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Vanni G, Pedini D, Materazzo M, Farinaccio A, Perretta T, Pistolese CA, Buonomo OC. Unusual Presentation of a Post-procedural Breast Hematoma: A Case Report. In Vivo 2021; 35:2957-2961. [PMID: 34410994 DOI: 10.21873/invivo.12589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 05/31/2021] [Accepted: 06/04/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM Hematoma is the most frequent complication after Vacuum-Assisted Breast Biopsy (VABB) in 13% of cases. A direct communication channel with patients eases the diagnosis of VABB complications and ensures treatment at an early stage, as outpatients, in most cases. In 2020, due to the COVID-19 pandemic, we observed a reduction of self-reported postoperative complication leading to delay in the identification of harmful complications, therefore leading to need for more invasive treatment. CASE REPORT A 50-year-old patient was admitted to the Emergency Department for dry cough, fever, chest discomfort, dyspnea, and slight confusion four days after VABB. Due to the reported symptoms, the patient was sent to our COVID-19 Emergency Department. The COVID-19 swab was negative. Ultrasound revealed a large hematoma at the biopsy site, with active bleeding. Open evacuation with accurate hemostasis was planned with rapid and complete resolution of the clinical symptoms. After surgery, the patient reported that she intentionally avoided admittance in the hospital due to the risk of COVID-19 infection. The patient was discharged in the first postoperative day and maintained in quarantine for 14 days. CONCLUSION In the COVID-19 era due to the risk of hospital cross-infections, reduction of patient-doctor communication could lead to misdiagnosis, delay in recognition of procedural complications thus leading to requirement for invasive treatment, hospitalization, while also further multiplying the risk of COVID-19 infection.
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Affiliation(s)
- Gianluca Vanni
- Breast Unit, Department of Surgical Science, Policlinico Tor Vergata University, Rome, Italy
| | - Domiziana Pedini
- Breast Unit, Department of Surgical Science, Policlinico Tor Vergata University, Rome, Italy
| | - Marco Materazzo
- Breast Unit, Department of Surgical Science, Policlinico Tor Vergata University, Rome, Italy;
| | - Andrea Farinaccio
- Cardiac and Thoracic Anesthesia Unit, Tor Vergata University Hospital, Rome, Italy
| | - Tommaso Perretta
- Department of Diagnostic Imaging and Interventional Radiology, Molecular Imaging and Radiotherapy, Policlinico Tor Vergata University, Rome, Italy
| | - Chiara Adriana Pistolese
- Department of Diagnostic Imaging and Interventional Radiology, Molecular Imaging and Radiotherapy, Policlinico Tor Vergata University, Rome, Italy
| | - Oreste Claudio Buonomo
- Breast Unit, Department of Surgical Science, Policlinico Tor Vergata University, Rome, Italy
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Materazzo M, Vanni G, Pellicciaro M, Anemona L, Servadei F, Giacobbi E, Farinaccio A, Pistolese CA, Perretta T, Chiocchi M, Bruno V, Tacconi F, Sadri A, De Majo A, Di Pasquali C, Meucci R, Santori F, Cotesta M, Buonomo OC. Case Report: Early Breast Cancer Recurrence Mimicking BIA-ALCL in a Patient With Multiple Breast Procedures. Front Surg 2021; 8:606864. [PMID: 33768110 PMCID: PMC7985528 DOI: 10.3389/fsurg.2021.606864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 02/18/2021] [Indexed: 12/02/2022] Open
Abstract
Breast reconstruction plays a fundamental role in the therapeutic process of breast cancer treatment and breast implants represents the leading breast reconstruction strategy. Breast Implant Associated-Anaplastic Large Cell Lymphoma (BIA-ALCL), locoregional recurrence in the skin flap, and skin flap necrosis are well-known complications following mastectomy and immediate breast reconstruction (IBR). We report a case of locoregional cancer recurrence in the mastectomy flap mimicking BIA-ALCL, in a patient who underwent 6 breast procedures in four facilities across 15 years including immediate breast reconstruction with macrotextured breast implants. Despite the rate and onset of the disease, clinicians should be aware of BIA-ALCL. Due to the risk of false negative results of fine needle aspiration, clinical suspicion of BIA-ALCL should drive clinicians' choices, aside from cytological results. In the present case, surgical capsulectomy of the abnormal periprosthesic tissue revealed locoregional recurrence.
