447 results match your criteria: "San Raffaele University Hospital[Affiliation]"

Introduction: Myocardial fibrosis (MF) is induced by factors activating pro-fibrotic pathways such as acute and prolonged inflammation, myocardial ischemic events, hypertension, aging process, and genetically-linked cardiomyopathies. Dynamics and characteristics of myocardial fibrosis development are very different. The broad range of myocardial fibrosis presentations suggests the presence of multiple potential targets.

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We reported a case of blood culture-negative infective endocarditis on a native valve, where the clinical presentation was exclusively related to extensive cerebral ischemia secondary to multiple systemic septic cardioembolic events. The cause was ascribed to subacute infection, presumably transmitted by cat scratch, documented by positive serologic findings.

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Article Synopsis
  • Mechanical complications (MCs) following acute myocardial infarction (AMI) are rare but serious, with surgery being the recommended treatment; this study evaluated outcomes of patients who underwent such surgeries from 2001 to 2019.
  • Among 720 patients analyzed, the average age was 70, with the majority being male; the most frequent complication was ventricular septal rupture, leading to a significant in-hospital mortality rate of 37.4%.
  • Despite high immediate mortality, long-term survival rates for hospital survivors were promising, showing 65.7% survival at 10 years, with older age and postoperative low cardiac output syndrome being key factors influencing overall mortality.
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Transcatheter edge-to-edge repair in papillary muscle injury complicating acute myocardial infarction.

ESC Heart Fail

April 2024

Jesselson Integrated Heart Centre, Shaare Zedek Medical Center / The Eisenberg R&D Authority, Hebrew University, Jerusalem, Israel.

Article Synopsis
  • Acute mitral regurgitation (MR) following myocardial infarction (MI) can result from papillary muscle rupture (PMR), leading to high risks for patients; this study explores using transcatheter edge-to-edge mitral valve repair (TEER) as a treatment option.
  • Data from 30 centers across Europe, North America, and the Middle East revealed that TEER was performed on 23 high-risk patients within a week of their MI, achieving procedural success in 87% and a significant reduction in MR severity.
  • The outcomes indicated that 70% of patients could be discharged after treatment, showcasing TEER's potential as a viable emergency intervention or a bridge to further surgical options for critically ill patients with PM
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The purpose of this study was to investigate choroidal morphology remodeling in AMD-associated type 1 macular neovascularization using two different anti-VEGF drugs. We registered 73 treatment-naïve eyes with a diagnosis of exudative AMD and type 1 MNV. Patients received 3 monthly intravitreal aflibercept (n = 36, aflibercept group [AG]) or brolucizumab (n = 37, brolucizumab group [BG]).

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  • The study investigates the differences in outcomes between two types of failed transcatheter heart valves (balloon-expandable valves vs. self-expanding valves) during surgical explantation.
  • Analyzing data from 401 patients, it reveals that failed balloon-expandable valves had higher rates of certain complications like endocarditis and paravalvular leaks compared to self-expanding valves.
  • Overall, mortality rates and stroke rates were similar across both groups post-explantation, but concomitant mitral surgery emerged as a significant independent predictor of 1-year mortality for both valve types.
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Background: Left ventricular assist device (L-VAD) implantation is increasingly used in patients with heart failure (HF) and most patients also have an implantable cardioverter defibrillator (ICD). Limited data are available on the incidence of ICD therapies and complications in this special setting. The aim of this study was to analyze the real-world incidence and predictors of ICD therapies, complications and interactions between ICD and L-VAD.

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  • The study examines how general anesthesia (GA) compares to conscious sedation/local anesthesia (CS/LA) in patients with minor strokes undergoing immediate mechanical thrombectomy (iMT).
  • The research involved analyzing data from 16 stroke centers, focusing on patients with isolated M2 occlusions and mild stroke severity, utilizing propensity score matching for a fair comparison.
  • Results showed no significant difference in patient outcomes or complications between those receiving GA or CS/LA, indicating that the choice of anesthesia does not impact recovery or procedural safety in these cases.
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Impact of COVID-19 on incidence and outcomes of post-infarction mechanical complications in Europe.

Interdiscip Cardiovasc Thorac Surg

December 2023

Department of Cardiothoracic Surgery, Heart and Vascular Centre, Maastricht University Medical Centre, Maastricht, Netherlands.

Objectives: Post-acute myocardial infarction mechanical complications (post-AMI MCs) represent rare but life-threatening conditions, including free-wall rupture, ventricular septal rupture and papillary muscle rupture. During the coronavirus disease-19 (COVID-19) pandemic, an overwhelming pressure on healthcare systems led to delayed and potentially suboptimal treatments for time-dependent conditions. As AMI-related hospitalizations decreased, limited information is available whether higher rates of post-AMI MCs and related deaths occurred in this setting.

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Persistent and Recurrent Device-Related Thrombus After Left Atrial Appendage Closure: Incidence, Predictors, and Outcomes.

JACC Cardiovasc Interv

November 2023

Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada; Department of Cardiology, Hospital Clínic of Barcelona, August Pi i Sunyer Biomedical Research Institute, University of Barcelona, Barcelona, Spain. Electronic address:

Article Synopsis
  • This study investigates device-related thrombus (DRT) occurrences after left atrial appendage closure (LAAC), focusing on how often it persists or recurs.
  • It found that about 29% of DRT cases persist, with being female and having a larger initial thrombus size being significant predictors.
  • Unfavorable DRT evolution is linked to a higher rate of thromboembolic events, emphasizing the importance of monitoring thrombus size post-LAAC.
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Purpose: To investigate the impact of diabetic retinopathy (DR) on morphological choriocapillaris (CC) modifications in eyes with type 1 macular neovascularization (MNV) secondary to AMD using optical coherence tomography angiography (OCTA).

