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Giordano M, Marzullo R, Gaio G, Bigazzi MC, Palladino MT, Della Cioppa N, Gaudieri G, Fabiani D, Sarubbi B, Russo MG. Assessing the feasibility of using the antecubital vein to perform right heart catheterization in children and adults with congenital heart disease: a retrospective, observational single-center study. J Invasive Cardiol 2023; 35. [PMID: 37984324 DOI: 10.25270/jic/23.00219] [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] [Subscribe] [Scholar Register] [Indexed: 11/22/2023]
Abstract
BACKGROUND Right heart catheterization (RHC) usually is performed via the femoral vein or the internal jugular vein. However, the antecubital fossa vein is a valid venous access, and it has become increasingly popular to perform right heart catheterization utilizing this access. METHODS A retrospective, observational study was conducted to describe use of the antecubital fossa vein for right heart catheterization in adults and children with congenital heart disease (CHD). Patients who had undergone RHC via antecubital fossa vein at the authors' hospital between September 2019 and December 2022 were included. The outcomes studied were procedural failure and procedure-related adverse events. RESULTS Fifty-two patients with CHD underwent right cardiac catheterization via an upper arm vein. The upper arm vein was unable to perform the RHC in only 2 patients (3.8%). Only 1 patient developed a minor adverse event. No irreversible and/or life-threating adverse events were detected. CONCLUSIONS The upper arm veins are safe and effective to perform a RHC in children and adults with CHD. This approach demonstrates a high percentage of technical success, and few mild complications.
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Affiliation(s)
- Mario Giordano
- Pediatric Cardiology Division, University of Campania Luigi Vanvitelli, AORN Ospedali dei Colli, Monaldi Hospital, Naples, Italy.
| | - Raffaella Marzullo
- Pediatric Cardiology Division, University of Campania Luigi Vanvitelli, AORN Ospedali dei Colli, Monaldi Hospital, Naples, Italy
| | - Gianpiero Gaio
- Pediatric Cardiology Division, University of Campania Luigi Vanvitelli, AORN Ospedali dei Colli, Monaldi Hospital, Naples, Italy
| | - Maurizio Cappelli Bigazzi
- Invasive Cardiology Unit, University of Campania Luigi Vanvitelli, AORN Ospedali dei Colli, Monaldi Hospital, Naples, Italy
| | - Maria Teresa Palladino
- Pediatric Cardiology Division, University of Campania Luigi Vanvitelli, AORN Ospedali dei Colli, Monaldi Hospital, Naples, Italy
| | - Nadia Della Cioppa
- Pediatric Cardiology Division, University of Campania Luigi Vanvitelli, AORN Ospedali dei Colli, Monaldi Hospital, Naples, Italy
| | - Gabriella Gaudieri
- Pediatric Cardiology Division, University of Campania Luigi Vanvitelli, AORN Ospedali dei Colli, Monaldi Hospital, Naples, Italy
| | - Dario Fabiani
- Pediatric Cardiology Division, University of Campania Luigi Vanvitelli, AORN Ospedali dei Colli, Monaldi Hospital, Naples, Italy
| | - Berardo Sarubbi
- Adult Congenital Heart Disease Unit, AORN Ospedali dei Colli, Monaldi Hospital, Naples, Italy
| | - Maria Giovanna Russo
- Pediatric Cardiology Division, University of Campania Luigi Vanvitelli, AORN Ospedali dei Colli, Monaldi Hospital, Naples, Italy
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Palmieri V, Amarelli C, Mattucci I, Bigazzi MC, Cacciatore F, Maiello C, Golino P. Predicting major events in ambulatory patients with advanced heart failure awaiting heart transplantation: a pilot study. J Cardiovasc Med (Hagerstown) 2022; 23:387-393. [PMID: 35645029 DOI: 10.2459/jcm.0000000000001304] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AIMS In heart failure (HF), prognostic risk scores focus on all-cause mortality prediction. However, in advanced HF (AdHF) ambulatory patients awaiting heart transplantation (HTx), hospitalizations for acutely decompensated/worsening HF are relevant to clinical decision-making, but unpredicted by common risk functions. METHODS Among consecutive ambulatory patients added to the waitlist for HTx, event discriminators within 2 years from recruitment were assessed prospectively by area under the curve from receiver-operating characteristic curves, and by Cox proportional hazards models. Primary composite end points included the first between all-cause mortality and acutely decompensated/worsening HF requiring hospitalization and specific treatments. RESULTS In 89 patients, 36 primary composite events were recorded in a 2-year follow-up (40% of the study sample), and associated with nonischemic etiology and nonsinus rhythm, with lower systolic blood pressure (BP), lower plasma sodium and hemoglobin concentrations, and with higher N-terminal pro-brain natriuretic peptide (NT-proBNP), larger left ventricular (LV) dimensions and lower LV ejection fraction, greater proportion of significant mitral regurgitation, lower tricuspid annulus peak systolic excursion (TAPSE), lower percentage of predicted distance at 6-minute walking test (%p6MWT) and lower global symptoms burden by the Kansas City Cardiomyopathy Questionnaire, lower peak oxygen uptake by cardiopulmonary exercise, and higher wedge pressure by right heart catheterization, as compared with those with no events (P < 0.05). Only Metabolic Exercise Cardiac Kidney Index (MECKI) at recruitment was higher with patients reporting events, which predicted composite end points in addition to and independently of NT-proBNP, and lower systolic BP (all P < 0.05). In an alternative risk model, severe mitral regurgitation and lower TAPSE replaced MECKI and BP but not NT-proBNP (all P < 0.01). CONCLUSION Higher NT-pro-BNP, lower systolic BP and higher MECKI may contribute to predicting all-cause death and acutely decompensated/worsening HF among ambulatory patients awaiting HTx, with lower TAPSE and severe mitral regurgitation representing further alternative independent prognosticators.
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Affiliation(s)
- Vittorio Palmieri
- Heart Transplantation Unit, Department of Cardiac Surgery and Transplantation, Ospedali dei Colli Monaldi-Cotugno-CTO
| | - Cristiano Amarelli
- Heart Transplantation Unit, Department of Cardiac Surgery and Transplantation, Ospedali dei Colli Monaldi-Cotugno-CTO
| | - Irene Mattucci
- Heart Transplantation Unit, Department of Cardiac Surgery and Transplantation, Ospedali dei Colli Monaldi-Cotugno-CTO
| | - Maurizio Cappelli Bigazzi
- Cardiology Unit, Department of Cardiology and Medicine, Ospedali dei Colli Monaldi-Cotugno-CTO & University of Campania 'Luigi Vanvitelli'
| | - Francesco Cacciatore
- Heart Transplantation Unit, Department of Cardiac Surgery and Transplantation, Ospedali dei Colli Monaldi-Cotugno-CTO.,Department of Translational Medical Sciences, Federico II University of Naples, Naples, Italy
| | - Ciro Maiello
- Heart Transplantation Unit, Department of Cardiac Surgery and Transplantation, Ospedali dei Colli Monaldi-Cotugno-CTO
| | - Paolo Golino
- Cardiology Unit, Department of Cardiology and Medicine, Ospedali dei Colli Monaldi-Cotugno-CTO & University of Campania 'Luigi Vanvitelli'
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Giordano M, Santoro G, Gaio G, Cappelli Bigazzi M, Esposito R, Marzullo R, Di Masi A, Palladino MT, Russo MG. Novel echocardiographic score to predict duct-dependency after percutaneous relief of critical pulmonary valve stenosis/atresia. Echocardiography 2022; 39:724-731. [PMID: 35466466 PMCID: PMC9322398 DOI: 10.1111/echo.15358] [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: 01/12/2022] [Revised: 02/07/2022] [Accepted: 04/10/2022] [Indexed: 11/30/2022] Open
Abstract
Objectives This study aimed to identify clinical, hemodynamic, or echocardiographic predictive features of persistent duct‐dependency of pulmonary circulation (PDDPC) after effective percutaneous relief of pulmonary atresia with the intact ventricular septum (PA‐IVS) or critical pulmonary stenosis (CPS). Methods From 2010 to 2021, 55 neonates with PA‐IVS or CPS underwent percutaneous right ventricle (RV) decompression at our Institution. After successfully relief of critical obstruction, 27 patients (group I) showed PDDPC, whereas RV was able to support the pulmonary circulation in the remaining 28 patients (group II). Clinical, hemodynamic, and echocardiographic features of these two groups were compared. Results No significant difference in clinical and hemodynamic data was found between the groups, although the group I had a lower oxygen saturation at hospital admission. However, tricuspid valve (TV) diameter <8.8 mm, TV z‐score ←2.12, tricuspid/mitral valve annular ratio <.78, pulmonary valve diameter <6.7 mm, pulmonary valve z‐score ←1.17, end‐diastolic RV area <1.35 cm2, end‐systolic right atrium area >2.45 cm2, percentage amount of interatrial right‐to‐left shunt >69.5%, moderate/severe tricuspid regurgitation, RV systolic pressure >42.5 mmHg, tricuspid E/E′ ratio >6.6 showed each significant predictive value of PDDPC. These parameters were used to build a composite echocardiographic score (PDDPC‐score), assigning one point each above the respective cut‐off value. A score ≥4.00 showed high sensitivity (100%) and specificity (86%) in predicting PDDPC. Conclusion Clinical and hemodynamic features fail to predict the short‐term fate of the pulmonary circulation after successful treatment of PA‐IVS/CPS. However, a simple, composite echocardiographic score is useful to predict PDDPC and could be crucial in the management of this frail subset of patients.
