1
|
Aschauer J, Zilberszac R, Gleiss A, Colizzi C, Binder T, Bruno P, Laufer G, Massetti M, Gabriel H, Rosenhek R. Long-term outcome of bicuspid aortic valve disease. Eur Heart J Cardiovasc Imaging 2024; 25:425-435. [PMID: 37966276 PMCID: PMC10883726 DOI: 10.1093/ehjci/jead312] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 11/06/2023] [Accepted: 11/06/2023] [Indexed: 11/16/2023] Open
Abstract
AIMS Bicuspid aortic valve (BAV) is a common congenital condition that is frequently associated with aortic stenosis (AS) and aortic regurgitation (AR), as well as aortic aneurysms, but specific outcome data are scarce. The present study sought to assess outcomes in a large cohort of consecutive patients with BAV. METHODS AND RESULTS A total of 581 consecutive patients (median age 29 years, 157 female) with BAV were included in the study and followed prospectively in a heart valve clinic follow-up programme. The overall survival rate after 10 years was 94.5%. During follow-up, 158 patients developed an indication for surgery. Event-free survival rates were 97%, 94%, 87%, and 73% at 1, 2, 5, and 10 years, respectively. In the multivariable analysis, event rates were independently predicted by AS [subdistribution hazard ratio (SHR) 2.3 per degree of severity], AR (SHR 1.5 per degree of severity), baseline aortic dilatation ≥ 40 mm (SHR 1.9), and age (SHR 1.3) (P < 0.001). CONCLUSION BAV disease is associated with a high rate of cardiac events, but state-of-the-art care results in good survival with low rates of infective endocarditis, aortic dissection, and sudden death. Incremental degrees of AS and regurgitation, the presence of aortic dilatation, and age are predictive of cardiac events.
Collapse
Affiliation(s)
- Julia Aschauer
- Department of Cardiology, Vienna General Hospital, Medical University of Vienna, Waehringer Guertel 18-20, Vienna 1090, Austria
| | - Robert Zilberszac
- Department of Cardiology, Vienna General Hospital, Medical University of Vienna, Waehringer Guertel 18-20, Vienna 1090, Austria
| | - Andreas Gleiss
- Center for Medical Data Science, Institute of Clinical Biometrics, Medical University of Vienna, Vienna, Austria
| | - Christian Colizzi
- Institute of Cardiology, Catholic University of Sacred Heart, Rome, Italy
| | - Thomas Binder
- Department of Cardiology, Vienna General Hospital, Medical University of Vienna, Waehringer Guertel 18-20, Vienna 1090, Austria
| | - Piergiorgio Bruno
- Institute of Cardiology, Catholic University of Sacred Heart, Rome, Italy
| | - Günther Laufer
- Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria
| | - Massimo Massetti
- Institute of Cardiology, Catholic University of Sacred Heart, Rome, Italy
| | - Harald Gabriel
- Department of Cardiology, Vienna General Hospital, Medical University of Vienna, Waehringer Guertel 18-20, Vienna 1090, Austria
| | - Raphael Rosenhek
- Department of Cardiology, Vienna General Hospital, Medical University of Vienna, Waehringer Guertel 18-20, Vienna 1090, Austria
| |
Collapse
|
2
|
Locorotondo G, Colizzi C, Lombardo A, Massetti M. Inter-atrial septal dehiscence due to incomplete closure of trans-septal incision after cardiac surgical bi-atrial trans-septal approach. Eur Heart J Cardiovasc Imaging 2023; 24:e307. [PMID: 37675844 PMCID: PMC10667023 DOI: 10.1093/ehjci/jead226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 09/03/2023] [Indexed: 09/08/2023] Open
Affiliation(s)
- Gabriella Locorotondo
- Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS Rome, Largo A. Gemelli 8, 00168 Rome, Italy
| | - Christian Colizzi
- Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS Rome, Largo A. Gemelli 8, 00168 Rome, Italy
| | - Antonella Lombardo
- Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS Rome, Largo A. Gemelli 8, 00168 Rome, Italy
- Department of Cardiovascular Sciences, Catholic University of the Sacred Heart, Rome, Italy
| | - Massimo Massetti
- Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS Rome, Largo A. Gemelli 8, 00168 Rome, Italy
- Department of Cardiovascular Sciences, Catholic University of the Sacred Heart, Rome, Italy
| |
Collapse
|
3
|
Panaioli E, Graziani F, Lillo R, Delogu AB, Grandinetti M, Di Molfetta A, Perri G, Pasquini A, Colizzi C, Lombardo A, Locorotondo G, Amodeo A, Secinaro A, Bruno P, Lanza GA, Massetti M. Early Right Heart Chambers Reverse Remodeling in Patients Operated in Adulthood for Congenital Lesions Associated with Right Heart Chambers Enlargement. World J Pediatr Congenit Heart Surg 2021; 12:747-753. [PMID: 34846962 DOI: 10.1177/21501351211040474] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Progressive right heart chambers dilatation is frequent in the adult congenital heart disease (ACHD) population. We evaluated the immediate and mid-term response of right heart chambers to surgery performed in adulthood for lesions associated with right heart chambers enlargement. METHODS Thirty-six adult patients with lesions associated with right heart chambers enlargement submitted to surgery were studied. We collected echocardiographic data of right ventricle (RV) mid-diameter, right atrial volume indexed, RV systolic pressure, and tricuspid annular plane systolic excursion (TAPSE) prior to surgery (T0), at 2 to 5 days (T1), and 3 to 6 months (T2) after surgery. RESULTS At T1, we observed a significant decrease of RV mid-diameter (47.2 ± 8.4 vs. 39.6 ± 7.4 mm, P < .001), right atrial volume indexed (45.6 ± 26.6 vs. 27.2 ± 11 ml/m2, P < .001), and RV systolic pressure (39 ± 14.8 vs. 32.8 ± 11.3 mm Hg, P = .03). At T2, a further significant deviation in the rate of RV diameter (39.6 ± 7.4 vs. 34.5 ± 5.1 mm, P < .001), in RV systolic pressure (32.8 ± 11.3 vs. 25.3 ± 5 mm Hg, P = .03) and TAPSE (13.9 ± 3.2 vs. 15.8 ± 2.6 mm, P < .001) was observed. CONCLUSIONS Positive right heart chambers remodeling occurs as early as in the immediate post-operative period in most ACHD patients operated for lesions associated with right heart chambers enlargement.
Collapse
Affiliation(s)
- Elena Panaioli
- 60234Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Catholic University of the Sacred Heart, Rome, Italy
| | | | - Rosa Lillo
- 60234Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Catholic University of the Sacred Heart, Rome, Italy
| | - Angelica Bibiana Delogu
- Catholic University of the Sacred Heart, Rome, Italy.,18654Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Maria Grandinetti
- 60234Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | | | - Gianluigi Perri
- 9342Bambino Gesù Hospital Children Hospital, IRCCS, Rome, Italy
| | - Annalisa Pasquini
- 60234Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Christian Colizzi
- 60234Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Antonella Lombardo
- 60234Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Catholic University of the Sacred Heart, Rome, Italy
| | | | - Antonio Amodeo
- 9342Bambino Gesù Hospital Children Hospital, IRCCS, Rome, Italy
| | | | - Piergiorgio Bruno
- 60234Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Gaetano Antonio Lanza
- 60234Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Catholic University of the Sacred Heart, Rome, Italy
| | - Massimo Massetti
- 60234Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Catholic University of the Sacred Heart, Rome, Italy
| |
Collapse
|
4
|
Cammertoni F, Bruno P, Pavone N, Farina P, Colizzi C, Coli A, Massetti M. Unexpected diagnosis following screening breast ultrasound. Clin Case Rep 2020; 8:2073-2075. [PMID: 33088557 PMCID: PMC7562835 DOI: 10.1002/ccr3.3014] [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: 03/22/2020] [Revised: 05/12/2020] [Accepted: 05/18/2020] [Indexed: 11/23/2022] Open
Abstract
Any instrumental examination may lead to unexpected diagnosis that in turn can radically change the clinical pathway of a patient.