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Affiliation(s)
- Marco Materazzo
- Breast Unit, Department of Surgical Science, Policlinico Tor Vergata University, Rome, Italy
| | - Gianluca Vanni
- Breast Unit, Department of Surgical Science, Policlinico Tor Vergata University, Rome, Italy
| | - Marco Pellicciaro
- Breast Unit, Department of Surgical Science, Policlinico Tor Vergata University, Rome, Italy
| | - Lucia Anemona
- Anatomic Pathology, Department of Experimental Medicine, Policlinico Tor Vergata University, Rome, Italy
| | - Francesca Servadei
- Anatomic Pathology, Department of Experimental Medicine, Policlinico Tor Vergata University, Rome, Italy
| | - Erika Giacobbi
- Anatomic Pathology, Department of Experimental Medicine, Policlinico Tor Vergata University, Rome, Italy
| | - Andrea Farinaccio
- Department of Cardiothoracic Anesthesia, Tor Vergata University Hospital, Rome, Italy
| | - Chiara Adriana Pistolese
- Department of Diagnostic Imaging and Interventional Radiology, Molecular Imaging and Radiotherapy, Policlinico Tor Vergata University, Rome, Italy
| | - Tommaso Perretta
- Department of Diagnostic Imaging and Interventional Radiology, Molecular Imaging and Radiotherapy, Policlinico Tor Vergata University, Rome, Italy
| | - Marcello Chiocchi
- Department of Diagnostic Imaging and Interventional Radiology, Molecular Imaging and Radiotherapy, Policlinico Tor Vergata University, Rome, Italy
| | - Valentina Bruno
- Section of Gynecology and Obstetrics, Academic Department of Biomedicine and Prevention, University Tor Vergata, Rome, Italy
| | - Federico Tacconi
- Division of Thoracic Surgery, Department of Surgical Science, Policlinico Tor Vergata University, Rome, Italy
| | - Amir Sadri
- Plastic Surgery, Great Hormond Hospital for Children NHS Foundation Trust, London, United Kingdom
| | - Adriano De Majo
- Breast Unit, Department of Surgical Science, Policlinico Tor Vergata University, Rome, Italy
| | - Camilla Di Pasquali
- Breast Unit, Department of Surgical Science, Policlinico Tor Vergata University, Rome, Italy
| | - Rosaria Meucci
- Department of Diagnostic Imaging and Interventional Radiology, Molecular Imaging and Radiotherapy, Policlinico Tor Vergata University, Rome, Italy
| | - Francesca Santori
- Breast Unit, Department of Surgical Science, Policlinico Tor Vergata University, Rome, Italy
| | - Maria Cotesta
- Breast Unit, Department of Surgical Science, Policlinico Tor Vergata University, Rome, Italy
| | - Oreste Claudio Buonomo
- Breast Unit, Department of Surgical Science, Policlinico Tor Vergata University, Rome, Italy
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Pisano C, Farinaccio A, Altieri C, Ajello V, Nardi P, Colella DF, Ruvolo G. Imaging and monitoring in minimally invasive valve surgery using an intra-aortic occlusion device: a single center experience. J Thorac Dis 2021; 13:1011-1019. [PMID: 33717574 PMCID: PMC7947524 DOI: 10.21037/jtd-20-3032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Background Minimally invasive approach through a right mini-thoracotomy is a world-wide used procedure for mitral valve surgery. We performed a retrospective analysis based on our center experience in order to propose an effective, safe and reproducible method using an intra-aortic occlusion device. Methods This is a retrospective analysis on 48 consecutive patients undergoing mitral valve surgery through a right anterolateral mini-thoracotomy in our center. An intra-aortic occlusion device was used for aortic clamping and cardioplegia delivery. Simultaneous multi-plane three-dimensional echocardiography imaging was acquired to detect the venous cannulas position, the intra-aortic device location in the ascending aorta, the balloon inflation, the complete occlusion of the aorta, the cardioplegia delivery, the origin and the blood flow