Methods: Eyes with AMD-related type 1 MNV with and without DR were prospectively included. We performed 3 × 3 mm OCTA scans at two visits: before the loading phase of intravitreal injections of aflibercept (T1) and 1 month after the last injection (T2).

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Article Synopsis
  • The study focused on primary mitral regurgitation (PMR) and how cardiac remodeling affects patient selection for transcatheter edge-to-edge repair (TEER).
  • Researchers analyzed data from 654 patients with PMR, looking at extra-mitral valve (MV) cardiac involvement and tracking outcomes over two years.
  • Results showed that patients with left or right heart involvement had significantly worse survival rates compared to those with no cardiac involvement, highlighting the importance of assessing cardiac involvement for better risk stratification.
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Atrial functional mitral regurgitation (aFMR) has a peculiar pathophysiology that may have distinctive outcomes. We investigated the impact of transcatheter edge-to-edge repair in aFMR compared with other FMR etiologies. The GIOTTO (GIse registry Of Transcatheter treatment of MR) is a multicenter, prospective study enrolling patients with symptomatic MR treated with MitraClip up to 2020.

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A Novel Transcatheter Device for the Edge-to-Edge Treatment of Tricuspid Regurgitation: A Preliminary Evaluation.

Ann Biomed Eng

March 2024

Department of Electronics, Information and Bioengineering, Politecnico di Milano, Via Golgi 39, 20133, Milan, Italy.

Tricuspid regurgitation (TR) is the most common pathology of the tricuspid valve (TV), with significant mortality in severe cases. A well-established strategy to treat TR is represented by the clover surgical technique, which consists of stitching together the free edges of TV leaflets, producing a clover-shaped valvular orifice. Transcatheter treatments for TR constitute a valuable alternative for high-risk patients.

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Perinatal asphyxia and hypothermic treatment from the endocrine perspective.

Front Endocrinol (Lausanne)

November 2023

Department of Translational Medical Sciences, Paediatric Endocrinology Unit, University "Federico II", Naples, Italy.

Article Synopsis
  • - Perinatal asphyxia significantly contributes to neonatal death and health issues, with therapeutic hypothermia being the standard treatment that reduces mortality and major developmental disabilities.
  • - Endocrine-related problems, such as glucose and electrolyte imbalances or adrenal complications, can arise in infants experiencing perinatal asphyxia, potentially impacting their health outcomes.
  • - Clinicians need to recognize the potential endocrine complications in asphyxiated infants to implement effective screening and timely interventions for improving overall outcomes.
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Article Synopsis
  • The study aimed to compare the characteristics and outcomes of patients with atrial STR (ASTR) and ventricular STR (VSTR) who underwent transcatheter edge-to-edge repair (T-TEER) for tricuspid regurgitation (TR).
  • Patients were categorized into ASTR or VSTR based on specific cardiac criteria, and a total of 298 were included in the analysis, with similar procedural success rates for both groups.
  • Results showed that while T-TEER effectively reduced TR in both ASTR and VSTR patients, survival rates at 12 months were significantly higher for ASTR (91%) compared to VSTR (72%).
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Purpose: This study was designed to investigate retinal nerve fiber layer (RNFL) and radial peripapillary capillaries (RPC) changes on optical coherence tomography (OCT) angiography and OCT thickness alterations associated with acutely increased intraocular pressure after intravitreal injections.

Methods: This observational clinical study was conducted on 35 eyes (35 patients) with treatment-naïve age-related macular degeneration (AMD) and type 1 or type 2 MNV were enrolled. All patients underwent anti-vascular endothelial grow factor (VEGF) intravitreal injections with 0.

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Background: The fourth-generation mitral transcatheter edge-to-edge repair (M-TEER) device introduced an improved clip deployment sequence, independent leaflet grasping, and 2 wider clip sizes to tailor the treatment of patients with mitral regurgitation (MR) for a broad range of anatomies. The 30-day safety and effectiveness of the fourth-generation M-TEER device were previously demonstrated.

Objectives: The aim of this study was to evaluate 1-year outcomes in a contemporary, real-world cohort of subjects treated with the MitraClip G4 system.

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Aims: Many historical and recent reports showed that post-infarction ventricular septal rupture (VSR) represents a life-threatening condition and the strategy to optimally manage it remains undefined. Therefore, disparate treatment policies among different centres with variable results are often described. We analysed data from European centres to capture the current clinical practice in VSR management.

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Background: Approximately 1 in 10 patients with an ileal pouch-anal anastomosis is diagnosed with Crohn's disease of the pouch (CDP). However, this diagnosis may be established inappropriately, as alternative underlying causes necessitating an alternative treatment approach, such as long-term surgical sequelae, may mimic CDP. In this study, we aimed to identify patients diagnosed with and treated for CDP with a (concurrent) alternative diagnosis.

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The purpose of this study was to investigate the effect of diabetic retinopathy (DR) on longitudinal morphological changes in AMD-associated type 1 macular neovascularization using optical coherence tomography angiography (OCTA). We enrolled fifty treatment-naïve eyes with a diagnosis of exudative AMD and type 1 MNV. Twenty of 50 eyes were affected by mild DR.

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Introduction: The aim of this work is to utilize swept-source optical coherence tomography angiography (SS-OCTA) to assess the long-term changes in the choroidal and choriocapillaris (CC) layers of the fellow unaffected eye of patients with unilateral resolved chronic central serous chorioretinopathy (cCSC) following treatment with continuous oral eplerenone (EPL).

Methods: The study included 35 patients with cCSC and subretinal fluid (SRF) in one eye. SS-OCTA imaging was performed on the fellow cCSC eyes at baseline, 6 months, and 12 months during eplerenone therapy.

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