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Affiliation(s)
- Mario Giordano
- Paediatric Cardiology Unit, University of Campania "Luigi Vanvitelli", A.O.R.N. "Ospedali dei Colli", Naples, Italy
| | - Giuseppe Santoro
- Paediatric Cardiology Unit, University of Campania "Luigi Vanvitelli", A.O.R.N. "Ospedali dei Colli", Naples, Italy.,Paediatric Cardiology and GUCH Unit, Heart Hospital "G. Pasquinucci", National Research Council-Tuscany Foundation "G. Monasterio", Massa, Italy
| | - Gianpiero Gaio
- Paediatric Cardiology Unit, University of Campania "Luigi Vanvitelli", A.O.R.N. "Ospedali dei Colli", Naples, Italy
| | - Maurizio Cappelli Bigazzi
- Paediatric Cardiology Unit, University of Campania "Luigi Vanvitelli", A.O.R.N. "Ospedali dei Colli", Naples, Italy.,Invasive Cardiology Unit, University of Campania "Luigi Vanvitelli", A.O.R.N. "Ospedali dei Colli", Naples, Italy
| | - Raffaella Esposito
- Paediatric Cardiology Unit, University of Campania "Luigi Vanvitelli", A.O.R.N. "Ospedali dei Colli", Naples, Italy
| | - Raffaella Marzullo
- Paediatric Cardiology Unit, University of Campania "Luigi Vanvitelli", A.O.R.N. "Ospedali dei Colli", Naples, Italy
| | - Antonio Di Masi
- Paediatric Cardiology Unit, University of Campania "Luigi Vanvitelli", A.O.R.N. "Ospedali dei Colli", Naples, Italy
| | - Maria Teresa Palladino
- Paediatric Cardiology Unit, University of Campania "Luigi Vanvitelli", A.O.R.N. "Ospedali dei Colli", Naples, Italy
| | - Maria Giovanna Russo
- Paediatric Cardiology Unit, University of Campania "Luigi Vanvitelli", A.O.R.N. "Ospedali dei Colli", Naples, Italy
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Sperlongano S, Renon F, Del Giudice C, Iannuzzi A, Bocchetti M, D'aquino MMC, Liccardo B, Scognamiglio G, Salerno G, Ciccarelli G, Bianchi R, Tartaglione D, Bigazzi MC, Golino P. 227 Myocardial work evaluation in severe aortic stenosis undergoing transcatheter aortic valve implantation. Eur Heart J Suppl 2021. [DOI: 10.1093/eurheartj/suab147.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Aims
Myocardial work (MW) is a novel echocardiographic technique which assesses left ventricular (LV) performance through LV pressure-strain loops. MW corrects speckle tracking echocardiography (STE)-derived parameters for afterload using non-invasive systolic blood pressure (SBP) as a surrogate for LV systolic pressure. In patients with severe aortic stenosis (AS), the corrected MW (cMW) has been proposed, consisting in adding the mean aortic gradient in SBP. This method revealed to be feasible and reliable, demonstrating good correlation with invasively measured LV systolic pressure.
To evaluate myocardial performance of patients with severe AS, before and after transcatheter aortic valve implantation (TAVI), by MW indices.
Methods
patients with severe AS undergoing TAVI were included. Transthoracic, standard echocardiography and STE were performed the day before the procedure and within 2 days after. MW was calculated by combining STE-derived indices with non-invasively estimated LV systolic pressure.
Results
30 patients (79±5 years old, 56% females) with severe AS (mean gradient 47±14 mmHg, aortic valve area 0.6±0.1 cm2), and eligible for TAVI were enrolled. Baseline global longitudinal strain was impaired (GLS −15±4%), in presence of normal LV ejection fraction (LVEF 57±10%). Corrected global work index and global constructive work were preserved at baseline and markedly decreased after TAVI (cGWI 2322±791 vs. 1710±505 mmHg%, P=0.001; cGCW 2774±803 vs. 2083±536 mmHg%, P=0.0007). Corrected global wasted work and global work efficiency were respectively higher and lower than reference values existing in literature, and no significant changes were observed after TAVI (cGWW 276±174 vs. 277±165 mmHg%, P=0.974; cGWE 89±5 vs. 87±5%, P=0.177). A significant inverse correlation was found between baseline cGWI and left atrial volume index (r = −0.5, P=0.03).
Conclusions
Patients with severe aortic stenosis and preserved LVEF show a good LV performance before and after TAVI, with a significant decrease in MW indices after TAVI, because of the reduced afterload due to AS treatment. The negative correlation between left atrial volume and cGWI may reflect the extent of myocardial damage in AS. However, further studies with larger sample size and appropriate follow-up are needed to evaluate the role of MW in prognosis and risk stratification of this subset of patients.
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Sperlongano S, Renon F, Bigazzi MC, Sperlongano R, Cimmino G, D’Andrea A, Golino P. Transcatheter Aortic Valve Implantation: The New Challenges of Cardiac Rehabilitation. J Clin Med 2021; 10:jcm10040810. [PMID: 33671340 PMCID: PMC7922533 DOI: 10.3390/jcm10040810] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 01/15/2021] [Revised: 02/04/2021] [Accepted: 02/09/2021] [Indexed: 12/13/2022] Open
Abstract
Transcatheter aortic valve implantation (TAVI) is an increasingly widespread percutaneous intervention of aortic valve replacement (AVR). The target population for TAVI is mainly composed of elderly, frail patients with severe aortic stenosis (AS), multiple comorbidities, and high perioperative mortality risk for surgical AVR (sAVR). These vulnerable patients could benefit from cardiac rehabilitation (CR) programs after percutaneous intervention. To date, no major guidelines currently recommend CR after TAVI. However, emerging scientific evidence shows that CR in patients undergoing TAVI is safe, and improves exercise tolerance and quality of life. Moreover, preliminary data prove that a CR program after TAVI has the potential to reduce mortality during follow-up, even if randomized clinical trials are needed for confirmation. The present review article provides an overview of all scientific evidence concerning the potential beneficial effects of CR after TAVI, and suggests possible fields of research to improve cardiac care after TAVI.
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Affiliation(s)
- Simona Sperlongano
- Department of Translational Medical Sciences, Division of Cardiology, University of Campania Luigi Vanvitelli, Monaldi Hospital, 80131 Naples, Italy; (F.R.); (M.C.B.); (G.C.); (P.G.)
- Correspondence: ; Tel.: +39-0817065185 or +39-0817064149
| | - Francesca Renon
- Department of Translational Medical Sciences, Division of Cardiology, University of Campania Luigi Vanvitelli, Monaldi Hospital, 80131 Naples, Italy; (F.R.); (M.C.B.); (G.C.); (P.G.)
| | - Maurizio Cappelli Bigazzi
- Department of Translational Medical Sciences, Division of Cardiology, University of Campania Luigi Vanvitelli, Monaldi Hospital, 80131 Naples, Italy; (F.R.); (M.C.B.); (G.C.); (P.G.)
| | - Rossella Sperlongano
- Department of Experimental Sciences, University of Campania Luigi Vanvitelli, 80138 Naples, Italy;
| | - Giovanni Cimmino
- Department of Translational Medical Sciences, Division of Cardiology, University of Campania Luigi Vanvitelli, Monaldi Hospital, 80131 Naples, Italy; (F.R.); (M.C.B.); (G.C.); (P.G.)
| | - Antonello D’Andrea
- Department of Cardiology and Intensive Coronary Care, Umberto I Hospital, 84014 Nocera Inferiore, Italy;
| | - Paolo Golino
- Department of Translational Medical Sciences, Division of Cardiology, University of Campania Luigi Vanvitelli, Monaldi Hospital, 80131 Naples, Italy; (F.R.); (M.C.B.); (G.C.); (P.G.)
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Bianchi R, Cappelli Bigazzi M, Salerno G, Tartaglione D, Ciccarelli G, Golino P. [Prevention and management of paravalvular leak post-transcatheter aortic valve implantation]. G Ital Cardiol (Rome) 2020; 21:17S-25S. [PMID: 33295331 DOI: 10.1714/3487.34669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
During transcatheter aortic valve implantation (TAVI) the native valve is not removed but crushed. Thus, a slight prosthesis insufficiency is not uncommon and has been reported up to 25% of patients for both available types of percutaneous valves. However, the definition of "clinically significant" valve regurgitation is not fully established yet. In most cases, aortic insufficiency is mild and clinical acceptable; however, severe insufficiency can occur. Paravalvular insufficiency is usually prevalent, and it may be the consequence of prosthesis-patient mismatch due to an undersizing of the implanted device or an incomplete expansion of the prosthesis stent frame, or also to incorrect site of prosthesis implantation. Thus, accurate assessment of the aortic valve annulus before TAVI is mandatory in order to select the optimal valve size. The presence of large calcium burden or bicuspid valve as well as the correct implantation of the device are other key determinants of final valve insufficiency. When severe regurgitation is present, an integration of hemodynamic, angiographic, transthoracic and transesophageal echocardiography data is necessary to tailor the best clinical decision on a per-patient basis.
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Affiliation(s)
| | | | - Gemma Salerno
- U.O.C. Cardiologia "Luigi Vanvitelli", AORN dei Colli Monaldi, Napoli
| | | | | | - Paolo Golino
- U.O.C. Cardiologia "Luigi Vanvitelli", AORN dei Colli Monaldi, Napoli
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Valente T, Bocchini G, Bigazzi MC, Muto M, Golino P, Sica G. First Multi-Detector Computed Tomography Evidence of Transcatheter Pacing System Migration and Embolization into the Pulmonary Vasculature. Korean J Thorac Cardiovasc Surg 2020; 53:310-312. [PMID: 33020349 PMCID: PMC7553824 DOI: 10.5090/kjtcs.19.085] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Accepted: 01/27/2020] [Indexed: 11/16/2022]
Abstract
Transcatheter leadless pacemaker dislodgment is a rare and potentially fatal complication of leadless device implantation. We present the first case of multidetector computed tomography images of leadless pacemaker migration and embolization in the pulmonary middle lobe artery. The patient was managed by percutaneous retrieval of the dislodged device and re-implantation in the appropriate position.
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Affiliation(s)
- Tullio Valente
- Division of Radiology, Department of Diagnostic Imaging, Monaldi Hospital, Vanvitelli University, Naples, Italy
| | - Giorgio Bocchini
- Division of Radiology, Department of Diagnostic Imaging, Monaldi Hospital, Vanvitelli University, Naples, Italy
| | | | - Massimo Muto
- Division of Radiology, Department of Diagnostic Imaging, Monaldi Hospital, Vanvitelli University, Naples, Italy
| | - Paolo Golino
- Division of Cardiology, Monaldi Hospital, Vanvitelli University, Naples, Italy
| | - Giacomo Sica
- Division of Radiology, Department of Diagnostic Imaging, Monaldi Hospital, Vanvitelli University, Naples, Italy
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Giordano M, Bigazzi MC, Palladino MT, Russo MG. A rare cause of massive hemoptysis in a child: Bronchial Dieulafoy's disease - the first report of transcatheter treatment in pediatric age. Ann Thorac Med 2020; 15:244-246. [PMID: 33381240 PMCID: PMC7720747 DOI: 10.4103/atm.atm_163_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Accepted: 06/12/2020] [Indexed: 12/31/2022] Open
Abstract
We report a case of bronchial Dieulafoy's disease in the pediatric age. Angio-computed tomography scan and arteriography addressed us to diagnosis. Bronchial endoscopy with biopsy was avoided due to the high risk of developing a life-threatening hemorrhage. Transcatheter embolization of the bleeding bronchial artery was achieved with a MicroPlex® 10 HyperSoft 3D 3.5 mm × 80 mm System (MicroVention, Tustin, CA, USA). Dieulafoy's disease is an extremely rare lesion in the pediatric age, and the small diameter of the bleeding vessels may complicate the percutaneous approach with procedural failure. Currently, the novel thin and soft detachable coils allowed to widen the transcatheter embolization in the pediatric age.
