice system for justice-involved youth (JIY) with cognitive-communication disorders (CCDs). It outlines models from abroad and reimagines the American juvenile justice system to include speech-language pathologists (SLPs) as interprofessional practice partners.
Method: Interprofessional (i.
Article Synopsis
- Patients undergoing postcardiotomy V-A-ECMO have a high risk of early mortality, with a 66.7% in-hospital mortality rate found in the analysis of 1269 patients across 25 hospitals.
- The study utilized a systematic review and methods like propensity score matching to identify performance differences among hospitals, revealing that some hospitals had significantly higher mortality rates than others.
- The research indicates that lower annual volumes of V-A-ECMO procedures may lead to worse outcomes, and it highlights the potential for improvement in many hospitals' results for this treatment.
Background: Acute type A aortic dissection (TAAD) is associated with significant mortality and morbidity. In this study we evaluated the prognostic significance of preoperative arterial lactate concentration on the outcome after surgery for TAAD.
Methods: The ERTAAD registry included consecutive patients who underwent surgery for acute type A aortic dissection (TAAD) at 18 European centers of cardiac surgery.
Background: Early postoperative glycemic variability is associated with worse outcome after cardiac surgery, but the underlying mechanisms remain unknown. This study aimed to describe the relationship between postoperative glycemic variability and endothelial function, as assessed by serum endocan level in cardiac surgery patients.
Methods: We performed a post hoc analysis of patients included in the single-center observational ENDOLUNG study.
Article Synopsis
- A study compared direct aortic cannulation to supra-aortic cannulation methods during surgery for type A aortic dissection to see which leads to better patient outcomes.
- Data from 3,902 patients in the European registry showed that direct aortic cannulation resulted in lower in-hospital mortality (12.7% vs. 18.1%) and fewer postoperative complications, including issues like paralysis and infections.
- The findings suggest that direct aortic cannulation is a safer option for patients undergoing surgery for acute type A aortic dissection.
Article Synopsis
- Postcardiotomy veno-arterial extracorporeal membrane oxygenation (V-A-ECMO) has a high mortality rate, and determining which patients are at the greatest risk for death is challenging, making clinical judgment essential for initiating the procedure.
- A systematic review analyzed data from 1269 patients across 10 studies, revealing that higher arterial lactate levels at the start of V-A-ECMO correlate with increased in-hospital mortality rates and a significant cut-off level of 6.8 mmol/L for predicting outcomes.
- The findings suggest that monitoring arterial lactate levels may aid clinicians in making more informed decisions on when to start V-A-ECMO, especially in older patients with elevated lactate levels.
Objective: The aim of this study was to evaluate the outcomes of different surgical strategies for acute Stanford type A aortic dissection (TAAD).
Summary Background Data: The optimal extent of aortic resection during surgery for acute TAAD is controversial.
Methods: This is a multicenter, retrospective cohort study of patients who underwent surgery for acute TAAD at 18 European hospitals.
Purpose: To evaluate the impact of individual institutions on the outcome after surgery for Stanford type A aortic dissection (TAAD).
Methods: This is an observational, multicenter, retrospective cohort study including 3902 patients who underwent surgery for TAAD at 18 university and non-university hospitals.
Results: Logistic regression showed that four hospitals had increased risk of in-hospital mortality, while two hospitals were associated with decreased risk of in-hospital mortality.
Article Synopsis
- The study aimed to evaluate how the experience of surgeons and the volume of surgeries performed at hospitals affect early results in patients undergoing off-pump coronary artery bypass (OPCAB) surgery.
- A total of 1,549 patients from a larger registry were analyzed, comparing outcomes between experienced OPCAB surgeons and non-OPCAB surgeons, as well as between high and low volume centres.
- Results indicated that surgeries by experienced surgeons and at high volume centres led to shorter procedure times, fewer complications, lower 30-day mortality rates, and shorter hospital stays, highlighting their importance for better patient outcomes.
Background: It is unclear whether peripheral arterial cannulation is superior to central arterial cannulation for postcardiotomy veno-arterial extracorporeal membrane oxygenation (VA-ECMO).
Methods: A systematic review was conducted using PubMed, Scopus, and Google Scholar to identify studies on postcardiotomy VA-ECMO for the present individual patient data (IPD) meta-analysis. Analysis was performed according to the intention-to-treat principle.