Collapse
Affiliation(s)
- Federico Cammertoni
- Department of Cardiovascular Sciences Cardiac Surgery Unit Fondazione Policlinico Universitario "A. Gemelli" IRCCS Rome Italy
| | - Piergiorgio Bruno
- Department of Cardiovascular Sciences Cardiac Surgery Unit Fondazione Policlinico Universitario "A. Gemelli" IRCCS Rome Italy
| | - Natalia Pavone
- Department of Cardiovascular Sciences Cardiac Surgery Unit Fondazione Policlinico Universitario "A. Gemelli" IRCCS Rome Italy
| | - Piero Farina
- Department of Cardiovascular Sciences Cardiac Surgery Unit Fondazione Policlinico Universitario "A. Gemelli" IRCCS Rome Italy
| | - Christian Colizzi
- Department of Cardiovascular Sciences Cardiac Surgery Unit Fondazione Policlinico Universitario "A. Gemelli" IRCCS Rome Italy
| | - Antonella Coli
- Department of Pathological Anatomy Fondazione Policlinico Universitario "A. Gemelli" IRCCS Rome Italy
| | - Massimo Massetti
- Department of Cardiovascular Sciences Cardiac Surgery Unit Fondazione Policlinico Universitario "A. Gemelli" IRCCS Rome Italy
| |
Collapse
|
5
|
Piarulli A, Chiariello GA, Bruno P, Cammertoni F, Rabini A, Pavone N, Pasquini A, Ferraro F, Mazza A, Nesta M, Iafrancesco M, Colizzi C, Massetti M. Psychological Effects of Skin Incision Size in Minimally Invasive Valve Surgery Patients. Innovations�(Phila) 2020; 15:532-540. [DOI: 10.1177/1556984520956980] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Objective Clinical benefits of minimally invasive cardiac valve surgery (MIVS) have been reported. Improved postoperative mental status was never analyzed with dedicated psychological tests. In the present study we intend to investigate potential benefits of MIVS for patient psychological well-being, with special attention to the relevance of the patient perception of the chest surgical scar, of the self body image and cosmetic aspects. Methods Between 2016 and 2017, 87 eligible patients, age 66.5 ± 14.5 years, operated on for heart valve surgery, underwent either conventional full sternotomy (CS; n = 48) or MIVS by V-shape hemi-sternotomy approach ( n = 39). Before selection of the surgical approach, patients had undergone preoperative evaluation of their psychological status using Beck Depression Inventory-II (BDI-II), State-Trait Anxiety Inventory Form Y (STAI-Y), and EuroQol-5D (EQ-5D) psychological tests. Six months postoperatively, patients filled in dedicated questionnaires to assess their psychological status, quality of life, and subjective perception, thus repeating the above-mentioned tests and adding the Body Image Questionnaire (BIQ) and Patient and Observer Scar Assessment Scale (POSAS) v2.0 tests for scar-healing process evaluation. Results No patient died during the study.The 4 post-test scales of psychological well-being (BDI-II P = 0.04, STAI-Y P = 0.04, 2 indices of EQ-5D P = 0.03, P = 0.01) showed significant differences between the MIVS group and CS group, with MIVS-small incision patients having lower level of depression and anxiety symptoms and better quality of life. Mean score differences of scar perception (BIQ and POSAS v2.0) were significant, with MIVS patients having evaluated the scar quality significantly better than CS patients. Conclusions MIVS appears associated with significant esthetical and related psychological benefits, as documented by technical tests. These findings should be considered when selecting the most appropriate technique for heart valve surgery.
Collapse
Affiliation(s)
- Alessandra Piarulli
- Cardiovascular Sciences Department, Agostino Gemelli Polyclinic Foundation IRCSS, Rome, Italy
- Catholic University of The Sacred Heart, Rome, Italy
| | - Giovanni Alfonso Chiariello
- Cardiovascular Sciences Department, Agostino Gemelli Polyclinic Foundation IRCSS, Rome, Italy
- Catholic University of The Sacred Heart, Rome, Italy
| | - Piergiorgio Bruno
- Cardiovascular Sciences Department, Agostino Gemelli Polyclinic Foundation IRCSS, Rome, Italy
| | - Federico Cammertoni
- Cardiovascular Sciences Department, Agostino Gemelli Polyclinic Foundation IRCSS, Rome, Italy
| | - Alessia Rabini
- Cardiovascular Sciences Department, Agostino Gemelli Polyclinic Foundation IRCSS, Rome, Italy
- Catholic University of The Sacred Heart, Rome, Italy
| | - Natalia Pavone
- Cardiovascular Sciences Department, Agostino Gemelli Polyclinic Foundation IRCSS, Rome, Italy
- Catholic University of The Sacred Heart, Rome, Italy
| | - Annalisa Pasquini
- Cardiovascular Sciences Department, Agostino Gemelli Polyclinic Foundation IRCSS, Rome, Italy
- Catholic University of The Sacred Heart, Rome, Italy
| | - Francesco Ferraro
- Cardiovascular Sciences Department, Agostino Gemelli Polyclinic Foundation IRCSS, Rome, Italy
- Catholic University of The Sacred Heart, Rome, Italy
| | - Andrea Mazza
- Cardiovascular Sciences Department, Agostino Gemelli Polyclinic Foundation IRCSS, Rome, Italy
| | - Marialisa Nesta
- Cardiovascular Sciences Department, Agostino Gemelli Polyclinic Foundation IRCSS, Rome, Italy
- Catholic University of The Sacred Heart, Rome, Italy
| | - Mauro Iafrancesco
- Cardiovascular Sciences Department, Agostino Gemelli Polyclinic Foundation IRCSS, Rome, Italy
| | - Christian Colizzi
- Cardiovascular Sciences Department, Agostino Gemelli Polyclinic Foundation IRCSS, Rome, Italy
- Catholic University of The Sacred Heart, Rome, Italy
| | - Massimo Massetti
- Cardiovascular Sciences Department, Agostino Gemelli Polyclinic Foundation IRCSS, Rome, Italy
- Catholic University of The Sacred Heart, Rome, Italy
| |
Collapse
|
6
|
Loria V, Colizzi C, Vaccarella M, Franceschi F, Aspromonte N. Left Ventricular Noncompaction: Cause or Consequence of Myocardial Disease? A Case Report and Literature Review. Cardiology 2019; 143:100-104. [PMID: 31509846 DOI: 10.1159/000500904] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 05/04/2019] [Indexed: 11/19/2022]
Abstract
A 57-year-old woman presented to the Emergency Department with symptoms of worsening heart failure (HF). She had a past medical history of breast cancer treated with surgery and chemotherapy with anthracyclines and no family history of cardiomyopathy (CMP). In the last year, she received a diagnosis of HF with normal coronary arteries, during hospitalization for acute onset of dyspnea and was treated with medical therapy. After several months, few days before admission to our hospital, an echocardiography (ECHO) showed features of left ventricular noncompaction (LVNC), not described in previous ECHO and further confirmed by cardiac magnetic resonance. This case highlights the current uncertainties regarding the pathogenesis of LVNC and the clinical challenge of cardiologists facing LVNC morphology to decide if they are observing a genetic CMP, a phenotype overlapping with dilated or hypertrophic CMP, or a variant of the left ventricular (LV) wall anatomy. No consensus exists among scientific communities regarding diagnostic criteria of LVNC and in most cases; the key element in the diagnostic decision is not the LVNC by itself, but the associated LV dilation and/or dysfunction, hypertrophy, arrhythmias, and embolic events.
