Publications by authors named "Vito D Bruno"

Article Synopsis
  • * An analysis of 189 patients revealed that older age and the need for redo surgery are the most significant predictors for a prolonged hospital stay, along with factors like heart function and chronic conditions.
  • * The study concludes that while age and redo surgery are key predictors, factors such as reduced left ventricular function, NYHA class, and chronic kidney disease also contribute to a longer recovery time, suggesting that more research is needed for better understanding.
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Background: Human CD16 monocytes (hCD16 Ms) have proangiogenic properties. We assessed the feasibility, safety and efficacy of hCD16 Ms in a porcine model of myocardial infarction (MI).

Methods And Results: A total of 27 female Large White pigs underwent MI with reperfusion and cardiac magnetic resonance (CMR).

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Article Synopsis
  • Randomised controlled trials often use surrogate endpoints instead of direct outcomes to enhance efficiency and reduce costs, but this can lead to increased uncertainty regarding treatment effects and intervention harms.
  • A new guideline, known as CONSORT-Surrogate, provides a checklist for reporting trials that utilize surrogate endpoints, ensuring better clarity and transparency in the results.
  • The recommended checklist, tailored for all stakeholders involved in clinical trials, aims to improve the reporting quality of these studies and ultimately reduce wasted research efforts.
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Article Synopsis
  • Randomised controlled trials often use surrogate endpoints instead of direct outcomes to save time, cost, and ethical concerns, but this can create uncertainty about the actual treatment effects and potential harms.
  • The SPIRIT-Surrogate is a new guideline to enhance the reporting standards for trial protocols that use surrogate endpoints, building on the existing SPIRIT checklist.
  • This guideline includes nine modified items, encouraging all stakeholders to adopt it, which aims to improve trial design, transparency, and ultimately reduce wasted research efforts.
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Sulfide-releasing compounds reduce reperfusion injury by decreasing mitochondria-derived reactive oxygen species production. We previously characterised ammonium tetrathiomolybdate (ATTM), a clinically used copper chelator, as a sulfide donor in rodents. Here we assessed translation to large mammals prior to clinical testing.

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Article Synopsis
  • The paper discusses the increasing use of surrogate endpoints in interventional trials and introduces a framework for better defining and reporting them.
  • A series of studies, including reviews and surveys involving various stakeholders, revealed inconsistencies in how surrogate endpoints are currently defined and understood.
  • It was found that while traditional surrogate endpoints focus on biomarkers, broader interpretations including intermediate outcomes like function or symptoms also require clearer consensus among stakeholders, particularly between patients and health technology experts.
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Introduction: Although staging of the extent of aortic stenosis (AS)-related cardiac damages is usually performed via echocardiography, this technique has considerable limitations in assessing pulmonary artery and right chamber pressures. The present hypothesis-generating study sought to explore the efficacy of a staging system of cardiac damage based on echocardiographic and invasive [right heart catheterization (RHC)] hemodynamic parameters in patients undergoing transcatheter aortic valve implantation (TAVI).

Methods: We studied 90 symptomatic patients with severe AS in whom echocardiographic and invasive evaluation by RHC was obtained prior to TAVI.

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Since its first implementation, minimally invasive cardiac surgery has become more and more popular among surgeons. By avoiding a complete opening of the sternum, this surgery is traditionally associated with a faster recovery, less surgical pain and less postoperative bleeding and transfusions. With its growing popularity, the need for specifically designed surgical instrumentation is evident.

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Objectives: No reliable scores are available to predict mortality following surgery for type A acute aortic dissection (TAAAD). Recently, the German Registry of Acute Aortic Dissection Type A (GERAADA) score has been developed. We aim to compare how the GERAADA score performs in predicting operative mortality for TAAAD to the European System for Cardiac Operative Risk Evaluation (EuroSCORE) II.

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In a porcine experimental model of myocardial infarction, a localised, layer-specific, circumferential left ventricular strain metric has been shown to indicate chronic changes in ventricular function post-infarction more strongly than ejection fraction. This novel strain metric might therefore provide useful prognostic information clinically. In this study, existing clinical volume indices, global strains, and the novel, layer-specific strain were calculated for a large human cohort to assess variations in ventricular function and morphology with age, sex, and health status.