in the right coronary artery. Aortic root pressure was measured by the tip of the intra-aortic occlusion device. A bilateral upper extremity invasive arterial pressure monitoring was detected. Neuromonitoring was performed through bilateral cerebral oximetry. Results The analysis has shown no aortic dissection, neurological damage type 1 and myocardial ischemia in the study population. In 3 cases a distal displacement of the intra-aortic occlusion device was promptly detected by the combined use of echocardiographic imaging and by a drop of the right cerebral oximetry saturation and of the right radial artery pressure. Conclusions The combined use of transesophageal simultaneous multi-plane three- dimensional echocardiography imaging, bilateral upper extremity invasive arterial pressure monitoring, aortic root pressure and cerebral oximetry is an effective, safe and reproducible method in patients undergoing minimally invasive valve surgery using an intra-aortic occlusion device.
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Affiliation(s)
- Calogera Pisano
- Cardiac Surgery Unit, Department of Surgical Science, Tor Vergata University Hospital, Rome, Italy
| | - Andrea Farinaccio
- Cardiac and Thoracic Anesthesia Unit, Tor Vergata University Hospital, Rome, Italy
| | - Claudia Altieri
- Cardiac Surgery Unit, Department of Surgical Science, Tor Vergata University Hospital, Rome, Italy
| | - Valentina Ajello
- Cardiac and Thoracic Anesthesia Unit, Tor Vergata University Hospital, Rome, Italy
| | - Paolo Nardi
- Cardiac Surgery Unit, Department of Surgical Science, Tor Vergata University Hospital, Rome, Italy
| | | | - Giovanni Ruvolo
- Cardiac Surgery Unit, Department of Surgical Science, Tor Vergata University Hospital, Rome, Italy
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Vanni G, Materazzo M, Dauri M, Farinaccio A, Buonomo C, Portarena I, Pellicciaro M, Legramante JM, Rizza S, Chiaramonte C, Bellia A, Grande M, Potenza S, Sbordone FP, Perrone MA, Grimaldi F, Chiocchi M, Buonomo OC. Lymphocytes, Interleukin 6 and D-dimer Cannot Predict Clinical Outcome in Coronavirus Cancer Patients: LyNC1.20 Study. Anticancer Res 2021; 41:307-316. [PMID: 33419825 DOI: 10.21873/anticanres.14777] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 12/14/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM Knowledge of Coronavirus 19 (COVID19) pathogenetic mechanisms is necessary to provide new treatment strategies. This study aims to assess how oncological disease impacts on the clinical course of COVID-19 patients. PATIENTS AND METHODS From 1st March to 30th April 2020, 96 COVID-19 patients were classified according to clinical outcome as severe (n=67) and moderate (n=29). Demographic data, medical history, admission lymphocytes, procalcitonin (PCT), c-reactive-protein (CRP), D-dimer, and Interleukin-6 (IL-6) were collected. RESULTS A statistically significant association was found between hypertension (p=0.007) and three or more comorbidities with severe outcomes (p=0.034). No statistical differences were found between the severe and moderate groups with regards to the rate of patients with past oncological history. However, no patient allocated in the moderate group had received oncological treatment within 12 months. Higher values of CRP, IL-6, D-Dimer and lower values of lymphocytes were reported in the severe group (p=0.0007, p=0.00386, p=0.041, and p=0.007, respectively). Using binary logistic regression, higher values of CRP (OR=8.861; p=0.012) and PCT were associated with a higher risk of severe outcome (OR=21.075; p=0.008). Within the oncological population, D-Dimer and IL-6 did not confirm their prognostic significance as in the general population (p>0.05). CONCLUSION Specific prognostic factors for oncological patients should be designed for COVID-19 clinical practice.