Collapse
Affiliation(s)
- Valentina Loria
- Institute of Cardiology, Department of Cardiovascular and Thoracic Sciences, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - Christian Colizzi
- Institute of Cardiac Surgery, Department of Cardiovascular and Thoracic Sciences, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - Marcello Vaccarella
- Institute of Cardiology, Department of Cardiovascular and Thoracic Sciences, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - Francesco Franceschi
- Emergency Department, Fondazione Policlinico Universitario A. Gemelli, IRCCS-Catholic University of the Sacred Heart, Rome, Italy
| | - Nadia Aspromonte
- Institute of Cardiology, Department of Cardiovascular and Thoracic Sciences, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy,
| |
Collapse
|
7
|
Chiariello GA, Nesta M, Bruno P, Pasquini A, Ferraro F, Cammertoni F, Marano R, Colizzi C, Farina P, D’Amario D, Trani C, Massetti M. Total Surgical Plication of Left Ventricular Aneurysm Using the BioVentrix Revivent Myocardial Anchoring System. Innovations�(Phila) 2019; 14:369-373. [DOI: 10.1177/1556984519858919] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Surgical ventricular reconstruction (SVR) is the therapy of choice for patients with left ventricular dilatation, apical and anterolateral transmural scar, and low ejection fraction. STICH trial did not show that SVR led to improved survival but several observational studies did. However, because of the considerable operative risk, open heart surgery is considered risky in debilitated patients and clinical results are controversial. Alternative less invasive strategies for left ventricular aneurysm repair have been proposed. We present a case of a left ventricular aneurysm repair using the less invasive ventricular enhancement technique (LIVE) with the Revivent TC system (BioVentrix Inc., San Ramon, CA) in a totally surgical approach, instead of a hybrid interventional-surgical one, as previously described.
Collapse
Affiliation(s)
- Giovanni A. Chiariello
- Cardiovascular Sciences Department, Foundation Polyclinic University A. Gemelli IRCCS, Rome, Italy
- Catholic University of The Sacred Heart, Rome, Italy
| | - Marialisa Nesta
- Cardiovascular Sciences Department, Foundation Polyclinic University A. Gemelli IRCCS, Rome, Italy
- Catholic University of The Sacred Heart, Rome, Italy
| | - Piergiorgio Bruno
- Cardiovascular Sciences Department, Foundation Polyclinic University A. Gemelli IRCCS, Rome, Italy
| | - Annalisa Pasquini
- Cardiovascular Sciences Department, Foundation Polyclinic University A. Gemelli IRCCS, Rome, Italy
- Catholic University of The Sacred Heart, Rome, Italy
| | - Francesco Ferraro
- Cardiovascular Sciences Department, Foundation Polyclinic University A. Gemelli IRCCS, Rome, Italy
| | - Federico Cammertoni
- Cardiovascular Sciences Department, Foundation Polyclinic University A. Gemelli IRCCS, Rome, Italy
- Catholic University of The Sacred Heart, Rome, Italy
| | - Riccardo Marano
- Catholic University of The Sacred Heart, Rome, Italy
- Institute of Radiology, Foundation Polyclinic University A. Gemelli IRCCS, Rome, Italy
| | - Christian Colizzi
- Cardiovascular Sciences Department, Foundation Polyclinic University A. Gemelli IRCCS, Rome, Italy
| | - Piero Farina
- Cardiovascular Sciences Department, Foundation Polyclinic University A. Gemelli IRCCS, Rome, Italy
| | - Domenico D’Amario
- Cardiovascular Sciences Department, Foundation Polyclinic University A. Gemelli IRCCS, Rome, Italy
- Catholic University of The Sacred Heart, Rome, Italy
| | - Carlo Trani
- Cardiovascular Sciences Department, Foundation Polyclinic University A. Gemelli IRCCS, Rome, Italy
- Catholic University of The Sacred Heart, Rome, Italy
| | - Massimo Massetti
- Cardiovascular Sciences Department, Foundation Polyclinic University A. Gemelli IRCCS, Rome, Italy
- Catholic University of The Sacred Heart, Rome, Italy
| |
Collapse
|
8
|
Aurigemma C, Burzotta F, Corrado M, Colizzi C, Trani C. Percutaneous Valve-in-Valve Treatment of a (Very Old and Fluoroscopy Invisible) Degenerated Tricuspid Prosthesis Through the Right Jugular Vein Approach. Front Cardiovasc Med 2019; 6:22. [PMID: 30941353 PMCID: PMC6433773 DOI: 10.3389/fcvm.2019.00022] [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: 12/20/2018] [Accepted: 02/19/2019] [Indexed: 11/23/2022] Open
Abstract
Tricuspid valve dysfunction adversely affects prognosis and may cause severe symptoms. Among the different opportunity offered by transcatheter techniques, the valve in valve represents an emerging strategy to treat patients with degenerated surgical biological prosthesis. We describe a case report of a percutaneous valve in valve treatment of a very old and fluoroscopy invisible tricuspid degenerated bioprosthesis. In the reported case, pivotal issue for percutaneous valve in valve procedure success was the achievement of perfect alignment between transcatheter valve and degenerated bioprosthesis despite the horizontal right chamber axis and the poor valve visibility. Of note, the combination of jugular vein approach, transapical delivery system rotation, right ventricle guidewire placement, and right atrium angiography made the valve in valve procedure safely.
Collapse
Affiliation(s)
- Cristina Aurigemma
- Institute of Cardiology, Fondazione Policlinico Universitario A. Gemelli IRCSS, Rome, Italy
| | - Francesco Burzotta
- Institute of Cardiology, Fondazione Policlinico Universitario A. Gemelli IRCSS, Rome, Italy.,Università Cattolica del Sacro Cuore, Rome, Italy
| | - Michele Corrado
- Institute of Cardiology, Fondazione Policlinico Universitario A. Gemelli IRCSS, Rome, Italy
| | - Christian Colizzi
- Institute of Cardiology, Fondazione Policlinico Universitario A. Gemelli IRCSS, Rome, Italy
| | - Carlo Trani
- Institute of Cardiology, Fondazione Policlinico Universitario A. Gemelli IRCSS, Rome, Italy.,Università Cattolica del Sacro Cuore, Rome, Italy
| |
Collapse
|
9
|
Chiariello GA, Bruno P, Villa E, Pasquini A, Pavone N, Cammertoni F, Mazza A, Colizzi C, Nesta M, Iafrancesco M, Perri G, Messina A, Troise G, Massetti M. Aortic Valve Replacement in Elderly Patients With Small Aortic Annulus: Results With Three Different Bioprostheses. Innovations�(Phila) 2019; 14:27-36. [DOI: 10.1177/1556984519826430] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objectives Aortic valve replacement (AVR) in patients with small aortic annulus (diameter ≤21 mm) is considered a challenging scenario because of technical aspects and the high risk of patient-prosthesis mismatch (PPM). The choice of the appropriate prosthesis is crucial, and at the moment, an ideal device has yet to be identified. We compare clinical and hemodynamic results after AVR with three bioprostheses with different design and characteristics. Methods We retrospectively evaluated 76 consecutive patients from two cardiac surgery centers who underwent AVR (Trifecta = 24; Edwards INTUITY Elite valve system = 26, and Perceval = 26) for severe aortic stenosis between 2013 and 2017. Patients selected were older than 75 years and with an annulus diameter ≤21 mm at preoperative echocardiogram. Reinterventions and combined procedures were excluded. Minimally invasive AVR was performed in 44 (57.8%) patients. Telephonic interview was obtained at 2.9 ± 0.5 years and echocardiographic follow-up at 2.2 ± 0.8 years. Results Clinical outcome was similar in the three groups. At follow-up, Trifecta patients presented significantly higher peak and mean transprosthetic pressure gradients ( P = 0.04 and 0.01). Effective orifice area and left ventricular mass regression were comparable, although an advantage was observed in Perceval patients without reaching the statistical significance. Incidence of moderate ( P = 0.2) and severe PPM ( P = 0.7) was comparable. Conclusions Despite higher postoperative pressure gradients observed with the Trifecta valve, all three prostheses (Trifecta, Edwards INTUITY Elite, and Perceval) have proven to be reliable when implanted in small aortic annuli, with good clinical outcome and favorable left ventricular mass regression.