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Affiliation(s)
- Mario Giordano
- Department of Paediatric Cardiology, “Ospedali dei Colli,” University of Campania “Luigi Vanvitelli,” Naples, Italy
| | - Maurizio Cappelli Bigazzi
- Department of Paediatric Cardiology, “Ospedali dei Colli,” University of Campania “Luigi Vanvitelli,” Naples, Italy
| | - Maria Teresa Palladino
- Department of Paediatric Cardiology, “Ospedali dei Colli,” University of Campania “Luigi Vanvitelli,” Naples, Italy
| | - Maria Giovanna Russo
- Department of Paediatric Cardiology, “Ospedali dei Colli,” University of Campania “Luigi Vanvitelli,” Naples, Italy
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Valente T, Bocchini G, Bigazzi MC, Muto M, Golino P, Sica G. First Multi-Detector Computed Tomography Evidence of Transcatheter Pacing System Migration and Embolization into the Pulmonary Vasculature. Korean J Thorac Cardiovasc Surg 2020:kjtcs.19.185. [PMID: 32919453 DOI: 10.5090/kjtcs.19.185] [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] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Accepted: 01/27/2020] [Indexed: 11/16/2022]
Abstract
Transcatheter leadless pacemaker dislodgment is a rare and potentially fatal complication of leadless device implantation. We present the first case of multidetector computed tomography images of leadless pacemaker migration and embolization in the pulmonary middle lobe artery. The patient was managed by percutaneous retrieval of the dislodged device and re-implantation in the appropriate position.
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Affiliation(s)
- Tullio Valente
- Division of Radiology, Department of Diagnostic Imaging, Monaldi Hospital, Vanvitelli University, Naples, Italy
| | - Giorgio Bocchini
- Division of Radiology, Department of Diagnostic Imaging, Monaldi Hospital, Vanvitelli University, Naples, Italy
| | | | - Massimo Muto
- Division of Radiology, Department of Diagnostic Imaging, Monaldi Hospital, Vanvitelli University, Naples, Italy
| | - Paolo Golino
- Division of Cardiology, Monaldi Hospital, Vanvitelli University, Naples, Italy
| | - Giacomo Sica
- Division of Radiology, Department of Diagnostic Imaging, Monaldi Hospital, Vanvitelli University, Naples, Italy
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Giordano M, Gaio G, D'Alto M, Santoro G, Scognamiglio G, Cappelli Bigazzi M, Palladino MT, Sarubbi B, Golino P, Russo MG. Transcatheter closure of atrial septal defect in the elderly: Early outcomes and mid-term follow-up. International Journal of Cardiology Congenital Heart Disease 2020. [DOI: 10.1016/j.ijcchd.2020.100058] [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: 10/22/2022] Open
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11
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Santoro G, Salerno G, Cappelli Bigazzi M, Golino P. Challenging Transcatheter Treatment of a "Complex" Refractory Congestive Heart Failure. Can J Cardiol 2020; 36:968.e3-968.e4. [PMID: 32330436 DOI: 10.1016/j.cjca.2019.11.040] [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] [Received: 11/03/2019] [Accepted: 11/26/2019] [Indexed: 11/29/2022] Open
Affiliation(s)
- Giuseppe Santoro
- Pediatric Cardiology and GUCH Unit, Heart Hospital "G. Pasquinucci", National Research Council-Tuscany Foundation "G. Monasterio," Massa, Italy.
| | - Gemma Salerno
- Cardiology, "Luigi Vanvitelli" University, A.O.R.N. "Ospedali dei Colli," Naples, Italy
| | | | - Paolo Golino
- Cardiology, "Luigi Vanvitelli" University, A.O.R.N. "Ospedali dei Colli," Naples, Italy
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Attisano T, Silverio A, Stabile E, Briguori C, Tuccillo B, Scotto Di Uccio F, Di Lorenzo E, Tesorio T, Giordano A, Calabrò P, Cappelli Bigazzi M, Golino P, Scherillo M, Vigorito F, Quaranta G, Esposito G, Mauro C, Musumeci G, Tarantini G, Galasso G. Safety and feasibility of balloon aortic valvuloplasty in non-TAVI centers: The “BAV for life” experience. Catheter Cardiovasc Interv 2018; 93:E63-E70. [DOI: 10.1002/ccd.27820] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [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: 05/14/2018] [Revised: 07/10/2018] [Accepted: 07/22/2018] [Indexed: 11/09/2022]
Affiliation(s)
- Tiziana Attisano
- Interventional Cardiology Unit, Cardiovascular and Thoracic Department; San Giovanni di Dio e Ruggi d'Aragona University Hospital; Salerno Italy
| | - Angelo Silverio
- Interventional Cardiology Unit, Cardiovascular and Thoracic Department; San Giovanni di Dio e Ruggi d'Aragona University Hospital; Salerno Italy
| | - Eugenio Stabile
- Division of Cardiology, Department of Advanced Biomedical Sciences; Università Federico II; Naples Italy
| | - Carlo Briguori
- Interventional Cardiology Unit; Clinica Mediterranea; Naples Italy
| | | | | | | | - Tullio Tesorio
- Interventional Cardiology Service; Casa di Cura Montevergine; Mercogliano Avellino Italy
| | - Arturo Giordano
- Interventional Cardiology Unit; Clinica Pineta Grande; Castelvolturno Caserta Italy
| | - Paolo Calabrò
- Department of Cardiothoracic and Respiratory Sciences; University of Campania "Luigi Vanvitelli"; Naples Italy
| | | | - Paolo Golino
- Cardiology-CCU Unit; A.O.R.N. dei Colli; Naples Italy
| | | | - Francesco Vigorito
- Interventional Cardiology Unit, Cardiovascular and Thoracic Department; San Giovanni di Dio e Ruggi d'Aragona University Hospital; Salerno Italy
| | | | - Giovanni Esposito
- Division of Cardiology, Department of Advanced Biomedical Sciences; Università Federico II; Naples Italy
| | - Ciro Mauro
- Cardiovascular Department; Antonio Cardarelli Hospital; Naples Italy
| | | | - Giuseppe Tarantini
- Department of Cardiac; Thoracic and Vascular sciences, University of Padua; Padua Italy
| | - Gennaro Galasso
- Interventional Cardiology Unit, Cardiovascular and Thoracic Department; San Giovanni di Dio e Ruggi d'Aragona University Hospital; Salerno Italy
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13
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Tarantini G, Esposito G, Musumeci G, Fraccaro C, Franzone A, Castiglioni B, La Manna A, Limbruno U, Marchese A, Mauro C, Rigattieri S, Tarantino F, Gandolfo C, Santoro G, Violini R, Airoldi F, Albiero R, Balbi M, Baralis G, Bartorelli AL, Bedogni F, Benassi A, Berni A, Bonzani G, Bortone AS, Braito G, Briguori C, Brscic E, Calabrò P, Calchera I, Cappelli Bigazzi M, Caprioglio F, Castriota F, Cernetti C, Cicala C, Cioffi P, Colombo A, Colombo V, Contegiacomo G, Cremonesi A, D'Amico M, De Benedictis M, De Leo A, Di Biasi M, Di Girolamo D, Di Lorenzo E, Di Mario C, Dominici M, Ettori F, Ferrario M, Fioranelli M, Fischetti D, Gabrielli G, Giordano A, Giudice P, Greco C, Indolfi C, Leonzi O, Lettieri C, Loi B, Maddestra N, Marchionni N, Marrozzini C, Medda M, Missiroli B, My L, Oreglia JA, Palmieri C, Pantaleo P, Paparoni SR, Parodi G, Petronio AS, Piatti L, Piccaluga E, Pierli C, Perkan A, Pitì A, Poli A, Ramondo AB, Reale MA, Reimers B, Ribichini FL, Rosso R, Saccà S, Sacra C, Santarelli A, Sardella G, Satullo G, Scalise F, Siviglia M, Spedicato L, Stabile A, Tamburino C, Tesorio TNM, Tolaro S, Tomai F, Trani C, Valenti R, Valsecchi O, Valva G, Varbella F, Vigna C, Vignali L, Berti S. [Updated SICI-GISE position paper on institutional and operator requirements for transcatheter aortic valve implantation]. G Ital Cardiol (Rome) 2018; 19:519-529. [PMID: 30087514 DOI: 10.1714/2951.29672] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Transcatheter aortic valve implantation (TAVI) has revolutionized the management of patients with symptomatic severe aortic stenosis and has become the standard of care for inoperable patients and the preferred therapy for those at increased surgical risk with peculiar clinical and anatomic features. Technology advances, growing experience and accumulating data prompted the update of the 2011 Italian Society of Interventional Cardiology (SICI-GISE) position paper on institutional and operator requirements to perform TAVI. The main objective of this document is to provide a guidance to assess the potential of institutions and operators to initiate and maintain an efficient TAVI program.
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Affiliation(s)
| | | | | | - Chiara Fraccaro
- A.O. Policlinico Universitario di Padova, Centro Gallucci, Padova
| | | | | | - Alessio La Manna
- Cardiologia Centro Alte Specialità e Trapianti, Ospedale Gaspare Rodolico, Catania
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Ciro Indolfi
- Policlinico Universitario Mater Domini, Catanzaro
| | | | | | | | | | | | - Cinzia Marrozzini
- A.O. Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna
| | | | | | - Luigi My
- Casa di Cura Villa Verde, Taranto
| | | | | | | | | | | | | | | | | | | | - Andrea Perkan
- Azienda Sanitaria Universitaria Integrata di Trieste, Ospedale di Cattinara, Trieste
| | | | | | | | | | | | | | | | | | - Cosimo Sacra
- Università Cattolica del Sacro Cuore, Campobasso
| | | | | | | | | | | | | | | | - Corrado Tamburino
- Cardiologia Centro Alte Specialità e Trapianti, Ospedale Gaspare Rodolico, Catania
| | | | | | | | - Carlo Trani
- Policlinico A. Gemelli, Università Cattolica del Sacro Cuore, Roma
| | | | | | | | | | - Carlo Vigna
- Ospedale Casa Sollievo della Sofferenza, IRCCS, San Giovanni Rotondo (FG)
| | | | - Sergio Berti
- Ospedale del Cuore, Fondazione CNR Toscana G. Monasterio, Pisa
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14
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Attisano T, Silverio A, Di Lorenzo E, Tesorio T, Di Girolamo D, Golino P, Giordano A, Valva G, Esposito G, Cappelli Bigazzi M, Briguori C, Monteforte I, Dialetto G, Rubino P, Vigorito F, Giudice P, Mauro C. [SICI-GISE commuNity CAmpania survey doNna TAVI (INCANTA): perioperative and short-term outcome of transcatheter aortic valve implantation in women]. G Ital Cardiol (Rome) 2017; 18:27S-32S. [PMID: 28652630 DOI: 10.1714/2718.27732] [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] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Nowadays the prognostic role of gender as a relevant factor after transcatheter aortic valve implantation (TAVI) is still unfair, since available data in the literature are few and uneven. The aim of this survey was to collect acute and 30-day safety and efficacy clinical data in high- and intermediate-risk women, who underwent TAVI with new-generation devices, in the Campania Region. METHODS All medium and high-volume TAVI centers in Campania have been invited to fulfill an online, ad-hoc questionnaire, collecting pre-, peri- and post-procedural data concerning female patients, treated between January and December 2016. RESULTS 331 women (representing the 61% of the overall population treated; mean age 83 ± 7 years) underwent TAVI in the participating Campania centers. Age >80 years (72%), high surgical risk score (63%) and frailty (55%) were found to be the top three reasons for the TAVI choice. Overall, 95% of the procedures were performed by transfemoral approach with local anesthesia; the remaining 5% (16 cases) were conducted via transapical (14, 4%) and transaortic (2, 1%) accesses, under general anesthesia. Edwards Sapien 3 (Edwards Lifesciences, Irvine, CA, USA) and Medtronic Evolut R (Medtronic Inc., Minneapolis, MN, USA) were the most frequently implanted valves (146, 44% and 132, 43%, respectively). The questioned Centers reported a mean length of hospital stay of 5.5 ± 1.1 days, 1.6 ± 0.37 of which in a cardiac care unit. The most prevalent in-hospital complication was pacemaker implantation (15%), followed by life-threatening vascular complications (3%). The 30-day VARC-2 composite endpoint occurred in 7% of cases, all-cause death in 4%, and stroke in 1%. CONCLUSIONS This survey, the first representative of women undergoing TAVI in Campania, appears to confirm the good safety and efficacy profile of this procedure, also in the high- and intermediate-risk settings, probably favored by a prevalent use of new-generation devices and a low rate prevalence of significant patient comorbidities.