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Affiliation(s)
- Gianluca Vanni
- Breast Unit, Department of Surgical Science, Policlinico Tor Vergata University, Rome, Italy;
| | - Marco Materazzo
- Breast Unit, Department of Surgical Science, Policlinico Tor Vergata University, Rome, Italy
| | - Mario Dauri
- Department of Emergency and Admission, Critical Care Medicine, Pain Medicine and Anesthetic Science, Policlinico Tor Vergata University, Rome, Italy
| | - Andrea Farinaccio
- Department of Emergency and Admission, Critical Care Medicine, Pain Medicine and Anesthetic Science, Policlinico Tor Vergata University, Rome, Italy
| | - Chiara Buonomo
- Department of Emergency and Admission, Critical Care Medicine, Pain Medicine and Anesthetic Science, Policlinico Tor Vergata University, Rome, Italy
| | - Ilaria Portarena
- Breast Unit, Department of Surgical Science, Policlinico Tor Vergata University, Rome, Italy
| | - Marco Pellicciaro
- Breast Unit, Department of Surgical Science, Policlinico Tor Vergata University, Rome, Italy
| | | | - Stefano Rizza
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Carlo Chiaramonte
- Department of Emergency and Admission, Critical Care Medicine, Pain Medicine and Anesthetic Science, Policlinico Tor Vergata University, Rome, Italy
| | - Alfonso Bellia
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Michele Grande
- Department of General and Emergency Surgery, University of Tor Vergata, Rome, Italy
| | - Saverio Potenza
- Department of Biomedicine and Prevention, Section of Legal Medicine, Social Security and Forensic Toxicology, University of Rome Tor Vergata, Rome, Italy
| | - Francesco Paolo Sbordone
- Department of Biomedicine and Prevention, Division of Diagnostic Imaging, University of Rome Tor Vergata, Rome, Italy
| | | | - Francesco Grimaldi
- Department of Biomedicine and Prevention, Division of Diagnostic Imaging, University of Rome Tor Vergata, Rome, Italy
| | - Marcello Chiocchi
- Department of Biomedicine and Prevention, Division of Diagnostic Imaging, University of Rome Tor Vergata, Rome, Italy
| | - Oreste Claudio Buonomo
- Breast Unit, Department of Surgical Science, Policlinico Tor Vergata University, Rome, Italy
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Vanni G, Legramante JM, Pellicciaro M, DE Carolis G, Cotesta M, Materazzo M, Buonomo C, Farinaccio A, Santori F, Saraceno F, Ielpo B, Aiello F, Paganelli C, Grande M, DE Andreis G, Chiocchi M, Palombi L, Buonomo OC. Effect of Lockdown in Surgical Emergency Accesses: Experience of a COVID-19 Hospital. In Vivo 2020; 34:3033-3038. [PMID: 32871849 PMCID: PMC7652486 DOI: 10.21873/invivo.12137] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 07/06/2020] [Accepted: 07/09/2020] [Indexed: 01/10/2023]
Abstract
BACKGROUND/AIM SARS-CoV-2 pandemic imposed extraordinary restriction measures and a complete reorganization of the Health System. The aim of the study was to evaluate the impact of COVID-19 on emergency surgical department accesses. PATIENTS AND METHODS Patients admitted to surgical emergency departments was retrospectively recorded during the Lockdown (March 11, 2020-May 3, 2020) and compared with the same number of days in 2019 and immediately before Lockdown (January 16, 2020-March 10, 2020). Diagnoses, priority levels, modes of patient's transportation, waiting times and outcomes were analysed. RESULTS During the lockdown phase, we ob-served a reduction in the access to emergency surgical departments of 84.45% and 79.78%, com-pared with the Pre-Lockdown2019 and Pre-Lockdown2020 groups, respectively. Patient's transportation, hospitalization and patients discharge with indications to an outpatient visit, waiting and total times exhibited a significant difference during the lockdown (p<0.005). CONCLUSION We observed a reduction of surgical emergency accesses during the lockdown. Implementing the use of the regional systems and preventing overcrowding of emergency departments could be beneficial for reducing waiting times and improving the quality of treatments for patients.