Collapse
Affiliation(s)
- Giovanni A. Chiariello
- Cardiovascular Sciences Department, Foundation Polyclinic University A. Gemelli IRCCS, Rome, Italy
- Catholic University of The Sacred Heart, Rome, Italy
| | - Piergiorgio Bruno
- Cardiovascular Sciences Department, Foundation Polyclinic University A. Gemelli IRCCS, Rome, Italy
| | - Emmanuel Villa
- Cardiac Surgery Unit, Poliambulanza Foundation Hospital, Brescia, Italy
| | - Annalisa Pasquini
- Cardiovascular Sciences Department, Foundation Polyclinic University A. Gemelli IRCCS, Rome, Italy
- Catholic University of The Sacred Heart, Rome, Italy
| | - Natalia Pavone
- Cardiovascular Sciences Department, Foundation Polyclinic University A. Gemelli IRCCS, Rome, Italy
- Catholic University of The Sacred Heart, Rome, Italy
| | - Federico Cammertoni
- Cardiovascular Sciences Department, Foundation Polyclinic University A. Gemelli IRCCS, Rome, Italy
| | - Andrea Mazza
- Cardiovascular Sciences Department, Foundation Polyclinic University A. Gemelli IRCCS, Rome, Italy
| | - Christian Colizzi
- Cardiovascular Sciences Department, Foundation Polyclinic University A. Gemelli IRCCS, Rome, Italy
| | - Marialisa Nesta
- Cardiovascular Sciences Department, Foundation Polyclinic University A. Gemelli IRCCS, Rome, Italy
- Catholic University of The Sacred Heart, Rome, Italy
| | - Mauro Iafrancesco
- Cardiovascular Sciences Department, Foundation Polyclinic University A. Gemelli IRCCS, Rome, Italy
| | - Gianluigi Perri
- Cardiovascular Sciences Department, Foundation Polyclinic University A. Gemelli IRCCS, Rome, Italy
- Catholic University of The Sacred Heart, Rome, Italy
| | - Antonio Messina
- Cardiac Surgery Unit, Poliambulanza Foundation Hospital, Brescia, Italy
| | - Giovanni Troise
- Cardiac Surgery Unit, Poliambulanza Foundation Hospital, Brescia, Italy
| | - Massimo Massetti
- Cardiovascular Sciences Department, Foundation Polyclinic University A. Gemelli IRCCS, Rome, Italy
- Catholic University of The Sacred Heart, Rome, Italy
| |
Collapse
|
10
|
Cammertoni F, Bruno P, Mazza A, Pavone N, Farina P, Perri G, Iafrancesco M, Nesta M, Chiariello G, Colizzi C, D’Errico D, Massetti M. RF30 INTEGRATED PERCUTANEOUS AND MINIMALLY INVASIVE APPROACH FOR HEART VALVE SURGERY. J Cardiovasc Med (Hagerstown) 2018. [DOI: 10.2459/01.jcm.0000549971.67787.79] [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] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
|
11
|
Chiariello G, Pasquini A, Bruno P, Colizzi C, Ruggio A, Nesta M, Mazza A, Iafrancesco M, Cammertoni F, Pavone N, Perri G, Massetti M. EP26 PRELIMINARY RESULTS OF LAST GENERATION SURGICAL BIOPROSTHESES IN SMALL AORTIC ANNULI. J Cardiovasc Med (Hagerstown) 2018. [DOI: 10.2459/01.jcm.0000549998.76303.f1] [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] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
|
12
|
Cammertoni F, Bruno P, Chiariello GA, Merlino B, Mazza A, Pavone N, Nesta M, Iafrancesco M, Colizzi C, Massetti M. From Cath Lab to Surgery Room. Circ Cardiovasc Imaging 2018; 11:e008174. [PMID: 30354678 DOI: 10.1161/circimaging.118.008174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Federico Cammertoni
- Cardiovascular Department, Cardiac Surgery Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy (F.C., P.B., G.A.C., A.M., N.P., M.N., M.I., C.C.)
| | - Piergiorgio Bruno
- Cardiovascular Department, Cardiac Surgery Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy (F.C., P.B., G.A.C., A.M., N.P., M.N., M.I., C.C.)
| | - Giovanni Alfonso Chiariello
- Cardiovascular Department, Cardiac Surgery Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy (F.C., P.B., G.A.C., A.M., N.P., M.N., M.I., C.C.)
| | - Biagio Merlino
- Institute of Radiology, Fondazione Policlinico A. Gemelli IRCCS, Catholic University of the Sacred Heart, Rome, Italy (B.M.)
| | - Andrea Mazza
- Cardiovascular Department, Cardiac Surgery Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy (F.C., P.B., G.A.C., A.M., N.P., M.N., M.I., C.C.)
| | - Natalia Pavone
- Cardiovascular Department, Cardiac Surgery Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy (F.C., P.B., G.A.C., A.M., N.P., M.N., M.I., C.C.)
| | - Marialisa Nesta
- Cardiovascular Department, Cardiac Surgery Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy (F.C., P.B., G.A.C., A.M., N.P., M.N., M.I., C.C.)
| | - Mauro Iafrancesco
- Cardiovascular Department, Cardiac Surgery Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy (F.C., P.B., G.A.C., A.M., N.P., M.N., M.I., C.C.)
| | - Christian Colizzi
- Cardiovascular Department, Cardiac Surgery Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy (F.C., P.B., G.A.C., A.M., N.P., M.N., M.I., C.C.)
| | - Massimo Massetti
- Cardiovascular Department, Cardiac Surgery Unit, Fondazione Policlinico A. Gemelli IRCCS, Catholic University of the Sacred Heart, Rome, Italy (M.M.)
| |
Collapse
|
13
|
Coli A, Chiariello GA, Novello M, Colizzi C, Massetti M. Treatment of cardiac synovial sarcoma: experience of two cases. J Cardiothorac Surg 2018; 13:84. [PMID: 29970129 PMCID: PMC6029359 DOI: 10.1186/s13019-018-0771-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [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: 11/08/2017] [Accepted: 06/22/2018] [Indexed: 12/15/2022] Open
Abstract
Background Primary heart sarcomas are exceedingly rare tumors. Among primary cardiac sarcomas, synovial sarcoma is one of the rarest, involving cardiac cavities or pericardium. Case presentation Two cases of synovial sarcoma are presented with the clinical course and therapy. Both cases were treated with surgery and chemo/radiotherapy. Interestingly, one of the patient, a 52-year-old male with an intracardiac synovial sarcoma, undergone a SynCardia total artificial heart implantation, but died for multiple pulmonary metastases waiting for transplantation. Conclusion Complete surgical resection of cardiac synovial sarcoma is the gold standard of therapy, though rarely possible. Although guidelines for the treatment are not well established, due to limited number of cases reported, chemotherapy and radiotherapy are frequently administered and seem to prolong mean patient’s survival. Cardiac transplantation could be considered in selected cases.