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Affiliation(s)
- Tiziana Attisano
- Cardiologia Interventistica, A.O.U. San Giovanni di Dio e Ruggi d'Aragona, Salerno
| | - Angelo Silverio
- Cardiologia Interventistica, A.O.U. San Giovanni di Dio e Ruggi d'Aragona, Salerno
| | | | - Tullio Tesorio
- Servizio di Emodinamica, Casa di Cura Montevergine, Mercogliano (AV)
| | | | - Paolo Golino
- Cattedra di Cardiologia, Seconda Università degli Studi, Napoli e A.O. San Sebastiano, Caserta
| | - Arturo Giordano
- Reparto di Interventistica Cardiovascolare, Clinica Pineta Grande, Castelvolturno (CE)
| | - Giuseppe Valva
- Laboratorio di Emodinamica, Casa di Cura San Michele, Maddaloni (CE)
| | - Giovanni Esposito
- Dipartimento di Scienze Biomediche Avanzate, Università degli Studi "Federico II", Napoli
| | | | - Carlo Briguori
- Laboratorio di Cardiologia Interventistica, Clinica Mediterranea, Napoli
| | | | | | - Paolo Rubino
- Emodinamica-UTIC, Presidio Ospedaliero IOS Pomigliano d'Arco, Napoli
| | - Francesco Vigorito
- Cardiologia Interventistica, A.O.U. San Giovanni di Dio e Ruggi d'Aragona, Salerno
| | - Pietro Giudice
- Cardiologia Interventistica, A.O.U. San Giovanni di Dio e Ruggi d'Aragona, Salerno
| | - Ciro Mauro
- Dipartimento Cardiovascolare, AORN A. Cardarelli, Napoli
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Gragnano F, Crisci M, Bigazzi MC, Bianchi R, Sperlongano S, Natale F, Fimiani F, Concilio C, Cesaro A, Pariggiano I, Diana V, Limongelli G, Cirillo P, Russo M, Golia E, Calabrò P. Von Willebrand Factor as a Novel Player in Valvular Heart Disease: From Bench to Valve Replacement. Angiology 2017; 69:103-112. [PMID: 28481153 DOI: 10.1177/0003319717708070] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
von Willebrand Factor (vWF) is a well-known mediator of hemostasis and vascular inflammation. Its dynamic modulation in the bloodstream, according to hemodynamic conditions, makes it an appealing biomarker in patients with valvular heart disease (VHD). Recent studies highlight the close connection between vWF and VHD, with possible implications in the pathogenesis of VHD, promoting valve aging and calcification or favoring the development of infective endocarditis. Moreover, vWF has been recently proposed as a new diagnostic and prognostic tool in patients with valve stenosis or regurgitation, showing a strict correlation with severity of valve disease, outcome, and bleeding (Heyde syndrome). A novel role for vWF is also emerging in patients undergoing percutaneous or surgical valve repair/replacement to select and stratify patients, evaluate periprocedural bleeding risk, and detect procedural complications. We also report our single-center experience, suggesting, for the first time, possible clinical implications for vWF in percutaneous mitral valve repair (MitraClip). This review summarizes recent advances in the role of vWF in VHD with an updated overview going from bench to operating room.
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Affiliation(s)
- Felice Gragnano
- 1 Division of Cardiology, Department of Cardio-thoracic and Respiratory Sciences, A.O. dei Colli Monaldi Hospital, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Mario Crisci
- 1 Division of Cardiology, Department of Cardio-thoracic and Respiratory Sciences, A.O. dei Colli Monaldi Hospital, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Maurizio Cappelli Bigazzi
- 1 Division of Cardiology, Department of Cardio-thoracic and Respiratory Sciences, A.O. dei Colli Monaldi Hospital, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Renatomaria Bianchi
- 1 Division of Cardiology, Department of Cardio-thoracic and Respiratory Sciences, A.O. dei Colli Monaldi Hospital, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Simona Sperlongano
- 1 Division of Cardiology, Department of Cardio-thoracic and Respiratory Sciences, A.O. dei Colli Monaldi Hospital, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Francesco Natale
- 1 Division of Cardiology, Department of Cardio-thoracic and Respiratory Sciences, A.O. dei Colli Monaldi Hospital, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Fabio Fimiani
- 1 Division of Cardiology, Department of Cardio-thoracic and Respiratory Sciences, A.O. dei Colli Monaldi Hospital, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Claudia Concilio
- 1 Division of Cardiology, Department of Cardio-thoracic and Respiratory Sciences, A.O. dei Colli Monaldi Hospital, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Arturo Cesaro
- 1 Division of Cardiology, Department of Cardio-thoracic and Respiratory Sciences, A.O. dei Colli Monaldi Hospital, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Ivana Pariggiano
- 1 Division of Cardiology, Department of Cardio-thoracic and Respiratory Sciences, A.O. dei Colli Monaldi Hospital, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Vincenzo Diana
- 1 Division of Cardiology, Department of Cardio-thoracic and Respiratory Sciences, A.O. dei Colli Monaldi Hospital, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Giuseppe Limongelli
- 1 Division of Cardiology, Department of Cardio-thoracic and Respiratory Sciences, A.O. dei Colli Monaldi Hospital, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Plinio Cirillo
- 2 Department of Advanced Biological Sciences, Federico II University, Naples, Italy
| | - Mariagiovanna Russo
- 1 Division of Cardiology, Department of Cardio-thoracic and Respiratory Sciences, A.O. dei Colli Monaldi Hospital, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Enrica Golia
- 1 Division of Cardiology, Department of Cardio-thoracic and Respiratory Sciences, A.O. dei Colli Monaldi Hospital, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Paolo Calabrò
- 1 Division of Cardiology, Department of Cardio-thoracic and Respiratory Sciences, A.O. dei Colli Monaldi Hospital, University of Campania "Luigi Vanvitelli", Naples, Italy
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16
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Carbone A, Formisano T, Natale F, Cappelli Bigazzi M, Tartaglione D, Golia E, Gragnano F, Crisci M, Bianchi RM, Calabrò R, Russo MG, Calabrò P. Management of unstable angina in a patient with Haemophilia A. World J Hematol 2017; 6:28-31. [DOI: 10.5315/wjh.v6.i2.28] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2016] [Revised: 03/15/2017] [Accepted: 04/07/2017] [Indexed: 02/05/2023] Open
Abstract
Hemophilia A is an X-linked recessive disorder characterized by a deficiency of coagulation factor VIII (FVIII) and therefore by a greater risk of bleeding during percutaneous interventional procedures and during the dual antiplatelet therapy (DAPT) in patients with ischemic heart disease. Information regarding safe percutaneous procedures in hemophiliacs is limited. Since the introduction of FVVIII concentrates, the life expectancy of hemophiliac patients has improved and consequently, the rate of ischemic heart disease in this population is increased. Frequently the replacement therapy can trigger the onset of an acute coronary syndrome. We report a case of a patient with mild Hemophilia A, who presents with unstable angina, treated successfully with coronary angioplasty and drug eluting stent implantation without replacement of FVVIII, treated with long term DAPT without major bleeding after six months of follow up.
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17
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Moscarella E, Santoro G, Gaio G, Palladino T, D'Aiello AF, Mahmoud HT, Cappelli Bigazzi M, Russo MG. [Percutaneous treatment of complex post-myocardial infarction ventricular septal defect: case report and literature review]. G Ital Cardiol (Rome) 2017; 18:159-163. [PMID: 28398369 DOI: 10.1714/2663.27301] [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] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Post-myocardial infarction (MI) ventricular septal defects (VSD) are a rare but life-threatening complication of acute MI, with very high mortality rates even if timely approached by surgical repair. Transcatheter closure is an attractive alternative to surgery. However, this option is currently deemed challenging and often unsuitable in complex VSD. We report the case of a young woman in poor hemodynamic conditions due to a complex post-MI VSD. A two-step percutaneous VSD closure was successfully performed adopting a patient-tailored approach based on a throughout knowledge of the anatomic and functional picture using both commercially available dedicated and off-label devices.
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Affiliation(s)
- Elisabetta Moscarella
- Dipartimento di Scienze Cardiotoraciche, Seconda Università degli Studi, AORN dei Colli, Ospedale Monaldi, Napoli
| | - Giuseppe Santoro
- Dipartimento di Scienze Cardiotoraciche, Seconda Università degli Studi, AORN dei Colli, Ospedale Monaldi, Napoli
| | - Gianpiero Gaio
- Dipartimento di Scienze Cardiotoraciche, Seconda Università degli Studi, AORN dei Colli, Ospedale Monaldi, Napoli
| | - Teresa Palladino
- Dipartimento di Scienze Cardiotoraciche, Seconda Università degli Studi, AORN dei Colli, Ospedale Monaldi, Napoli
| | - Angelo Fabio D'Aiello
- Dipartimento di Scienze Cardiotoraciche, Seconda Università degli Studi, AORN dei Colli, Ospedale Monaldi, Napoli
| | - Heba Talat Mahmoud
- Dipartimento di Scienze Cardiotoraciche, Seconda Università degli Studi, AORN dei Colli, Ospedale Monaldi, Napoli
| | - Maurizio Cappelli Bigazzi
- Dipartimento di Scienze Cardiotoraciche, Seconda Università degli Studi, AORN dei Colli, Ospedale Monaldi, Napoli
| | - Maria Giovanna Russo
- Dipartimento di Scienze Cardiotoraciche, Seconda Università degli Studi, AORN dei Colli, Ospedale Monaldi, Napoli
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18
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Bianchi R, D'Acierno L, Crisci M, Tartaglione D, Cappelli Bigazzi M, Canonico M, Albanese M, Gragnano F, Fimiani F, Russo M, Cirillo P, Calabrò P. From Femoral to Radial Approach in Coronary Intervention. Angiology 2016; 68:281-287. [PMID: 27401210 DOI: 10.1177/0003319716656714] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [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: 12/21/2022]
Abstract
Since the first cardiac catheterization in 1929, this procedure has evolved considerably. Historically performed via the transfemoral access, in the last years, the transradial access has been spreading gradually due to its many advantages. We have conducted a review of published literature concerning efficacy, safety, and cost-effectiveness, and we analyzed our patients' data, including the results of the recently published Minimizing Adverse hemorrhagic events by TRansradial access site and systemic implementation of angioX (MATRIX) study. This review confirmed the superiority of the transradial access compared to the femoral access, especially regarding complications related to the access site, duration of hospitalization, and comfort for the patient. The transradial approach is an excellent option for coronary angiography, and the procedure's risks are reduced by increased operator experience.