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Affiliation(s)
- Gianluca Vanni
- Breast Unit, Department of Surgical Science, Policlinico Tor Vergata University, Rome, Italy
| | - Jacopo Maria Legramante
- Department of Medical Systems, Università di Tor Vergata, Rome, Italy
- Emergency Department, Policlinico Tor Vergata, Rome, Italy
| | - Marco Pellicciaro
- Breast Unit, Department of Surgical Science, Policlinico Tor Vergata University, Rome, Italy
| | | | - Maria Cotesta
- Breast Unit, Department of Surgical Science, Policlinico Tor Vergata University, Rome, Italy
| | - Marco Materazzo
- Breast Unit, Department of Surgical Science, Policlinico Tor Vergata University, Rome, Italy
| | - Chiara Buonomo
- Department of Emergency and Admission, Critical Care Medicine, Pain Medicine and Anes-thetic Science, Policlinico Tor Vergata University, Rome, Italy
| | - Andrea Farinaccio
- Department of Emergency and Admission, Critical Care Medicine, Pain Medicine and Anes-thetic Science, Policlinico Tor Vergata University, Rome, Italy
| | - Francesca Santori
- Breast Unit, Department of Surgical Science, Policlinico Tor Vergata University, Rome, Italy
| | | | | | - Francesco Aiello
- Ophthalmology Unit, Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy
| | | | - Michele Grande
- Department of General and Emergency Surgery, University of Tor Vergata, Rome, Italy
| | | | - Marcello Chiocchi
- Department of Diagnostic Imaging, Molecular Imaging, Interventional Radiology and Radio-therapy, University of Rome Tor Vergata, Rome, Italy
| | - Leonardo Palombi
- Department of Biomedicine and Prevention, Policlinico Tor Vergata University, Rome, Italy
| | - Oreste Claudio Buonomo
- Breast Unit, Department of Surgical Science, Policlinico Tor Vergata University, Rome, Italy
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Farinaccio A, Pisano C, Ajello V, Prati P, Scafuri A, Buonomo C, Ruvolo G, Colella D. Safe management of minimally invasive valve surgery using a intra aortic occlusion device: case series of 52 patients. J Cardiothorac Vasc Anesth 2019. [DOI: 10.1053/j.jvca.2019.07.080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Ajello V, Flaminio M, Moresco M, Farinaccio A, Prati P, Tartaglione A, Scaini R, Strudel F, Iasevoli N, Colella D. Risk factors associated with the onset of delirium in a post-operative cardiac surgical ICU. J Cardiothorac Vasc Anesth 2019. [DOI: 10.1053/j.jvca.2019.07.093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Bassano C, Bovio E, Uva F, Iacobelli S, Iasevoli N, Farinaccio A, Ruvolo G. Partially anaortic clampless off-pump coronary artery bypass prevents neurologic injury compared to on-pump coronary surgery: a propensity score-matched study on 286 patients. Heart Vessels 2015; 31:1412-7. [PMID: 26498755 PMCID: PMC5010601 DOI: 10.1007/s00380-015-0748-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Accepted: 09/09/2015] [Indexed: 11/26/2022]
Abstract
Anaortic coronary artery bypass proved to prevent early neurologic injury compared to on-pump CABG. The Cardica PAS-Port(®) is a fully automated device that might be able to perform proximal aorto-venous anastomoses without an increased embolic risk. We evaluated early post-operative neurologic outcome in a matched population following clampless OPCAB (CCAB: either "all-arterial" or with automatically anastomosed venous grafts) or on-pump CABG. 366 consecutive patients were submitted to isolated coronary bypass by a single surgeon experienced in both off and on-pump procedures between January 2009 and December 2013. Of these patients, 223 underwent a clampless off-pump revascularization. After propensity score matching, 143 pairs were selected, who received either off-pump or on-pump surgery. In the off-pump group, CCAB was performed with an all-arterial approach (n = 33) or with automated proximal anastomosis of the venous graft(s) by means of the Cardica PAS-Port(®) connector (n = 110). Neurologic injury was defined as non-reversible (NRNI: lethal coma or stroke) or reversible (RNI: TIA or delirium). Operative mortality was 2.4 % (CCAB 1.4 %; CABG 3.5 %; p = 0.14). The global rate of early neurologic injury was 5.6 % (CCAB 2.1 vs. CABG 9.1 %; p = 0.006). Incidence was 1.4 % for NRNI (CCAB 0 vs. CABG 2.8 %; p = 0.04) and 4.2 % for RNI (CCAB 2.1 vs. CABG 6.3 %; p = 0.06). No differences were found among other major perioperative outcomes. CCAB prevents both early post-operative RNI and NRNI. This result can be achieved with a totally anaortic strategy and also with the aid of a fully automated device for proximal aorto-venous anastomoses.