Collapse
Affiliation(s)
- Antonella Coli
- Institute of Anatomic Pathology, Catholic University of Sacred Heart, Largo F. Vito 1, 00168, Rome, Italy.
| | | | - Mariangela Novello
- Institute of Anatomic Pathology, Catholic University of Sacred Heart, Largo F. Vito 1, 00168, Rome, Italy
| | - Christian Colizzi
- Department of Cardiovascular Sciences, Catholic University of Sacred Heart, Rome, Italy
| | - Massimo Massetti
- Department of Cardiovascular Sciences, Catholic University of Sacred Heart, Rome, Italy
| |
Collapse
|
14
|
Cammertoni F, Bruno P, Colizzi C, Merlino B, Pavone N, Nesta M, Massetti M. Expect the Unexpected: A Bizarre Lookalike of Left Atrial Tumor. Ann Thorac Surg 2017; 104:e457-e458. [PMID: 29153818 DOI: 10.1016/j.athoracsur.2017.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 07/21/2017] [Accepted: 08/05/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Federico Cammertoni
- Department of Cardiac Surgery, Catholic University of the Sacred Heart, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy
| | - Piergiorgio Bruno
- Department of Cardiac Surgery, Catholic University of the Sacred Heart, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy.
| | - Christian Colizzi
- Department of Cardiac Surgery, Catholic University of the Sacred Heart, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy
| | - Biagio Merlino
- Institute of Radiology, Catholic University of the Sacred Heart, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy
| | - Natalia Pavone
- Department of Cardiac Surgery, Catholic University of the Sacred Heart, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy
| | - Marialisa Nesta
- Department of Cardiac Surgery, Catholic University of the Sacred Heart, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy
| | - Massimo Massetti
- Department of Cardiac Surgery, Catholic University of the Sacred Heart, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy
| |
Collapse
|
15
|
Nesta M, Cammertoni F, Mangini S, Colizzi C, Bruno P, Massetti M. Angina in left main coronary artery occlusion by pulmonary artery aneurysm. Asian Cardiovasc Thorac Ann 2016; 25:216-218. [DOI: 10.1177/0218492315603212] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A 51-year-old woman with exercise angina and a history of pulmonary artery hypertension related to a previous pulmonary thromboembolism, was referred to our hospital. Computed tomography and coronary angiography showed a 95-mm aneurysm of the main pulmonary artery, which totally occluded the left main coronary artery. After a multidisciplinary evaluation, we recommended heart-lung transplantation, but the patient refused any kind of surgical procedure. Due to the chronic occlusion, stenting of the left main coronary artery was unfeasible. With no other options available, we could only start pulmonary antihypertensive therapy. At the 1-year follow-up, the patient reported relief of her angina.
Collapse
Affiliation(s)
- Marialisa Nesta
- Department of Cardiovascular Medicine, Division of Cardiac Surgery, Catholic University Hospital, Rome, Italy
| | - Federico Cammertoni
- Department of Cardiovascular Medicine, Division of Cardiac Surgery, Catholic University Hospital, Rome, Italy
| | - Stefano Mangini
- Department of Cardiovascular Medicine, Division of Cardiac Surgery, Catholic University Hospital, Rome, Italy
| | - Christian Colizzi
- Department of Cardiovascular Medicine, Division of Cardiac Surgery, Catholic University Hospital, Rome, Italy
| | - Piergiorgio Bruno
- Department of Cardiovascular Medicine, Division of Cardiac Surgery, Catholic University Hospital, Rome, Italy
| | - Massimo Massetti
- Department of Cardiovascular Medicine, Division of Cardiac Surgery, Catholic University Hospital, Rome, Italy
| |
Collapse
|
16
|
Affiliation(s)
- Giovanni Alfonso Chiariello
- Department of Cardiovascular Sciences; Catholic University of The Sacred Heart; Agostino Gemelli Policlinic Rome Italy
| | - Piergiorgio Bruno
- Department of Cardiovascular Sciences; Catholic University of The Sacred Heart; Agostino Gemelli Policlinic Rome Italy
| | - Christian Colizzi
- Department of Cardiovascular Sciences; Catholic University of The Sacred Heart; Agostino Gemelli Policlinic Rome Italy
| | - Filippo Crea
- Department of Cardiovascular Sciences; Catholic University of The Sacred Heart; Agostino Gemelli Policlinic Rome Italy
| | - Massimo Massetti
- Department of Cardiovascular Sciences; Catholic University of The Sacred Heart; Agostino Gemelli Policlinic Rome Italy
| |
Collapse
|
17
|
Chiariello GA, Colizzi C, Pavone N, Trotta F, Biondi R, Lauriola L, Novello M, Coli A. Left ventricular rhabdomyoma in an adult patient: a rare disease successfully treated. Int J Cardiol 2014; 176:e107-9. [PMID: 25127964 DOI: 10.1016/j.ijcard.2014.07.244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2014] [Accepted: 07/27/2014] [Indexed: 11/27/2022]
Affiliation(s)
| | - Christian Colizzi
- Department of Cardiovascular Sciences, Catholic University, Rome, Italy
| | - Natalia Pavone
- Department of Cardiovascular Sciences, Catholic University, Rome, Italy
| | - Francesco Trotta
- Department of Cardiovascular Sciences, Catholic University, Rome, Italy
| | - Raoul Biondi
- Department of Cardiovascular Sciences, Catholic University, Rome, Italy
| | - Libero Lauriola
- Institute of Anatomic Pathology, Catholic University, Rome, Italy.
| | | | - Antonella Coli
- Institute of Anatomic Pathology, Catholic University, Rome, Italy
| |
Collapse
|
18
|
Gaudino M, Farina P, Bernazzali S, Bruno P, Colizzi C, Sani G, Massetti M. Ventricular assistance devices as bridge to transplantation. Heart Fail Clin 2013; 10:S39-45. [PMID: 24262351 DOI: 10.1016/j.hfc.2013.08.006] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The authors herein review the rationale and indications for the use of ventricular assistance devices as a bridge to heart transplantation and discuss the current evidence on the subject. The potential effects of device implantation on posttransplant outcomes and the therapeutic strategies in acute and elective cases are revised and illustrated.
Collapse
Affiliation(s)
- Mario Gaudino
- Division of Cardiac Surgery, Department of Cardiovascular Sciences, Catholic University, L.go Gemelli 8, 00168 Rome, Italy.
| | | | | | | | | | | | | |
Collapse
|
19
|
Biasucci LM, Colizzi C, Rizzello V, Vitrella G, Crea F, Liuzzo G. Role of inflammation in the pathogenesis of unstable coronary artery diseases. Scandinavian Journal of Clinical and Laboratory Investigation 2010. [DOI: 10.1080/00365519909168322] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
20
|
Galiuto L, Giubilato S, De Caterina AR, Porfidia A, Colizzi C, Sestito A, Porto I, Trani C, Rebuzzi AG, Crea F. Patent foramen ovale and hypercoagulable state in the pathogenesis of acute thrombotic myocardial infarction. Case Reports 2009; 2009:bcr11.2008.1211. [DOI: 10.1136/bcr.11.2008.1211] [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] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
21
|
Rizzello V, Lombardo A, Colizzi C, Pennestrì F. Entrapment of a floating thrombus in the right atrium by persistent Chiari's network: A barrier to massive pulmonary embolism. Int J Cardiol 2009; 132:e40-1. [DOI: 10.1016/j.ijcard.2007.07.116] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2007] [Accepted: 07/07/2007] [Indexed: 10/22/2022]
|
22
|
Affiliation(s)
- Vittoria Rizzello
- Cardiology Department, University Hospital "A. Gemelli", The Catholic University, Largo "A. Gemelli" 8, 00168 Rome, Italy.
| | | | | |
Collapse
|
23
|
Di Muro L, Pallini R, Pietrini D, Colizzi C, Denaro L. Minimally invasive echo-guided placement of the cardiac tube in a ventriculoatrial shunt during pregnancy: technical note. Neurosurgery 2008; 61:E398; discussion E398. [PMID: 18091227 DOI: 10.1227/01.neu.0000303999.97397.ec] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE We describe a minimally invasive echo-guided placement of the cardiac tube in a ventriculoatrial shunt in a young pregnant woman, in order to avoid any radiological procedure. METHODS We used a central venous catheter placement kit for percutaneous echo-guided right internal jugular vein puncture located by a 7.5 mHz microlinear probe. Through the catheter, the distal portion of the shunt device was positioned into the internal jugular vein to the right atrium using ultrasound control by a 2.5 to 3.5 mHz probe in a four-chamber transthoracic view. RESULTS Sonographic guidance in percutaneous placement of a vertebral artery shunt is a safe and fast minimally invasive technique that improves success rates and decreases complications such as incidental puncture of the carotid artery and pneumothorax. The use of a two-dimensional echocardiographic apparatus in a four-chamber transthoracic view is an accurate and simple method to verify the position of the distal tip of the shunt in the mid-right atrium with no risks for the patient. CONCLUSION The use of these two techniques allows a minimally invasive, safe, accurate, and complete x-ray-free procedure.
