Partially Resorbable Mesh Inclusion between Dissected Layers during Surgical Repair of Aortic Dissection.

Surgical management of aortic dissection is technically challenging for different reasons. Reapproximation of dissected layers because of fragility of the dissected aortic wall layers is of major concern. Many techniques have been described to restore the integrity of aortic wall.

Prognostic value of SARS-CoV-2 on patients undergoing cardiac surgery.

Objective: To analyze Italian Cardiac Surgery experience during the pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) identifying risk factors for overall mortality according to coronavirus disease 2019 (COVID-19) status.

Methods: From February 20 to May 31, 2020, 1354 consecutive adult patients underwent cardiac surgery at 22 Italian Centers; 589 (43.5%), patients came from the red zone.

Direct proximal right subclavian artery cannulation during surgery of the thoracic aorta.

Objective: To evaluate outcomes of single sternum access for right subclavian artery cannulation without infraclavicular incision in surgery of the thoracic aorta.

Methods: Between January 2015 and December 2019, 44 consecutive patients underwent surgery of the thoracic aorta with cannulation of the right subclavian artery, after sternotomy and before pericardiotomy, through a direct percutaneous cannula with a single access without additional infraclavicular skin incision. The indication for surgery was type A acute aortic dissection in 29 patients (65.

Optimal Management of Patients Treated With Minimally Invasive Cardiac Surgery in the Era of Enhanced Recovery After Surgery and Fast-Track Protocols: A Narrative Review.

Objectives: Use of minimally invasive cardiac surgery (MICS) is increasing, but to exert its maximum effect on patient outcomes, MICS must be coupled with improved perioperative management, including the Enhanced Recovery after Surgery (ERAS) and fast-track protocols. This study aimed to evaluate the impact of ERAS and fast track in this context.

Design: NARRATIVE REVIEW: The authors performed a narrative review that included patients treated with MICS and patients treated with the ERAS/fast-track protocols in the MEDLINE/PubMed database.

Right subclavian artery cannulation for aortic dissection surgery, without infraclavicular incision.

The choice of arterial cannulation strategy for acute type A dissection surgery remains a controversial  issue and a subject of great debate because of its impact on clinical outcomes. A review of retrospective studies shows that surgeons are tending to switch from a retrograde to an antegrade perfusion strategy. Innominate artery cannulation has a number of advantages when compared to other cannulation techniques; however when the vessel is dissected, the proximal right subclavian artery can be used for arterial return.

Does pre-existing aortic regurgitation protect from death in patients who develop paravalvular leak after TAVI?

Objective: The aim of this study was to investigate interactions among pre-procedural aortic regurgitation (AR), post-procedural paravalvular leak (PVL) and long-term clinical outcomes.

Methods And Results: We analyzed data prospectively collected in the Italian Transcatheter balloon-Expandable Registry (ITER) on aortic stenosis (AS) patients. The degree of pre-procedural AR and post-procedural PVL was stratified as: absent/trivial, mild, and moderate/severe.

Outcomes after surgery for acute type A aortic dissection in "non-Marfan syndrome" patients with long life expectancy: A 24-year follow-up.

Background: Long-term survival and risk of reoperation in "non-Marfan syndrome" patients with a long life expectancy who undergo emergency surgery for acute type A aortic dissection (aTAAD) are not well known.

Aim: To analyse survival, risk of reoperation and quality of life in this population.

Methods: From 1990 to 2010, all patients aged≤50 years and not affected by Marfan syndrome, who underwent emergency surgery for aTAAD at two institutions, were included in this analysis.

Early outcomes in re-do operation after acute type A aortic dissection: results from the multicenter REAAD database.

This study provides early results of re-operations after the prior surgical treatment of acute type A aortic dissection (AAD) and identifies risk factors for mortality. Between May 2003 and January 2014, 117 aortic re-operations after an initial operation for AAD (a mean time from the first procedure was 3.98 years, with a range of 0.

Early and mid-term outcomes of 1904 patients undergoing transcatheter balloon-expandable valve implantation in Italy: results from the Italian Transcatheter Balloon-Expandable Valve Implantation Registry (ITER).

Objectives: The aim of this multicentre study is to report the clinical experiences of all patients undergoing transcatheter aortic valve implantation (TAVI) with a balloon-expandable device in Italy.

Methods: The Italian Transcatheter balloon-Expandable valve Registry (ITER) is a real-world registry that includes patients who have undergone TAVI with the Sapien (Edwards Lifesciences, Irvine, CA, USA) bioprosthesis in Italy since it became available in clinical practice. From 2007 to 2012, 1904 patients were enrolled to undergo TAVI in 33 Italian centres.

Predictive ability of the CHADS2 and CHA2DS2-VASc scores for stroke after transcatheter aortic balloon-expandable valve implantation: an Italian Transcatheter Balloon-Expandable Valve Implantation Registry (ITER) sub-analysis.

Objectives: Stroke incidence after transcatheter aortic valve implantation (TAVI) still represents a concern. This multicentre study aimed at investigating the hypothesis that CHADS2 and CHA2DS2-VASc scores may be used to predict perioperative stroke after TAVI.

Methods: The Italian Transcatheter Balloon-Expandable Valve Implantation Registry (ITER) is a multicentre, prospective registry of patients undergoing balloon-expandable TAVI using Edwards Sapien and Sapien XT prosthesis between 2007 and 2012.

Expectation and quality of life after aortic valve replacement over 85 years of age match those of the contemporary general population.