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Affiliation(s)
- Carlo Bassano
- Operative Units of Cardiac Surgery, Tor Vergata University, Rome, Italy.
| | - Emanuele Bovio
- Operative Units of Cardiac Surgery, Tor Vergata University, Rome, Italy
| | - Floriano Uva
- Operative Units of Cardiac Surgery, Tor Vergata University, Rome, Italy
| | - Simona Iacobelli
- Interdepartmental Center of Biostatistics and Bioinformatics, Tor Vergata University, Rome, Italy
| | - Nicola Iasevoli
- Operative Units of Anesthesiology, Tor Vergata University, Rome, Italy
| | - Andrea Farinaccio
- Operative Units of Anesthesiology, Tor Vergata University, Rome, Italy
| | - Giovanni Ruvolo
- Operative Units of Cardiac Surgery, Tor Vergata University, Rome, Italy
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Bassano C, Bovio E, Sperandio M, Uva F, Farinaccio A, Prati P, Chiariello L. Five-year clinical outcome and patency rate of device-dependent venous grafts after clampless OPCAB with PAS-port automated proximal anastomosis: the PAPA Study. J Card Surg 2014; 29:325-32. [PMID: 24883445 DOI: 10.1111/jocs.12274] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To evaluate long-term clinical performance and angiographic patency of automated proximal venous anastomoses following clampless coronary artery bypass (C-CAB). METHODS Observational study in patients submitted for isolated C-CAB and at least one proximal aortosaphenous anastomosis performed with an automated connector (Cardica PAS-Port) including 152 consecutive patients (165 devices and 199 device-dependent distal anastomoses), with LVEF > 30% and saphenous vein diameter of 4-6 mm. Clinical follow-up was 96% complete (4101/4269 pt-months). Graft patency rate was assessed with 64-slice CT-scan or coronary angiography. Freedom from major adverse cardiac and cerebrovascular events (MACCE) was reported as actuarial probability with 95% confidence limits and venous graft patency as actual rate at every year interval. RESULTS Early operative mortality was 1.9%; incidence of neurologic injury was zero. Freedom from MACCE was 92.7 ± 2.1 at one year and 85.2 ± 4.8 at five years. The actual patency rate of device-dependent venous grafts was 90%, 85%, 84%, 84%, and 93% for one-, two-, three-, four-, and five-year-old grafts, respectively. CONCLUSIONS The device is a well-performing system for proximal anastomoses. The incidence of neurologic complications seems to be reduced with this clampless approach. The high patency rate is stable over time.
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Ajello V, Farinaccio A, Prati P, De Vico P, Colella DF. O-38 TEG and thrombin generation during coronary artery bypass grafting: a comparison between on-pump and off-pump techniques. J Cardiothorac Vasc Anesth 2011. [DOI: 10.1053/j.jvca.2011.03.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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