Collapse
Affiliation(s)
- Licia Di Muro
- Department of Neurosurgery, Catholic University School of Medicine, Rome, Italy
| | | | | | | | | |
Collapse
|
24
|
Scapigliati A, Sanna T, Zamparelli R, Sandroni C, Colizzi C, Fenici P, Arlotta G, Nuzzo C, Bonarrigo C, Bellocci F, Schiavello R, Possati G. The immediate life support (ILS) course – The Italian experience. Resuscitation 2007; 72:451-7. [PMID: 17161900 DOI: 10.1016/j.resuscitation.2006.07.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2006] [Revised: 07/20/2006] [Accepted: 07/27/2006] [Indexed: 11/23/2022]
Abstract
AIM OF THE STUDY The 1-day immediate life support course (ILS) was started in the United Kingdom and adopted by the ERC to train healthcare professionals who attend cardiac arrests only occasionally. Currently, there are no reports about the ILS course from outside the UK. In this paper we describe our initial Italian experience of teaching ILS to nurses. We have also measured the impact that ILS has on the resuscitation knowledge of nurses. METHODS The ILS course materials were translated by Italian ALS instructors who had observed the ILS course previously in the UK. From March to November 2005 nurses from a single hospital department attended the Italian ILS course. Candidate feedback was collected using an evaluation form. The change in knowledge of candidates was measured using a pre- and post-course test. Variables associated with candidate performance on course papers were investigated using multivariate linear regression analysis. RESULTS A total of 119 nurses attended nine ILS courses. All candidates completed the course successfully and gave high evaluation scores. ILS produced a significant increase from pre- to post-course score (10.15+/-2.75 to 13.19+/-2.53, p<0.001). The pre-course score was higher for nurses working in ICU compared with those coming from non-intensive wards, but this difference disappeared in the post-course evaluation (13.89+/-2.18 versus 12.79+/-2.65, p=ns). CONCLUSIONS We have reproduced the ILS course in Italy successfully. ILS teaching resulted in an improvement in resuscitation knowledge of the first group of nurses trained.
Collapse
Affiliation(s)
- Andrea Scapigliati
- Department of Cardiovascular Medicine, Catholic University of the Sacred Heart, Largo A. Gemelli 8, 00168 Rome, Italy.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
25
|
Abstract
A growing body of evidence suggests that inflammation plays a major role in the pathogenesis of unstable angina; this evidence is mainly derived from the prognostic role of the acute phase reaction proteins, such as C-reactive protein (CRP) and fibrinogen. Since the production of acute phase protein is under the control of the pro-inflammatory cytokines, it is probable that citokines, such as tumour-necrosis factor (TNF)-alpha, interleukin (IL)-1 and IL-6 are involved in the same process. Indeed, elevated levels of IL-1 and IL-6 have been found by our group and by others, in patients with acute coronary syndromes. Cytokines may have procoagulant effects, directly or via endothelial dysfunction, and may induce plaque vulnerability or rupture. They may also be responsible for the activation of other cells, as neutrophils or mast-cells. Although it is conceivable that activated lymphocytes, via interferon-gamma production, are responsible for macrophage activation and cytokine production in unstable angina, the trigger and the precise mechanism of this event are still unknown. The multiple roles of cytokines in unstable angina suggest that a targeted anti-inflammatory therapy might be a novel approach in the future for the treatment of this syndrome.
Collapse
Affiliation(s)
- L M Biasucci
- Institute of Cardiology, Catholic University of the Sacred Heart, Rome, Italy
| | | | | | | |
Collapse
|
26
|
Liuzzo G, Angiolillo DJ, Buffon A, Rizzello V, Colizzi C, Ginnetti F, Biasucci LM, Maseri A. Enhanced response of blood monocytes to in vitro lipopolysaccharide-challenge in patients with recurrent unstable angina. Circulation 2001; 103:2236-41. [PMID: 11342470 DOI: 10.1161/01.cir.103.18.2236] [Citation(s) in RCA: 71] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND C-reactive protein (CRP) plasma levels have been associated with short- and long-term occurrence of coronary events. We investigated whether circulating inflammatory cell responsiveness to low-grade stimuli could contribute to the reported association between CRP and coronary events. METHODS AND RESULTS We studied 32 patients with unstable angina who were followed for 24 months and were free of symptoms for 6 months (group 1): 19 patients had persistently high CRP levels (>0.3 mg/dL) (group 1A); 13 patients had normal CRP levels (group 1B). During the follow-up, 12 (63%) group 1A but no group 1B patients developed an infarction or recurrence of unstable angina (P<0.001). Eighteen patients with chronic stable angina (group 2) and 18 healthy subjects (group 3) were studied as controls. Interleukin (IL)-6 production (median, range) by peripheral blood mononuclear cells after 4 hours of in vitro stimulation with 1 ng/mL lipopolysaccharide (LPS) was significantly higher in group 1A (4526 pg/mL, 3042 to 10 583 pg/mL) than in group 1B (1752 pg/mL, 75 to 3981 pg/mL), group 2 (707 pg/mL, 41 to 3275 pg/mL), and group 3 (488 pg/mL, 92 to 3503 pg/mL) (all P<0.001). No significant differences were observed among the other groups. IL-6 production after LPS-challenge was correlated with baseline CRP levels (r=0.42, P=0.005). CONCLUSIONS Mononuclear cells of patients with recurrent phases of instability exhibit an enhanced production of IL-6 in response to low-dose of LPS, correlated with baseline CRP levels, 6 months after the last acute event. This persisting enhanced acute-phase responsiveness may help explain the association between CRP and acute coronary events.
Collapse
Affiliation(s)
- G Liuzzo
- Department of Cardiology, Catholic University, Rome, Italy.
| | | | | | | | | | | | | | | |
Collapse
|
27
|
Spisni R, Faviana P, Pingitore R, Castagna M, Baroncini R, Biondi R, Lagomarsini B, Colizzi C. [Clinical significance of a carcinogenesis model of colorectal carcinoma]. Ann Ital Chir 2001; 72:323-7. [PMID: 11765350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
OBJECTIVE Carcinoma of the rectal colon begins as a small neoplastic polyp which gradually increases in size and, after passing through various degrees of dysplasia, develops into an overtly malignant carcinoma. Clinical experience suggests that patients may be divided into subgroups based on the aggressivity of the tumour. The genetic mutations associated with colorectal cancer have been studied and it is known that the genes primarily responsible for biological changes in the tumour cell, in the early stages, are APC, hMSH2, k-ras2 and, in particular, p53. Indeed, the mutation at the level of gene p53 has been recognized as the most common mutation in tumour cells. The aim of this study was investigate the role of p53 and CD34 in colorectal cancer. METHODS We studied p53 positivity using immunohistological methods and compared our results with the site, stage (using the TNM system) and histological grade of the tumour. We evaluated CD34 positivity using the same methods in order to detect and quantity the presence of angiogenesis in colorectal cancer. RESULT P53 was found to be markedly raised in the T3 stage of colorectal cancer, while its expression was decreased in stage T2 and stage T1 carcinomas and it was not detectable in adenomas. These results suggest a close correlation between the tumour stage and the expression of p53. An analogous correlation was found between CD34 expression and angiogenesis. CONCLUSION The overexpression of p53 in epithelial cells and raised angiogenesis (as reflected in CD34 levels) in stromal cells could represent useful prognostic factors in the management of colorectal cancer.