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Affiliation(s)
- Renatomaria Bianchi
- 1 Division of Cardiology, Second University of Naples, A.O. dei Colli Monaldi Hospital, Naples, Italy
| | - Ludovica D'Acierno
- 1 Division of Cardiology, Second University of Naples, A.O. dei Colli Monaldi Hospital, Naples, Italy
| | - Mario Crisci
- 1 Division of Cardiology, Second University of Naples, A.O. dei Colli Monaldi Hospital, Naples, Italy
| | - Donato Tartaglione
- 1 Division of Cardiology, Second University of Naples, A.O. dei Colli Monaldi Hospital, Naples, Italy
| | - Maurizio Cappelli Bigazzi
- 1 Division of Cardiology, Second University of Naples, A.O. dei Colli Monaldi Hospital, Naples, Italy
| | - Mario Canonico
- 1 Division of Cardiology, Second University of Naples, A.O. dei Colli Monaldi Hospital, Naples, Italy
| | - Michele Albanese
- 1 Division of Cardiology, Second University of Naples, A.O. dei Colli Monaldi Hospital, Naples, Italy
| | - Felice Gragnano
- 1 Division of Cardiology, Second University of Naples, A.O. dei Colli Monaldi Hospital, Naples, Italy
| | - Fabio Fimiani
- 1 Division of Cardiology, Second University of Naples, A.O. dei Colli Monaldi Hospital, Naples, Italy
| | - Mariagiovanna Russo
- 1 Division of Cardiology, Second University of Naples, A.O. dei Colli Monaldi Hospital, Naples, Italy
| | - Plinio Cirillo
- 2 Department of Advanced Biological Sciences, Federico II University, Naples, Italy
| | - Paolo Calabrò
- 1 Division of Cardiology, Second University of Naples, A.O. dei Colli Monaldi Hospital, Naples, Italy
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Granata F, Attizzani GF, Tartaglione D, Cappelli Bigazzi M, Bianchi R, Varricchio A, Russo MG, Calabrò P. Atypical "vacuum" inside of neoatherosclerosis long term after DES implantation: insights from optical coherence tomography. Int J Cardiol 2015. [PMID: 26209822 DOI: 10.1016/j.ijcard.2015.06.064] [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: 10/23/2022]
Affiliation(s)
- Francesco Granata
- Chair of Cardiology, Cardio-thoracic and Respiratory Sciences Department, Second University of Naples, Monaldi Hospital, A.O.R.N. dei Colli, Via L. Bianchi n.1, Naples, Italy.
| | | | - Donato Tartaglione
- Chair of Cardiology, Cardio-thoracic and Respiratory Sciences Department, Second University of Naples, Monaldi Hospital, A.O.R.N. dei Colli, Via L. Bianchi n.1, Naples, Italy
| | - Maurizio Cappelli Bigazzi
- Chair of Cardiology, Cardio-thoracic and Respiratory Sciences Department, Second University of Naples, Monaldi Hospital, A.O.R.N. dei Colli, Via L. Bianchi n.1, Naples, Italy
| | - Renatomaria Bianchi
- Chair of Cardiology, Cardio-thoracic and Respiratory Sciences Department, Second University of Naples, Monaldi Hospital, A.O.R.N. dei Colli, Via L. Bianchi n.1, Naples, Italy
| | - Attilio Varricchio
- Laboratory of Interventional Cardiology, Department of Cardiology, Santa Maria della Pietà Hospital, Nola, Italy
| | - Maria Giovanna Russo
- Chair of Cardiology, Cardio-thoracic and Respiratory Sciences Department, Second University of Naples, Monaldi Hospital, A.O.R.N. dei Colli, Via L. Bianchi n.1, Naples, Italy
| | - Paolo Calabrò
- Chair of Cardiology, Cardio-thoracic and Respiratory Sciences Department, Second University of Naples, Monaldi Hospital, A.O.R.N. dei Colli, Via L. Bianchi n.1, Naples, Italy
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20
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Salerno G, Schmidt FP, Bigazzi MC, Sordelli C, Bianchi R, Golino P, Calabrò P, Russo MG, Calabrò R, Pacileo G. Preoperative evaluation before MitraClip®: present and future perspective. Future Cardiol 2014; 10:725-44. [PMID: 25495815 DOI: 10.2217/fca.14.53] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Mitral regurgitation (MR) is the second most common heart valve disease worldwide. Currently, the management of MR is based on medical therapy (including biventricular pacing), surgery (mitral valve replacement or repair) and percutaneous therapy. However, in spite of guideline recommendations, 50% of individuals assessed in the Euro Heart Survey were not referred to surgical intervention due to comorbidities or real or perceived high risks for cardiac surgery; thus, in recent years, the focus of research has shifted to the development of percutaneous approaches to treat severe MR in order to restore valve function in a minimally invasive fashion. Among these techniques, the percutaneous mitral valve repair procedure using the MitraClip(®) system (Abbott Vascular, IL, USA) is one of the most promising. Usually, patient selection for MitraClip implantation is based on careful echocardiographic assessment of valve disease; however, although definitive data are lacking, evidence is mounting for a multiparametric approach including the evaluation of the functional status of patients.
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Affiliation(s)
- Gemma Salerno
- Department of Cardiology, Second University of Naples, Ospedale dei Colli, Naples, Italy
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21
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D'Andrea A, Padalino R, Cocchia R, Di Palma E, Riegler L, Scarafile R, Rossi G, Bianchi R, Tartaglione D, Cappelli Bigazzi M, Calabrò P, Citro R, Bossone E, Calabrò R, Russo MG. Effects of transcatheter aortic valve implantation on left ventricular and left atrial morphology and function. Echocardiography 2014; 32:928-36. [PMID: 25323699 DOI: 10.1111/echo.12808] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [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: 12/12/2022] Open
Abstract
AIMS Transcatheter aortic valve implantation (TAVI) is an alternative treatment in surgically high-risk or inoperable patients with severe aortic stenosis (AS). The objective of this study was to analyze the effects of TAVI on left ventricular (LV) and left atrial (LA) longitudinal function assessed by speckle tracking echocardiography (2DSTE) in patients with AS. METHODS In our prospectively conducted study, a total of 55 symptomatic (New York Heart Association class II or higher) patients with severe AS, considered to be at increased risk for undergoing surgical aortic valve replacement, were recruited (age: 78.6 ± 7.4 year). Patients underwent a complete clinical and laboratory evaluation, in addition to standard echocardiography and 2DSTE. Echocardiographic analysis was performed before and 6 months after TAVI. 2DSTE measured segmental and global longitudinal strain (GLS) and radial strain. RESULTS All the patients received the CoreValve self-expanding prosthesis. Six months after TAVI, patients showed a significant reduction in mean transaortic gradient (52.1 ± 15.8 vs. 11.2 ± 3.3 mmHg, P < 0.0001), LV mass, LA volume index, and an improvement of ejection fraction (P < 0.0001). In addition, LV GLS (-11.8 ± 3.2 vs. -16.3 ± 4.2%; P < 0.0001) and LA longitudinal strain (14.2 ± 5.4 vs. 26.6 ± 10.8%, P < 0.0001) significantly increased after TAVI. In a stepwise forward multiple logistic regression analysis, LV mass before TAVI (P < 0.001) and peak CK MB mass after TAVI (P < 0.0001) were powerful independent predictors of lower improvement of LV GLS. Moreover, LV mass index (P < 0.001) and LV GLS strain (P < 0.001) before TAVI were powerful independent predictor of LA longitudinal strain after TAVI CONCLUSIONS: TAVI in patients with AS resulted in geometric changes known as "reverse remodelling," and improved LV and LA function assessed by 2DSTE.
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Affiliation(s)
- Antonello D'Andrea
- Chair of Cardiology, Second University of Naples, AORN dei Colli, Monaldi Hospital, Naples, Italy
| | - Roberto Padalino
- Chair of Cardiology, Second University of Naples, AORN dei Colli, Monaldi Hospital, Naples, Italy
| | - Rosangela Cocchia
- Chair of Cardiology, Second University of Naples, AORN dei Colli, Monaldi Hospital, Naples, Italy
| | - Enza Di Palma
- Chair of Cardiology, Second University of Naples, AORN dei Colli, Monaldi Hospital, Naples, Italy
| | - Lucia Riegler
- Chair of Cardiology, Second University of Naples, AORN dei Colli, Monaldi Hospital, Naples, Italy
| | - Raffaella Scarafile
- Chair of Cardiology, Second University of Naples, AORN dei Colli, Monaldi Hospital, Naples, Italy
| | - Giovanni Rossi
- Department of Radiology, Monaldi Hospital, Naples, Italy
| | - Renato Bianchi
- Chair of Cardiology, Second University of Naples, AORN dei Colli, Monaldi Hospital, Naples, Italy
| | - Donato Tartaglione
- Chair of Cardiology, Second University of Naples, AORN dei Colli, Monaldi Hospital, Naples, Italy
| | | | - Paolo Calabrò
- Chair of Cardiology, Second University of Naples, AORN dei Colli, Monaldi Hospital, Naples, Italy
| | - Rodolfo Citro
- Department, University Hospital San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy
| | - Eduardo Bossone
- Department, University Hospital San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy
| | - Raffaele Calabrò
- Chair of Cardiology, Second University of Naples, AORN dei Colli, Monaldi Hospital, Naples, Italy
| | - Maria Giovanna Russo
- Chair of Cardiology, Second University of Naples, AORN dei Colli, Monaldi Hospital, Naples, Italy
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Calabrò P, Bianchi R, Crisci M, Caprile M, Bigazzi MC, Palmieri R, Golia E, De Vita A, Romano IJ, Limongelli G, Russo MG, Calabrò R. Use and efficacy of saline hydration and N-acetyl cysteine to prevent contrast-induced nephropathy in low-risk populations undergoing coronary artery angiography. Intern Emerg Med 2011; 6:503-7. [PMID: 21279477 DOI: 10.1007/s11739-011-0513-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [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] [Received: 08/15/2010] [Accepted: 01/05/2011] [Indexed: 11/24/2022]
Abstract
Contrast-induced nephropathy (CIN) is most commonly defined as acute renal failure occurring within 48-72 h of exposure to an intravascular radiographic contrast medium that is not attributable to other causes. In the international literature, a 25% increase in serum creatinine levels or an increase in absolute values of 0.5 mg/dl from baseline has been suggested to define CIN. The reported incidence of CIN varies widely, ranging from 2 to 50%. This variability results from differences in the presence or absence of risk factors. With a retrospective analysis we evaluated the use of saline hydration plus N-acetyl cysteine (NAC) to prevent CIN in a low-risk population of patients undergoing coronary artery angiography compared with an historic low risk group not treated. From January 2009 to December 2009, 152 consecutive patients who underwent coronary artery angiography with a low osmolarity contrast agent were enrolled in our study, and compared with an historic control group consisting of 172 low-risk patients. Nephrotoxic drugs such as diuretics, ACE-I and ARBs were stopped at least 24 h before the procedure. Inclusion criteria to define low-risk population were the absence of: diabetes, age >65 years, or baseline creatinine >1.4 mg/dl. We have treated group A (152 patients, 47.3%) with a saline hydration (1 ml/kg/h) plus N-acetyl cysteine 600 mg 12 h before and 12 h after the procedure; group B (group control of 170 patients, 52.7%) were not treated. The overall incidence of CIN was 7.1% (23 patients). In particular, the incidence of CIN was 2.6% (4 patients) in the group A and 11.2% (19 patients) in the group B (p = 0.002). In the multivariate analysis, including risk factor such as age, hypertension, hypercholesterolemia, current smoking habit baseline creatinine level, contrast index and hydration, the last variable was the only one inversely correlated independently with the incidence of CIN (p = 0.001). In conclusion, intravenous hydration with saline and NAC is an effective and low cost tool in preventing CIN in patients undergoing coronary artery angiography, and, according to the current guidelines, should be used in all high-risk patients for CIN. Our results show that even in patients at low risk, hydration with saline 0.9% plus NAC is useful and significantly reduces the incidence of CIN.