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Article Synopsis
  • The study focuses on a new aggressive treatment method for acute type A aortic dissection using the frozen elephant trunk (FET) technique, which extends repair to the aortic arch and proximal descending thoracic aorta.
  • A total of 66 patients (average age ~63 years, mostly men) underwent emergency surgery between December 2017 and January 2022, with researchers assessing 30-day mortality, in-hospital mortality, and postoperative complications.
  • Results showed a 30-day mortality rate of 10.6% and in-hospital mortality of 13.6%, with key predictors for long-term survival identified, including left ventricular ejection fraction and presence of peripheral vascular disease
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The frozen elephant trunk (FET) technique is an increasingly common procedure to treat complex extensive aortic disease both in elective and emergency setting. In a contemporary era, several prostheses are available to be used by surgeons performing such procedures, merging the advantages of endovascular and conventional surgery and preparing a more useful landing zone for second-stage downstream endovascular or open repair. Thoraflex hybrid (Terumo Aortic, Scotland) is a largely used hybrid vascular device merging a conventional surgical vascular graft made of gelatin-sealed woven polyester graft with a nitinol self-expanding stent graft.

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Purpose: The aim of this study was to provide 2-year clinical outcomes for patients with Medina 1,1,1 bifurcation lesions treated with a culotte technique, comparing Synergy and Xience drug eluting stent (DES) platforms. A sub-group analysis of 9-month Optical Coherence Tomography (OCT) was performed to assess stent healing.

Methods: A total of 170 patients with non-left main stem Medina 1,1,1 lesions, were randomized to treatment with Synergy or Xience DES.

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Background: Hybrid coronary revascularization (HCR) combines the benefits of a left internal mammary artery to left anterior descending artery anastomosis, via a mini thoracotomy, with percutaneous coronary intervention (PCI) for other diseased coronaries.

Aims: The aim of this meta-analysis is to compare the short- and long-term outcomes of HCR with those of coronary artery bypass grafting (CABG) for multi-vessel coronary artery disease (MCAD).

Methods: We performed a meta-analysis with a primary outcome of short-term mortality and secondary outcomes of mid-term survival, length of hospital stay, stroke, renal failure and mid-term MACE rate.

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Article Synopsis
  • The study investigates the relationship between serum lactate levels and postoperative outcomes in patients undergoing repair for type A acute aortic dissection (TAAAD), finding that elevated lactate is linked to higher in-hospital mortality.
  • A total of 132 patients were analyzed, with measurements of lactate taken at three critical stages: preoperatively, post-cardiopulmonary bypass, and six hours after ICU admission.
  • The results indicate that higher lactate levels consistently predict increased mortality risk, even after adjusting for other factors, although 1-year survival rates were similar between patients with normal and elevated lactate.
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Transcatheter aortic valve implantation (TAVI) is rapidly spreading across the world with the endorsement of the cardiological community and the supporting results of randomized controlled trials. However, TAVI-related complications like aortic dissection, aortic valvular rupture, or left ventricle perforation are still potentially catastrophic.

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Background: Coronary artery aneurysm represents a challenging and potentially fatal disease.

Aim And Material Methods: We present the case of a giant right coronary artery aneurysm treated surgically after percutaneous intervention and fracture of the stent.

Results And Discussion: The aneurism was opened and the coronary ligated proximally and distally.

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Article Synopsis
  • The study evaluates early clinical outcomes of the frozen elephant trunk (FET) technique for treating complex aortic diseases, transitioning from traditional methods.
  • A total of 70 patients were treated, with a 100% technical success rate; however, in-hospital mortality was 14.2% with some occurrences of major strokes and spinal cord injury.
  • The FET technique showed promising results in a real-world context, suggesting good feasibility and outcomes, particularly in neurological complications, but further refinement and protocols for safety are needed.
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Acute type A aortic dissection (ATAAD) is an indisputable emergency with very poor outcomes without surgical treatment. Although the aortic arch is often involved in the aortic dissection, its optimal management during surgical therapy remains uncertain. A conservative tear-oriented approach has traditionally been adopted, limiting the procedure to the ascending aorta (or hemiarch) replacement.

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