Collapse
Affiliation(s)
- R Spisni
- Dipartimento di Chirurgia, Università degli Studi di Pisa
| | | | | | | | | | | | | | | |
Collapse
|
28
|
Biasucci LM, Liuzzo G, Colizzi C, Rizzello V. Clinical use of C-reactive protein for the prognostic stratification of patients with ischemic heart disease. Ital Heart J 2001; 2:164-71. [PMID: 11305527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
C-reactive protein (CRP), the prototypic acute phase reactant and a sensitive marker of inflammation, consistently predicts new coronary events, including myocardial infarction and death, in patients with ischemic heart disease. The data are very consistent with regard to the long-term outcome, but in many studies are also significant for in-hospital events. The predictive value of CRP is, in the majority of the studies, independent of and additive to that of the troponins. Moreover recent data suggest that CRP may be a reliable marker of the risk of restenosis after percutaneous coronary interventions and that its levels can be modulated by statins. Taken together, all these data suggest that CRP, probably with different cut-offs, should be used as a marker of risk and as a guide to therapy in patients hospitalized for acute coronary syndromes and in outpatients suffering from ischemic heart disease.
Collapse
Affiliation(s)
- L M Biasucci
- Institute of Cardiology, Catholic University of the Sacred Heart, Rome, Italy.
| | | | | | | |
Collapse
|
29
|
Trani C, Burzotta F, Andreotti F, Colizzi C, Rebuzzi AG, Schiavoni G, Mazzari MA. Reversible left anterior descending artery spasm, prolonged cardiac arrest and left main thrombosis during a PTCA attempt of the circumflex artery. J Invasive Cardiol 2000; 12:151-4. [PMID: 10731284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
The authors report a case of percutaneous transluminal coronary angioplasty of the circumflex artery complicated by occlusion of the non-diseased left anterior descending artery by spasm. During advanced cardiac life support, required for the subsequent cardiac arrest, intra-coronary nitrates and calcium antagonists were administered. After 45 minutes, the spasm resolved, but N probably as a result of prolonged blood stasis N a thrombus appeared in the left main artery. While attempting to stent the left main, the thrombus was mechanically dislodged, leaving the epicardial coronary tree free, with a good flow.
Collapse
Affiliation(s)
- C Trani
- Cardiology, Catholic University, L.go A. Gemelli, 8, 00168, Rome, Italy.
| | | | | | | | | | | | | |
Collapse
|
30
|
Biasucci LM, Colizzi C, Rizzello V, Vitrella G, Crea F, Liuzzo G. Role of inflammation in the pathogenesis of unstable coronary artery diseases. Scand J Clin Lab Invest Suppl 1999; 230:12-22. [PMID: 10389197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
Inflammation has been shown to play a pivotal role in ischemic heart disease, in particular unstable angina. The instability that characterizes this syndrome is related to the waxing and waning of ischemic stimuli, especially thrombotic ones. Angiographically and autoptically the severity of the atherosclerotic background in unstable angina does not differ from that in chronic stable angina, but in the former mural thrombi are often found and coronary atherosclerotic plaques are characterized by an inflammatory infiltrate, mostly consisting of activated lymphocytes, macrophages and mast-cells. In addition to these local findings, systemic evidence also suggests the importance of the role of inflammation in unstable angina as platelets, neutrophils and monocytes are activated, and elevated levels of serum markers of inflammation, e.g. C-Reactive Protein, have been consistently found. CRP has been demonstrated to be a reliable marker of prognosis in coronary heart disease. The consequences of inflammation are a disruption in the dynamic balance between antithrombotic and prothrombotic activities, an altered extracellular matrix metabolism, hyper-reactivity of cells such as monocytes and smooth muscle cells, all important features of unstable angina. These findings have important prognostic implications, since markers of inflammation are associated to a worse prognosis, and may also have therapeutic implications in the near future.
Collapse
Affiliation(s)
- L M Biasucci
- Istituto di Cardiologia, Università Cattolica, Roma, Italy
| | | | | | | | | | | |
Collapse
|
31
|
Colizzi C, Rizzello V, Angiolillo DJ, Liuzzo G, Ginnetti F, Monaco C, Comerci G, Vitrella G, Maseri A, Biasucci LM. In vitro hyperreactivity to lipopolysaccharide in patients with history of unstable angina is not associated with seropositivity for Cytomegalovirus, Helicobacter pylori and Chlamydia pneumoniae. Cardiologia 1999; 44:377-80. [PMID: 10371790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
BACKGROUND Inflammation and possibly chronic infections are associated with acute coronary syndromes; however, the mechanisms responsible for this association are not yet fully elucidated. The aim of this study was to assess whether the hyperreactivity of the inflammatory system, that we have shown in unstable patients with persistently elevated C-reactive protein and with recurrence of symptoms, was associated with chronic infection. METHODS In 20 unstable angina patients seropositivity and antibody levels vs Cytomegalovirus, Helicobacter pylori and Chlamydia pneumoniae were measured and correlated with the interleukin-6 production in vivo in 1 ml of whole blood stimulated with 0.1 microgram lipopolysaccharide for 4 hours. RESULTS No positive correlation was found between antibody titer and interleukin-6 levels. No correlation was also found between seropositivity to Cytomegalovirus, Helicobacter pylori or Chlamydia pneumoniae and interleukin-6 levels. CONCLUSIONS Our study suggests that seropositivity for infective agents, including Chlamydia pneumoniae, does not affect the monocyte response to lipopolysaccharide and thus cannot account for the enhanced interleukin-6 production observed in unstable angina patients with raised levels of C-reactive protein and worse prognosis, and suggests the predominant role of the individual response to different stimuli.
Collapse
Affiliation(s)
- C Colizzi
- Istituto di Cardiologia, Università Cattolica del Sacro Cuore, Roma
| | | | | | | | | | | | | | | | | | | |
Collapse
|
32
|
Biasucci L, Colizzi C, Rizzello V, Vitrella G, Crea F, Liuzzo G. Role of inflammation in the pathogenesis of unstable coronary artery diseases. Scand J of Clinical & Lab Investigation 1999. [DOI: 10.3109/00365519909168322] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
33
|
Nicolini A, Ferdeghini M, Colizzi C. Evaluation of CEA, TPA, CA 15-3, CA 549 and TPS in the monitoring of metastatic breast cancer. J Nucl Biol Med (1991) 1993; 37:126-33. [PMID: 8218459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Monitoring the response to treatment in relapsed breast cancer patients is one of the chief uses of tumor markers. Thus far the carcinoembryonic antigen (CEA)-tissue polypeptide antigen (TPA)-breast cancer associated antigen 115 D8/DF3 (CA 15-3) association has been routinely used to follow-up breast cancer patients. We have found that TPA reflects the response to treatment much better than CEA and slightly better than CA 15-3. Recently carcinoma associated antigen 549 (CA 549) and tissue polypeptide specific antigen (TPS) have been reported to be highly sensitive tumor markers for breast cancer. TPS is claimed to be particularly suitable for monitoring the response to treatment because of its more specific assessment of proliferation activity. Therefore, in 13 relapsed patients with prolonged follow-up and detailed clinical-instrumental information, the mean percentage of samples with high CEA, TPA, and CA 15-3 values and their expressions were compared with those of CA 549 and TPS. All markers were also evaluated in terms of their correspondence with the evolution of disease. The correspondence with clinical-instrumental behaviour was scored absent (0), poor (1), good (2) and very good (3) by three different observers. Other more suitable associations than those already used were also investigated. It was found that CA 15-3 and CA 549 were expressed more often (92%) than TPS (85%), TPA (60%) and CEA (46%).(ABSTRACT TRUNCATED AT 250 WORDS)
Collapse
Affiliation(s)
- A Nicolini
- Institute of Clinical Medicine II, University of Pisa, Italy
| | | | | |
Collapse
|
34
|
Spisni R, Lijoi C, Nervi M, Caldarelli GF, Colizzi C. [Roux-en-y hepatojejunostomy in benign pathology of the common duct]. MINERVA CHIR 1989; 44:1547-51. [PMID: 2771104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Personal experience is reported of 59 hepaticojejunostomies performed on an excluded Roux loop in the treatment of benign pathologies of the main bile duct. The advantages and disadvantages of this approach are discussed. Several particular cases are described as is the surgical technique adopted. Complications arising in 5 patients included 3 duodenal ulcers, one of them bleeding and 2 cases of anastomotic stenosis. In all other cases the operation was satisfactory. Follow-up involved echographic and cholescintigraphic examinations. It is concluded that Roux en Y hepaticojejunostomy is the treatment of choice in benign pathologies of the main bile duct when transduodenal papillostomy is contraindicated.