Background: In the transcatheter aortic valve implantation (TAVI) years, very elderly patients with aortic stenosis (AS) are referred to surgery with reluctance despite excellent hospital outcomes. A poorly assessed outcome of discharged survivors might further overlook the actual efficacy of the surgical strategy in this cohort. We thus evaluated life-expectancy and functional results in discharged survivors over 85 years operated on for AS.

Does patient-prosthesis mismatch after aortic valve replacement affect survival and quality of life in elderly patients?

Background: To evaluate the impact of patient-prosthesis mismatch (PPM) on survival, functional status, and quality of life (QoL) after aortic valve replacement (AVR) with small prosthesis size in elderly patients.

Methods: Between January 2005 and December 2013, 152 patients with pure aortic stenosis, aged at least 75 years, underwent AVR, with a 19 or 21 mm prosthetic heart valve. PPM was defined as an indexed effective orifice area less than 0.

Biological and clinical outcomes in the elderly with left ventricular dysfunction: Are there differences between on-pump and off-pump coronary artery bypass grafting?

Aim: To compair biological and clinical outcomes after off-pump coronary artery bypass grafting (OPCABG) and conventional on-pump coronary artery bypass grafting (CCABG) in the elderly with left ventricular (LV) dysfunction.

Material Of Study: We retrospectively reviewed 90 consecutive patients aged more than 75 years with preoperative left ventricular ejection fraction (LVEF) < 50% who underwent isolated coronary artery bypass grafting at our Institution between January 2000 and July 2009. According to operative technique, patients were categorized in to the OPCABG group (39 patients) or in to the CCABG group (51 patients).

Coronary artery bypass grafting in the octogenarian. Is complete revascularization always necessary?

Aim: The aim of this study was to investigate whether the completeness of revascularization affects the outcomes in the octogenarian.

Material Of Study: We retrospectively reviewed 130 consecutive octogenarians who underwent isolated coronary artery bypass grafting (CABG) between January 2003 and September 2010. According to operative technique, patients were categorized in Complete Revascularization (CRV) Group (96 patients) and in Incomplete Revascularization (IRV) Group (34 patients).

Octogenarians with uncomplicated acute type a aortic dissection benefit from emergency operation.

Background: The management of acute type A aortic dissection (aTAAD) in octogenarian patients is controversial. This study analyzed the surgical outcomes to identify patients who should undergo operations.

Methods: Beginning in January 2000, we established a registry including all octogenarian patients operated on for type A acute aortic dissection.

Aortic valve replacement with smaller prostheses in elderly patients: does patient prosthetic mismatch affect outcomes?

Background And Aim Of The Study: To evaluate the influence of patient-prosthesis mismatch (PPM) on survival, and quality of life (QOL) after aortic valve replacement (AVR) in elderly patients with small prosthesis size.

Methods: Between 2005 and 2010, 142 patients older than 65 years were discharged from the hospital after AVR with 19 or 21 mm prosthesis for aortic stenosis. Their median age was 79 years (range 66 to 91).

Fate of the preserved aortic root after treatment of acute type A aortic dissection: 23-year follow-up.

Objective: The objective of this study was to examine the fate of the native aortic root after replacement of the ascending aorta to treat acute type A aortic dissection.

Methods: Between June 1985 and January 2010, 319 consecutive patients (mean age, 63 ± 11 years) with acute type A aortic dissection underwent replacement of the ascending aorta with preservation of the aortic root. The aortic valve was also replaced in 21 of these patients (7%).

Fate of the aortic valve after root reconstruction in type A aortic dissection: a 20-year follow up.

Background And Aim Of The Study: The study aim was to evaluate the fate of the aortic valve after root reconstruction in acute type A aortic dissection.

Methods: Between 1982 and 2006, a total of 373 consecutive patients underwent emergency surgery for acute type A aortic dissection at the authors' institution. Of these patients, 298 (mean age 63 +/- 11 years; range: 22-85 years) underwent replacement of the supracoronary aorta with root reconstruction.

Outcomes after surgical treatment for type A acute aortic dissection in octogenarians: a multicenter study.

Background: Management of octogenarian patients with acute type A acute aortic dissection is controversial. This study analyzed the surgical outcomes to identify patients who should undergo operations.

Methods: Beginning January 2000, we established a registry including all octogenarian patients operated on for type A acute aortic dissection.

A 20-year experience with mitral valve repair with artificial chordae in 608 patients.

Objective: Mitral valve repair with artificial chordae for degenerative mitral regurgitation is widely adopted. We evaluated long-term results of mitral repair with expanded polytetrafluoroethylene sutures (GORE-TEX CV-5; W. L.

Surgical treatment of active infective endocarditis: a continued challenge.

Objective: This study was undertaken to examine the outcomes of surgery for active infective endocarditis in a large cohort of patients.

Methods: Three hundred eighty-three consecutive patients underwent surgery for active infective endocarditis. The mean age was 51 +/- 16 years, and 64% were men.

Surgical treatment of paravalvular abscess: long-term results.

Objective: To examine the outcomes of surgery for active infective endocarditis with paravalvular abscess.

Methods: Paravalvular abscess was defined as infective necrosis of the valve annulus that required patch reconstruction before implanting a new valve. Of 383 patients with active infective endocarditis who underwent surgical treatment, 135 (35%) had paravalvular abscess.

"Edge-to-edge" repair for anterior mitral leaflet prolapse.

The aim of this study is to report our results in a series of 150 consecutive patients (mean age 53 +/- 15.4 years) in whom mitral regurgitation (MR) due to isolated anterior mitral leaflet (AML) prolapse was corrected using the edge-to-edge (E to E) technique over a period of more than 10 years. At admission, 49 (32.