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Affiliation(s)
- Paolo Calabrò
- Division of Cardiology, Department of Cardiothoracic Sciences, Monaldi Hospital, Second University of Naples, Via L. Bianchi, 80131 Naples, Italy.
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D'Andrea A, Cocchia R, Caso P, Riegler L, Scarafile R, Salerno G, Golia E, Di Salvo G, Calabrò P, Bigazzi MC, Liccardo B, Esposito N, Cuomo S, Bossone E, Russo MG, Calabrò R. Global longitudinal speckle-tracking strain is predictive of left ventricular remodeling after coronary angioplasty in patients with recent non-st elevation myocardial infarction. Int J Cardiol 2011; 153:185-91. [DOI: 10.1016/j.ijcard.2010.08.025] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2010] [Revised: 05/31/2010] [Accepted: 08/08/2010] [Indexed: 11/15/2022]
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Calabrò P, Bianchi R, Caprile M, Bigazzi MC, Sordelli C, Palmieri R, D'Alessandro R, Golia E, Limongelli G, Pacileo G, Calabrò R. Contemporary evidence of coronary atherosclerotic disease and myocardial bridge on left anterior descending artery in a patient with a nonobstructive hypertrophic cardiomyopathy. J Cardiovasc Med (Hagerstown) 2011; 12:510-2. [DOI: 10.2459/jcm.0b013e3283339acd] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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25
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D'Andrea A, Severino S, Mita C, Riegler L, Cocchia R, Gravino R, Castaldo F, Scarafile R, Salerno G, Pirone S, Calabrò P, Bigazzi MC, Citro R, Cuomo S, Caso P, Calabrò R. Clinical Outcome in Patients with Intermediate Stenosis of Left Anterior Descending Coronary Artery after Deferral of Revascularization on the Basis of Noninvasive Coronary Flow Reserve Measurement. Echocardiography 2009; 26:431-40. [DOI: 10.1111/j.1540-8175.2008.00807.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Calabrò P, Bianchi R, Palmieri R, Sordelli C, Bigazzi MC, Calabrò R. Evidence of right coronary from mid-left anterior descending coronary: a rare case of coronary anomalous origin. Eur Heart J 2008; 30:565. [PMID: 18786915 DOI: 10.1093/eurheartj/ehn414] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Paolo Calabrò
- Division of Cardiology, Department of Cardiothoracic Sciences, Second University of Naples, Naples, Italy.
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Capozzi G, Caputo S, Pizzuti R, Martina L, Santoro M, Santoro G, Sarubbi B, Iacono C, D'Alto M, Bigazzi MC, Pacileo G, Merlino E, Caianiello G, Russo MG, Calabrò R. Congenital heart disease in live-born children: incidence, distribution, and yearly changes in the Campania Region. J Cardiovasc Med (Hagerstown) 2008; 9:368-74. [DOI: 10.2459/jcm.0b013e3282eee866] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Carrozza M, Santoro G, Gaio G, Bigazzi MC, Morelli C, Caianiello G, Russo MG, Calabrò R. Dysphagia lusoria due to retro-esophageal right subclavian artery in a neonate. J Cardiovasc Med (Hagerstown) 2007; 8:547-8. [PMID: 17568292 DOI: 10.2459/jcm.0b013e3280101f98] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Marianna Carrozza
- Division of Cardiology, Second University of Naples, Monaldi Hospital, Naples, Italy
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Santoro G, Pacileo G, Bigazzi MC, Russo MG, Caianiello G, Calabrò R. Transcatheter closure of ruptured sinus of Valsalva aneurysm causing Fontan circulation failure. J Cardiovasc Med (Hagerstown) 2007; 8:470-2. [PMID: 17502768 DOI: 10.2459/01.jcm.0000269713.10565.91] [Citation(s) in RCA: 3] [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] [Indexed: 11/05/2022]
Abstract
Congenital sinus of Valsalva aneurysm is a rare cardiac malformation that usually becomes symptomatic as a consequence of intracardiac or extracardiac rupture. It is difficult to suspect in association with complex cardiac defects and its rupture may be misdiagnosed as progressive aortic regurgitation. This case report refers to a patient with tricuspid atresia submitted to Fontan procedure five years previously, in whom a sinus of Valsalva aneurysm rupture into the accessory ventricular chamber caused rapidly progressive heart failure. The malformation was suspected by echocardiography and treated by percutaneous implantation of an Amplatzer duct occluder, with immediate improvement of the patient's clinical and functional status.
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Affiliation(s)
- Giuseppe Santoro
- Division of Cardiology, Second University of Naples, Monaldi Hospital, Naples, Italy.
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Gaio G, Santoro G, Iacono C, Carrozza M, Cappelli Bigazzi M, Giovanna Russo M, Calabrò R. Non-surgical treatment of ruptured sinus of Valsalva aneurysm. Int J Cardiol 2006; 113:e44-5. [PMID: 17045668 DOI: 10.1016/j.ijcard.2006.07.041] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2006] [Accepted: 07/08/2006] [Indexed: 11/28/2022]
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Santoro G, Bigazzi MC, Lacono C, Gaio G, Caputo S, Pisacane C, Caianiello G, Russo MG, Calabrò R. Transcatheter closure of complex atrial septal defects: feasibility and mid-term results. J Cardiovasc Med (Hagerstown) 2006; 7:176-81. [PMID: 16645382 DOI: 10.2459/01.jcm.0000203852.82643.f2] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Transcatheter closure of atrial septal defects (ASDs) is currently a reliable alternative to surgery, even though challenging in the case of complex septal anatomy. The aim of this study was to evaluate the feasibility and mid-term results of percutaneous closure of complex ASDs in a tertiary referral centre compared with simple ASD closure. METHODS Between April 2000 and November 2004, 209 patients were submitted to transcatheter ASD closure; 83 patients (39.7%) presented with a complex defect (large ASDs with a deficient rim or a multifenestrated/aneurysmal septum) and were treated using different devices tailored to the atrial septal anatomy. RESULTS The transcatheter procedure was successful in 72 patients (86.8%), using a single device in 69 patients and two devices in the remaining three patients. Overall, 71 Amplatzer septal occluders, two multifenestrated Amplatzer septal occluders and two Cardioseal/Starflex devices were used. Procedural and fluoroscopy times were 141 +/- 45 min and 28 +/- 22 min, respectively (P < 0.0001 vs. simple ASD closure for both comparisons). Procedure-related complications were recorded in nine patients (12.5%) (P < 0.01 vs. simple ASD closure). One patient required surgical repair of a femoral arteriovenous fistula and another developed mitral valve dysfunction. Immediate ASD occlusion was recorded in 59.7% of patients, reaching 95.9% at the last follow-up control (P = NS vs. simple ASD closure for both comparisons). CONCLUSIONS Percutaneous closure of complex ASDs may be considered technically feasible, relatively safe and highly effective, although the procedure is still significantly more demanding than transcatheter closure of simple ASDs.
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Affiliation(s)
- Giuseppe Santoro
- Division of Cardiology, Monaldi Hospital, Second University of Naples, Naples, Italy.
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32
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Pascotto M, Santoro G, Cerrato F, Caputo S, Bigazzi MC, Iacono C, Carrozza M, Russo MG, Caianiello G, Calabrò R. Time-course of cardiac remodeling following transcatheter closure of atrial septal defect. Int J Cardiol 2005; 112:348-52. [PMID: 16303193 DOI: 10.1016/j.ijcard.2005.10.008] [Citation(s) in RCA: 59] [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] [Received: 06/23/2005] [Revised: 09/27/2005] [Accepted: 10/02/2005] [Indexed: 11/29/2022]
Abstract
BACKGROUND Right chamber dilatation and right-to-left volumetric unbalance are well-known cardiac consequences of atrial septal defect (ASD) shunt, accounting for most of its long-term complications. Thus, cardiac volumetric unloading is a major aim of ASD closure. Different from surgery, transcatheter option might be considered as an "unbiased" tool to evaluate the cardiac geometric remodeling following ASD closure. METHODS Extent and time-course of cardiac geometric changes were assessed by echocardiography 24 h, 1 and 6 months after percutaneous closure of large ASD (mean diameter 17+/-6 mm, QP/QS 2.2+/-0.9) in 42 asymptomatic patients (age 22+/-18 years). RESULTS Transcatheter closure was accomplished using the Amplatzer Septal Occluder device (mean 23+/-7 mm, median 24 mm), achieving a complete occlusion in all patients at the 6-month follow-up control. After ASD closure, right atrial (RA) volume reduced from 45+/-24 to 28+/-12 ml (-37.8%, p<0.001), while left atrial (LA) volume did not significantly change. Inlet and infundibulum right ventricular (RV) end-diastolic diameters reduced by 23+/-2% and 23+/-3%, respectively (p<0.001 for both measurements), although with a different time-course of changes. Finally, transverse left ventricular (LV) end-diastolic diameter increased from 39+/-7 to 44+/-5 mm (+11.4%, p<0.01). These geometric changes resulted in an RV/LV diameter ratio decrease by 34+/-3% (p<0.001). Nearly 90% of cardiac remodeling ensued within 1 month from shunt disappearance (50% within 24 h). CONCLUSIONS Percutaneous ASD closure results in early and striking cardiac geometric changes that almost completely revert the right-to-left volumetric unbalance. Most of this geometric remodeling ensues within a few weeks from ASD closure.