Collapse
|
35
|
Spisni R, Nervi M, Lijoi C, Colizzi C. [Roux loop conversion of Billroth II gastric resection complicated by alkaline reflux gastritis]. MINERVA CHIR 1988; 43:1227-30. [PMID: 3205389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
|
36
|
Spisni R, Nervi M, Matronola M, Lijoi C, Caldarelli GF, Colizzi C. [Pathology of the residual cystic stump in the onset of post-cholecystectomy syndrome]. MINERVA CHIR 1988; 43:821-4. [PMID: 3412619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
|
37
|
Abstract
Glutathione S-transferase (GST) was investigated with benzo(a)pyrene-4,5-oxide (BPO) as substrate in tissue specimens from 26 fetal and 27 adult livers and 27 placentas. The average (+/- SEM) of GST activity in the cytosol was 1.80 +/- 0.18 (fetal liver), 3.05 +/- 0.30 (adult liver) and 1.18 +/- 0.07 (placenta) nmol/min/mg. GST was also investigated in human fetal and adult lungs, kidneys and gut. In these tissues the average (+/- SEM) GST activity ranged between 0.71 +/- 0.12 (adult intestine) and 2.11 +/- 0.18 (fetal lungs) nmol/min/mg. Whereas in the fetal liver the conjugation of BPO was catalyzed at a rate of about two-thirds of the adult rate, similar or higher GST activities were found in the fetal non-hepatic tissues as compared to the adult organs. No correlation was found between the activity of the GST in fetal liver and placenta and the gestational age (11-25 weeks). GST develops before the 11th week of gestation and it does not undergo changes during the mid-gestation. No correlation was found between GST activity in adult liver and age (32-70 years).
Collapse
Affiliation(s)
- G M Pacifici
- Department of General Pathology, Medical School, University of Pisa, Italy
| | | | | | | | | |
Collapse
|
38
|
Abstract
Sulfotransferase with 2-naphthol as substrate was investigated in the cytosolic fraction of human fetal liver, lungs, kidneys, adrenal glands, intestine and placenta and also in liver, lungs, kidneys, intestinal and urinary bladder mucosa from human adult subjects. All tissue specimens assayed catalyzed the sulfation of 2-naphthol at a significant rate. The activity (expressed as pmole per minute per milligram protein; mean +/- SD) was 211 +/- 197 (n = 46) fetal liver; 22 +/- 12 (n = 29) placenta; 625 +/- 205 (n = 42) human adult liver. In fetal kidneys (576 +/- 177; n = 6) and gut (558 +/- 293; n = 6) the activity was twice as high as in liver. In the lungs (273 +/- 125; n = 6) and in the adrenals (174 +/- 119; n = 19) the sulfotransferase activity was comparable with the hepatic one. In human adult extrahepatic tissues the highest activity was found in the intestinal mucosa (153 +/- 49; n = 4) and the lowest one in the urinary bladder mucosa (16 +/- 4; n = 4). This paper shows that the sulfotransferase has a wide distribution in the human fetus and the distribution pattern of this enzyme is different in the human fetus and adult subject.
Collapse
Affiliation(s)
- G M Pacifici
- Department of General Pathology, Medical School, University of Pisa, Italy
| | | | | | | | | |
Collapse
|
39
|
Ansaldo V, Cecchini G, Di Marco G, Pelosini M, Giuliani L, Colizzi C. [Diverticulitis of the right colon]. MINERVA CHIR 1987; 42:843-7. [PMID: 3627490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
|
40
|
Caldarelli GF, Pelosini M, Meucci G, Calcaprina R, Lijoi C, Cecchini G, Matronola M, Camerini E, Colizzi C. [Association of lumbar sympathectomy and bypass in the treatment of femoro-popliteal obstructive arteriopathies]. MINERVA CHIR 1987; 42:33-7. [PMID: 3561827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
|
41
|
Spisni R, Conte M, Nervi M, Caldarelli GF, Colizzi C. [Splenectomy in lymphoma: surgical considerations]. MINERVA CHIR 1986; 41:1585-8. [PMID: 3808362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
|
42
|
Spisni R, Conte M, Nervi M, Ceragioli T, Caldarelli GF, Colizzi C. [Non-epithelial neoplasms of the stomach. Case reports]. MINERVA CHIR 1986; 41:1635-40. [PMID: 3808366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
|
43
|
Spisni R, Conte M, Nervi M, Caldarelli GF, Matronola M, Colizzi C. [Gastric cancer: diagnostic and therapeutic considerations]. MINERVA CHIR 1986; 41:1573-7. [PMID: 2433643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
|
44
|
Giuliani L, Calcaprina R, Ceragioli T, Ansaldo V, Colizzi C. [Surgery of cancer of the thyroid. Our experience in 158 operated cases]. MINERVA CHIR 1984; 39:431-6. [PMID: 6472650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
|
45
|
Abstract
The epoxide hydrolase activity with styrene oxide as substrate was investigated in the nuclear fraction of human fetal and adult liver specimens. All investigated liver fractions catalyzed the hydration of styrene oxide and the average epoxide hydrolase activities were 0.37 and 1.90 nmol/min/mg protein in fetal and adult specimens, respectively. The enzyme followed Michaelis-Menten kinetics in fetal nuclear fraction and biphasic kinetics in adult livers. The nuclear/microsomal enzyme activity ratios of epoxide hydrolase were 0.09 and 0.11 for fetal and adult livers, respectively.
Collapse
|
46
|
Abstract
The epoxide hydrolase and glutathione S-transferase activity towards styrene oxide as substrate were investigated and compared in fetal and adult human liver cytosols. The rate of formation of styrene glycol from styrene oxide (nmole/min/mg protein) was 0.23 +/- 0.02 (means +/- SE; n = 10) in fetal and 0.83 +/- 0.05 (means +/- SE; n = 14) in adult liver specimens. The enzyme followed Michealis-Menten kinetics in the fetal liver. In adult liver specimens the enzyme showed biphasic kinetics. For comparative purposes, the cytosolic glutathione S-transferase activity was investigated in the cytosolic fractions from the same liver specimens. The fetal activity was 40% of the adult activity 3.9 +/- 0.50 (means +/- SE; n = 10) versus 9.94 +/- 1.75 (means +/- SE; n = 14) nmoles/min/mg protein.
Collapse
|
47
|
Fabris GFM, Calcaprina R, Bianchi B, Ansaldo V, Cavirani G, Giuliani L, Mariani M, Ceragioli T, Izzo PL, Colizzi C. Evoluzione E Risultati Del Trattamento. Urologia 1983. [DOI: 10.1177/039156038305000647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
| | | | | | - V. Ansaldo
- Istituto di Patologia Speciale Chirurgica
| | | | | | | | | | | | - C. Colizzi
- Istituto di Patologia Speciale Chirurgica
| |
Collapse
|
48
|
Ceragioli T, Ansaldo V, Calcaprina R, Giuliani L, Colizzi C. [Cholelithiasis in patients over 75 years of age. Apropos of 130 surgical cases]. MINERVA CHIR 1983; 38:713-7. [PMID: 6877632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
|
49
|
Ansaldo V, Ceragioli T, Calcaprina R, Giuliani L, Colizzi C. [Effectiveness of papillostomy as treatment of choice in lithiasic pathology of the common bile duct]. MINERVA CHIR 1983; 38:621-6. [PMID: 6877637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
|