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Affiliation(s)
- Marco Pascotto
- Division of Cardiology, A.O. Monaldi, 2nd University of Naples, Naples, Italy
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Di Salvo G, Drago M, Pacileo G, Rea A, Carrozza M, Santoro G, Bigazzi MC, Caso P, Russo MG, Carminati M, Calabro' R. Atrial Function After Surgical and Percutaneous Closure of Atrial Septal Defect: A Strain Rate Imaging Study. J Am Soc Echocardiogr 2005; 18:930-3. [PMID: 16153516 DOI: 10.1016/j.echo.2005.01.029] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.2] [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] [Received: 11/04/2004] [Indexed: 12/01/2022]
Abstract
The effect of operation and the effect of the imposition of an occluding device on atrial function for patients with an atrial septal defect (ASD) has never been studied. Thus, the aim of this study was to evaluate for the first time both left atrial (LA) and right atrial (RA) function of children after transcatheter ASD closure with that of sex- and age-matched patients with surgically treated ASD, and sex- and age-matched control subjects using strain (epsilon) and epsilon rate imaging (SR). In all, 45 participants formed our studied sample: 15 patients after successful ASD device closure (ASD-D [atrial septal defect device closure] group, mean age: 9 +/- 3 years) and 15 age- and sex-matched patients after successful ASD surgical closure (ASD-S [atrial septal defect surgical closure] group, mean age: 9 +/- 3 years). All patients underwent ASD correction at least 6 months before the study. As a control group we selected 15 age- and sex-matched control subjects. In the ASD-S group the peak systolic epsilon and SR values were significantly reduced in both RA and LA when compared with control and ASD-D groups (P < .01). In the ASD-D group there was no significant difference in both LA and RA deformation properties when compared with control subjects. SR imaging indexes could provide new, noninvasive, clinically relevant insight on regional changes in atrial function for patients with ASD. ASD percutaneous closure is useful not only because it is less expensive and invasive than open-heart operation but also for its conservation of both LA and RA regional myocardial properties.
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Affiliation(s)
- Giovanni Di Salvo
- Physiopathology of the Cardio-Respiratory System and Associated Biotechnologies, Second University of Naples, Naples, Italy.
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Caputo S, Capozzi G, Santoro G, Pacileo G, Bigazzi MC, Russo MG, Calabrò R. Multiple Right Coronary Artery Fistulae in a Patient with Diffuse Hypertrophic Cardiomyopathy: A Case Report. J Am Soc Echocardiogr 2005; 18:884. [PMID: 16084346 DOI: 10.1016/j.echo.2004.09.026] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [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: 06/20/2004] [Indexed: 11/28/2022]
Affiliation(s)
- Salvatore Caputo
- Paediatric Cardiology, Second University of Naples, Monaldi Hospital, Naples, Italy.
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Pascotto M, Santoro G, Caso P, Cerrato F, Caso I, Caputo S, Bigazzi MC, D'Andrea A, Russo MG, Calabrò R. Global and regional left ventricular function in patients undergoing transcatheter closure of secundum atrial septal defect. Am J Cardiol 2005; 96:439-42. [PMID: 16054478 DOI: 10.1016/j.amjcard.2005.03.096] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [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] [Received: 12/30/2004] [Revised: 03/25/2005] [Accepted: 03/25/2005] [Indexed: 11/18/2022]
Abstract
This study sought to evaluate global and regional left ventricular (LV) function before and early after device closure of atrial septal defects (ASDs) in patients with normal pulmonary pressure. Global LV diastolic function was unaffected by ASD closure. An improvement in global LV systolic function at rest resulted in an increase in stroke volume at rest. Nevertheless, total cardiac output did not change after the procedure, because of a decrease in heart rate at rest counterbalancing the increase in stroke volume. Thus, lateral and inferior LV regional systolic function were preserved after device implantation. Moreover, no changes in regional LV diastolic function were highlighted during the study.
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Affiliation(s)
- Marco Pascotto
- Pediatric Cardiology, Second University of Naples, Naples, Italy.
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Di Salvo G, Drago M, Pacileo G, Carrozza M, Santoro G, Bigazzi MC, Caso P, Russo MG, Carminati M, Calabró R. Comparison of strain rate imaging for quantitative evaluation of regional left and right ventricular function after surgical versus percutaneous closure of atrial septal defect. Am J Cardiol 2005; 96:299-302. [PMID: 16018860 DOI: 10.1016/j.amjcard.2005.02.060] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.1] [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] [Received: 11/11/2004] [Revised: 02/18/2005] [Accepted: 02/18/2005] [Indexed: 11/28/2022]
Abstract
For the first time, peak systolic strain and strain rate (SR) were used to assess right ventricular (RV) and left ventricular (LV) regional function in children after transcatheter and surgical atrial septal defect (ASD) closure. Fifteen patients with successful ASD device closure (the ASD-D group, mean age 9 +/- 3 years), 15 age- and gender-matched patients with successful ASD surgical closure (the ASD-S group, mean age 9 +/- 3 years), and 15 age- and gender-matched controls were enrolled. Regional RV and LV longitudinal function was significantly reduced in the ASD-S group compared with controls in all the studied segments. The ASD-D group presented significantly (p <0.001) reduced strain and SR values only on the basal and mid segments of the septal wall compared with controls. In the ASD-D group, only the RV basal segment showed significantly (p <0.001) reduced strain and SR values compared with controls but significantly greater values than those measured in the ASD-S group. SR imaging indexes could provide new, noninvasive, clinically relevant insight into regional changes in RV function and support the transcatheter approach to ASD for its less negative impact on RV and LV function.
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Affiliation(s)
- Giovanni Di Salvo
- Physiopathology of the Cardio-Respiratory System and Associated Biotechnologies, Second University of Naples, Naples, Italy.
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Santoro G, Bigazzi MC, Carrozza M, Palladino MT, Sarubbi B, Scarpati C, Dalto M, Russo MG, Calabrò R. Percutaneous treatment of moderate-to-large patent ductus arteriosus with different devices: early and mid-term results. Ital Heart J 2005; 6:396-400. [PMID: 15934412] [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: 05/02/2023]
Abstract
BACKGROUND Transcatheter closure is now accepted as the first-choice therapeutic option in patients with patent ductus arteriosus (PDA). However, this procedure is still challenging in large PDA and/or younger patients. This study evaluated feasibility and results of this approach in large, symptomatic PDA using different devices. METHODS Between April 2000 and July 2004, 57 patients underwent attempt of transcatheter closure of a large PDA at our Institution. Nineteen patients (33.3 %) were on pharmacologic therapy for congestive heart failure. PDA diameter was 3.2+/-1.2 mm (range 1.8-9 mm), resulting in a pulmonary to systemic flow ratio of 2.1+/-1.8 (range 1.4-5). RESULTS The procedure was successfully performed in 54 patients (94.7%), using the Amplatzer duct occluder (ADO) device (34 patients) or a multiple detachable coil approach (20 patients). Complete PDA occlusion was recorded in 77.8% of patients at 24 hours, 92.6% at 1 month, and 94.4% at last follow-up control (23+/-12 months). PDA morphology and pulmonary to systemic flow ratio did not influence the success rate of the procedure or the residual shunt. A trend toward a higher occlusion rate at any follow-up point was recorded in the ADO group (79.5 vs 75.0% at 24 hours, 97.1 vs 85.0% at 1 month, and 97.1 vs 90% at last follow-up control, p = NS for all comparisons). CONCLUSIONS Percutaneous closure might be considered effective and safe also in large, clinically significant PDA, by tailoring the device choice to the patient size and ductal morphology. In this setting, the multiple coil option revealed as effective as the ADO device over a mid-term follow-up.
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Santoro G, Bigazzi MC, Rossi G, Palladino MT, Gaio G, Russo MG, Calabrò R. Pulmonary artery stenting without angiographic imaging. Ital Heart J 2005; 6:150-3. [PMID: 15819509] [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: 05/02/2023]
Abstract
Pulmonary artery stenosis is a frequent complication seen after surgical repair of tetralogy of Fallot. In this setting, endovascular stent implantation is now accepted as the first-choice therapeutic option. However, angiographic imaging still being held as mandatory to check the stent position before final deployment, this procedure is not considered suitable for patients who cannot be submitted to angiography. In this paper, we report a novel method for the correct implantation of an endovascular stent without angiographic imaging. A 9-year-old boy underwent cardiac catheterization to relieve a severe left pulmonary artery stenosis. A previous attempt had been aborted due to a life-threatening anaphylactic reaction to the contrast medium. To avoid angiography, a contrast medium-filled compliant atrial septal defect sizing balloon (Amplatzer Sizing Balloon, AGA Medical Corporation) was used to image the vessel stenosis and successfully guide stent deployment. After the procedure, the transstenotic pressure gradient disappeared and the left-to-right pulmonary perfusion imbalance almost completely reverted.
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Santoro G, Bigazzi MC, Palladino MT, Russo MG, Carrozza M, Calabrò R. Transcatheter palliation of tetralogy of Fallot with pulmonary artery discontinuity. Tex Heart Inst J 2005; 32:102-4. [PMID: 15902835 PMCID: PMC555837] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Affiliation(s)
- Giuseppe Santoro
- Division of Pediatric Cardiology, 2nd University of Naples, Monaldi Hospital, Naples, Italy.
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Santoro G, Bigazzi MC, Caianiello G, Carrozza M, Palladino MT, Palma G, Russo MG, Vosa C, Calabrò R. Transcatheter palliation of congenital heart disease with reduced pulmonary blood flow. Ital Heart J 2005; 6:35-40. [PMID: 15773271] [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: 05/02/2023]
Abstract
BACKGROUND Although surgical shunt is still considered as the best palliation of congenital heart disease with reduced pulmonary blood flow, stent implantation may be technically simpler, safer and more cost-effective than surgery in high-risk patients. This study evaluated the feasibility and results of this option in patients with duct-dependent pulmonary blood flow or systemic-to-pulmonary shunt malfunction. METHODS Between April 2003 and July 2004, 9 patients (age 11 days-52 years, weight 2.1-52 kg) with complex congenital heart disease underwent stent implantation inside the patent ductus arteriosus (4 patients) or a stenotic surgical shunt (5 patients). RESULTS The stenting procedure was successfully completed in all cases. The procedural time was 162 +/- 36 min (range 90-225 min). The fluoroscopy time was 33.8 +/- 6.8 min. No patient died. The morbidity rate was 22.2% (1 patient had local infection at the site of puncture and 1 had transient femoral artery pulse loss). After the procedure, the ductus/shunt diameter increased from 1.2 +/- 0.6 to 3.6 +/- 0.6 mm (p < 0.0001) and oxygen saturation improved from 74.0 +/- 6.5 to 85.2 +/- 3.3% (p < 0.01). Three patients underwent corrective surgery without technical problems after 8.0 +/- 1.0 months while oxygen saturation remained constantly >80% in patients still waiting for surgical repair (follow-up 5.3 +/- 3.1 months). CONCLUSIONS Stent implantation is a technically feasible, safe and effective palliative option in high-risk surgical patients with congenital heart disease and reduced pulmonary blood flow. Although larger series are required to define the cost-effective clinical impact of this therapeutic option, it is reasonable to hypothesize a further extension of its indication even to elective and low-risk surgical patients.
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Affiliation(s)
- Giuseppe Santoro
- Division of Cardiology, Second University of Naples, Naples, Italy.
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Santoro G, Bigazzi MC, Palladino MT, Russo MG, Carrozza M, Calabrò R. Comparison of percutaneous closure of large patent ductus arteriosus by multiple coils versus the Amplatzer duct occluder device. Am J Cardiol 2004; 94:252-5. [PMID: 15246917 DOI: 10.1016/j.amjcard.2004.03.079] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [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] [Received: 01/09/2004] [Revised: 03/19/2004] [Accepted: 03/19/2004] [Indexed: 11/16/2022]
Abstract
This study compared the efficacy and costs of the most used approaches for percutaneous closure of large patent ductus arteriosus, that is, multiple coils and the Amplatzer duct occluder (ADO) device. From April 2000 to September 2003, 47 patients underwent closure of large, symptomatic patent ductus arteriosus (diameter 4.6 +/- 3.0 mm/m(2); QP/QS 2.1 +/- 1.9) with multiple Cook detachable coils (n = 19) or the ADO device (n = 28). The multiple coil approach was significantly cheaper (1,389 +/- 168 vs 3,811 +/- 38, p <0.0001) but as effective as the ADO device over a mid-term follow-up (occlusion rate 89.5% vs 96.4%, p = NS).
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Affiliation(s)
- Giuseppe Santoro
- Department of Pediatric Cardiology, 2nd University of Naples, "Monaldi" Hospital, Naples, Italy.
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Santoro G, Pascotto M, Sarubbi B, Cappelli Bigazzi M, Calvanese R, Iacono C, Pisacane C, Palladino MT, Pacileo G, Russo MG, Calabrò R. Early electrical and geometric changes after percutaneous closure of large atrial septal defect. Am J Cardiol 2004; 93:876-80. [PMID: 15050492 DOI: 10.1016/j.amjcard.2003.12.027] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.4] [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] [Received: 07/22/2003] [Revised: 12/04/2003] [Accepted: 12/04/2003] [Indexed: 11/20/2022]
Abstract
Cardiac arrhythmias and right chamber enlargement are well known long-term sequelae of atrial septal defect (ASD). Surgical ASD closure relieves patient symptoms but often fails to revert cardiac volume overload findings. Transcatheter ASD closure might be an attractive alternative to surgery, also because of the possibility to study the amount and time-course of the electro-geometric modifications following shunt disappearance. Between March 2000 and December 2002, 24 patients (age 22.7 +16.8 years) underwent percutaneous closure of large ASD (stretched diameter >20 mm and/or QP/QS ratio >1.5:1). ASD closure was performed with the Amplatzer Septal Occluder device (mean 25 +/- 7 mm), achieving a complete occlusion in all patients at 1 month. In 6 patients, right ventricular (RV) monophasic action potential was recorded during the procedure. All patients underwent standard 12-lead electrocardiography and transthoracic echocardiography before and at 24 hours and 1 month after ASD closure. After the procedure, monophasic action potential length increased from 359 +/- 27 to 372 +/- 27 ms (p <0.0001). At 1 month, QT dispersion decreased from 54 +/- 25 to 41 +/- 17 ms (p <0.05), RV diastolic diameter decreased from 42 +/- 6 to 34 +/- 5 mm (p <0.00001), and left ventricular (LV) diastolic diameter increased from 39 +/- 5 to 44 +/- 5 mm (p <0.0001), resulting in a decrease in the RV/LV ratio from 1.11 +/- 0.22 to 0.79 +/- 0.11 (-28.8%, p <0.00001). Electrocardiographic changes, as well as the amount and time-course of RV overload relief, did not significantly differ between pediatric (<16 years of age; n = 11) and adult patients (n = 13). In conclusion, regardless of age at procedure, percutaneous ASD closure results in early striking electrical and geometric cardiac changes that may be beneficial during long-term follow-up.
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Affiliation(s)
- Giuseppe Santoro
- Division of Pediatric Cardiology, A.O. Monaldi, 2nd University of Naples, Naples, Italy.
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Sarubbi B, Calvanese R, Cappelli Bigazzi M, Santoro G, Giovanna Russo M, Calabrò R. Electrophysiological changes following balloon valvuloplasty and angioplasty for aortic stenosis and coartaction of aorta: clinical evidence for mechano-electrical feedback in humans. Int J Cardiol 2004; 93:7-11. [PMID: 14729428 DOI: 10.1016/s0167-5273(03)00147-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [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 Basic research and animal experiments have shown electrophysiological changes during or after changes in mechanical loading. Electrical instability following mechanical stretch has been observed as development of after-depolarisation and dispersion of refractoriness and repolarisation. The aim of the present study was to evaluate the presence of the mechano-electrical feedback in humans, assessing the ventricular repolarisation changes following acute changes in left ventricular pressure. MATERIAL AND METHODS The study group comprised 30 consecutive patients (22 M and 8 F, aged 2 days-24 years) affected by severe congenital aortic stenosis and 30 patients (20 M and 10 F, aged 6 months-16 years) affected by severe coartaction of aorta. Ventricular repolarisation was evaluated before and after percutaneous balloon valvuloplasty and angioplasty in terms of absolute measures (JT, JTc, QT, QTc) and in terms of dispersion across the myocardium: QT and QTc dispersion (QTD, QTcD), JT and JTc dispersion (JTD and JTcD) and T-peak to T-end interval (Tp-Te). RESULTS Patients with severe aortic stenosis and patients with aortic coartaction showed a significant decrease in dispersion of ventricular repolarisation time indexes (QTD, QTcD, JTD, JTcD and Tp-Te) following valvuloplasty and angioplasty. CONCLUSIONS Changes in hemodynamic loading can also produce electrophysiological effects in humans. Acute reduction in left ventricular pressure overload following balloon valvuloplasty and angioplasty, decreases electrical instability, as expressed by the reduction across the myocardium of the dispersion of ventricular repolarisation.
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Affiliation(s)
- Berardo Sarubbi
- Second University of Naples, Chair of Cardiology, Division of Pediatric Cardiology, Monaldi Hospital, Via Leonardo Bianchi, 80131 Naples, Italy.
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Santoro G, Palma G, Merlino E, Bigazzi MC, Palladino MT, Calabrò R, Vosa C. Late-onset Blalock-Taussig shunt occlusion due to a subclavian artery pseudoaneurysm. Ital Heart J 2003; 4:559-61. [PMID: 14564983] [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: 04/27/2023]
Abstract
A 3-month-old infant with tetralogy of Fallot presented with progressive severe cyanosis and intractable acidosis about 2 months after a successful modified right-sided Blalock-Taussig shunt. At cardiac catheterization, the suspected shunt malfunction was confirmed. It was due to a bulky, pear-like mass arising from the right subclavian artery and compressing the polytetrafluoroethylene conduit. Any attempt to recanalize the shunt by percutaneous techniques proved unsuccessful. At surgery, a huge dilation of the anterior wall of the right subclavian artery, that sharply bent the prosthetic conduit, was found. Pathologic examination revealed that the compressing mass was pseudo-aneurysmal in nature. Despite a second successful shunt operation with a dramatic clinical improvement, the patient died due to multiorgan failure 72 hours following surgery. Extrinsic compression by a false aneurysm is a rare cause of shunt occlusion that should always be suspected in patients presenting with a rapidly progressive shunt malfunction late after a successful shunt procedure.
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Affiliation(s)
- Giuseppe Santoro
- Department of Pediatric Cardiology, Second University of Naples, Naples, Italy.
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Santoro G, Bigazzi MC, Palladino MT, Carrozza M, Russo MG, Calabrò R. One-step treatment of patent ductus arteriosus and pulmonary artery stenosis by cardiac catheterization. Catheter Cardiovasc Interv 2003; 59:271-5; discussion 276. [PMID: 12772258 DOI: 10.1002/ccd.10507] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [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: 11/08/2022]
Abstract
Coexistence of pulmonary artery (PA) stenosis and patent ductus arteriosus (PDA) may lead to overestimating the relative importance of these malformations. This article reports on a patient with a trivial PDA and severe PA stenosis erroneously diagnosed as moderate PDA. He was successfully submitted to simultaneous PA stenting and PDA embolization.
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Affiliation(s)
- Giuseppe Santoro
- Cardiac Catheterization Laboratory, Division of Pediatric Cardiology, A.O. "Monaldi," II University of Naples, Naples, Italy.
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Sarubbi B, Santoro G, Bigazzi MC, Calabrò R. Images in cardiovascular medicine. His bundle recording in congenital corrected transposition of the great arteries with mirror atrial arrangement (situs inversus) and mesocardia. Ital Heart J 2003; 4:214-5. [PMID: 12784750] [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] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Affiliation(s)
- Berardo Sarubbi
- Chair of Cardiology, Division of Pediatric Cardiology, Second University of Naples, Naples, Italy.
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Santoro G, Carrozza M, Cappelli Bigazzi M, Morelli C, Sessa F, Calabrò R. Images in cardiovascular medicine. Life-threatening hemoptysis after the Fontan procedure. Ital Heart J 2003; 4:139-41. [PMID: 12762279] [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] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Affiliation(s)
- Giuseppe Santoro
- Cardiac Catheterization Laboratory, Division of Pediatric Cardiology, Second University of Naples, Naples, Italy.
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Santoro G, Carminati M, Bigazzi MC, Palladino MT, Russo MG, Sarubbi B, Calabrò R. Primary stenting of native aortic coarctation. Tex Heart Inst J 2002; 28:226-7. [PMID: 11693122 PMCID: PMC101186] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Affiliation(s)
- G Santoro
- Division of Pediatric Cardiology, Monaldi Hospital, Naples, Italy
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Santoro G, Bigazzi MC, Palladino MT, Russo MG, Pacileo G, Calabrò R. Images in cardiovascular medicine. "Corkscrew" aortic arch branching pattern. Ital Heart J 2002; 3:143-4. [PMID: 11926015] [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] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Affiliation(s)
- Giuseppe Santoro
- Cardiac Catheterization Laboratory, Division of Pediatric Cardiology, Monaldi Hospital, Naples, Italy.
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Santoro G, Caianiello G, Bigazzi MC, Russo MG, Vosa C, Calabrò R. Images in cardiovascular medicine. Right-sided double aortic arch in tetralogy of fallot. Tex Heart Inst J 2002; 29:222-3. [PMID: 12224731 PMCID: PMC124767] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Affiliation(s)
- Giuseppe Santoro
- Department of Pediatric Cardiology, Monaldi Hospital, Naples, Italy
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