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6. Correlations Between Cardiac Magnetic Resonance and Myocardial Histologic Findings in Fabry Disease

Author

Ditaranto, Raffaello, primary, Leone, Ornella, additional, Lovato, Luigi, additional, Niro, Fabio, additional, Cenacchi, Giovanna, additional, Papa, Valentina, additional, Baldovini, Chiara, additional, Ferracin, Manuela, additional, Salamon, Irene, additional, Kurdi, Hibba, additional, Parisi, Vanda, additional, Capelli, Irene, additional, Pession, Andrea, additional, Liguori, Rocco, additional, Potena, Luciano, additional, Seri, Marco, additional, Martin Suarez, Sofia, additional, Galiè, Nazzareno, additional, Moon, James C., additional, and Biagini, Elena, additional

Published
2023
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14. Coronary Stent Infection and Subsequent Abscessualization Causing Dislocation in Extravascular Position

Author

Bendandi, Francesco, primary, Bruno, Antonio Giulio, additional, Donati, Francesco, additional, Ciurlanti, Leonardo, additional, Orzalkiewicz, Mateusz, additional, Palmerini, Tullio, additional, Marrozzini, Cinzia, additional, Saia, Francesco, additional, Galiè, Nazzareno, additional, Martin Suarez, Sofia, additional, Taglieri, Nevio, additional, and Ghetti, Gabriele, additional

Published
2022
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15. Asymmetrical aortic root aneurism in patient with Filamin A mutation.

Author

Martin‐Suarez, Sofia, Gliozzi, Gregorio, Pagano, Vincenzo, Leone, Ornella, Foà, Alberto, Ruggiero, Andrea, Snaidero, Silvia, Cerchierini, Elisa, Pacini, Davide, and Martin-Suarez, Sofia

Abstract

We report the case of a 28 years old woman with periventricular nodular heterotopia, due to Filamin A mutation. She had an asymmetrical aneurysm of the aortic root, involving, above all, noncoronary Valsalva sinus. She was asymptomatic and she had moderate aortic regurgitation. Reimplantation of the aortic valve with replacement of the aortic root was successfully accomplished. Filamin A is a protein that is encoded by the FLNA gene, which shows X-linked dominant inheritance. This protein is involved in neuronal migration, angiogenesis, cytoskeleton regulation, and cell signaling. Therefore, mutations of FLNA gene might result in brain, blood vessels, heart, and connective tissue disorders. A miscellany of cardiovascular abnormalities could be present in this subset of patients; cardiac symptoms may precede neurological manifestations. Aorta seems to be frequently affected. Consequently, in presence of FLNA gene mutations, cardiovascular evaluation should include vascular magnetic resonance imaging or computed tomography scan. [ABSTRACT FROM AUTHOR]

Published
2022
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16. Is Pulmonary Artery Pulsatility Index (PAPi) a Predictor of Outcome after Pulmonary Endarterectomy?

Author

Martin-Suarez, Sofia, primary, Gliozzi, Gregorio, additional, Cavalli, Giulio Giovanni, additional, Orioli, Valentina, additional, Loforte, Antonio, additional, Pastore, Saverio, additional, Rossi, Barbara, additional, Zardin, Davide, additional, Galiè, Nazzareno, additional, Palazzini, Massimiliano, additional, Dardi, Fabio, additional, Saia, Francesco, additional, Niro, Fabio, additional, and Pacini, Davide, additional

Published
2022
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20. Therapeutic alternatives in CTEPH: from PEA to BPA to medical therapy. State of the art from a multidisciplinary team

Author

Martin-Suarez, Sofia, primary, Loforte, Antonio, additional, Cavalli, Giulio Giovanni, additional, Gliozzi, Gregorio, additional, Botta, Luca, additional, Mariani, Carlo, additional, Orioli, Valentina, additional, Votano, Daniela, additional, Costantino, Antonino, additional, Santamaria, Valeria, additional, Tassi, Sara, additional, Fiaschini, Costanza, additional, Campanini, Francesco, additional, Palazzini, Massimiliano, additional, Rossi, Barbara, additional, Barbera, Nicolò Antonino, additional, Niro, Fabio, additional, Manes, Alessandra, additional, Saia, Francesco, additional, Dardi, Fabio, additional, Galiè, Nazzareno, additional, and Pacini, Davide, additional

Published
2022
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22. Therapeutic alternatives in chronic thromboembolic pulmonary hypertension: from pulmonary endarterectomy to balloon pulmonary angioplasty to medical therapy. State of the art from a multidisciplinary team

Author

Martin-Suarez, Sofia, primary, Loforte, Antonio, additional, Cavalli, Giulio Giovanni, additional, Gliozzi, Gregorio, additional, Botta, Luca, additional, Mariani, Carlo, additional, Orioli, Valentina, additional, Votano, Daniela, additional, Costantino, Antonino, additional, Santamaria, Valeria, additional, Tassi, Sara, additional, Fiaschini, Costanza, additional, Campanini, Francesco, additional, Palazzini, Massimiliano, additional, Rossi, Barbara, additional, Barbera, Nicolò Antonino, additional, Niro, Fabio, additional, Manes, Alessandra, additional, Saia, Francesco, additional, Dardi, Fabio, additional, Galiè, Nazzareno, additional, and Pacini, Davide, additional

Published
2022
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23. Angioplastica delle arterie polmonari nel cuore polmonare cronico tromboembolico: un caso clinico paradigmatico

Author

Guarino, Daniele, Saia, Francesco, Taglieri, Nevio, Dardi, Fabio, Rotunno, Mariangela, Manes, Alessandra, Niro, Fabio, Martin Suarez, Sofia, Pacini, Davide, Galiè, Nazzareno, Palazzini, Massimiliano, Guarino, Daniele, Saia, Francesco, Taglieri, Nevio, Dardi, Fabio, Rotunno, Mariangela, Manes, Alessandra, Niro, Fabio, Martin Suarez, Sofia, Pacini, Davide, Galiè, Nazzareno, and Palazzini, Massimiliano

Subjects
Pulmonary endarterectomy, Chronic thromboembolic pulmonary hypertension, Balloon pulmonary angioplasty
Abstract

Chronic thromboembolic pulmonary hypertension (CTEPH) is a complex disease where organized pulmonary thrombi and progressive vascular remodeling of the pulmonary arterial tree act synergistically to increase pulmonary vascular resistance and cause pulmonary hypertension. Balloon pulmonary angioplasty (BPA) has gained a renewed interest for the treatment of patients with CTEPH who are not undergoing surgery with pulmonary endarterectomy (PEA) or with persistent/recurrent pulmonary hypertension after PEA and has shown promising results in several observational studies conducted to date. We describe the case of a 42-year-old man with inoperable CTEPH in NYHA functional class III who normalized functional capacity, hemodynamic profile and main hemodynamic parameters after three BPA sessions.

Published
2021

26. Pulmonary thrombo-endarterectomy for chronic thromboembolic pulmonary artery hypertension

Author

Martin-Suarez, Sofia, primary, Gliozzi, Gregorio, additional, Loforte, Antonio, additional, Niro, Fabio, additional, Fiorentino, Mariafrancesca, additional, Cavalli, Giulio Giovanni, additional, Palazzini, Massimiliano, additional, Saia, Francesco, additional, Barbera, Niccolò, additional, La Monaca, Marco, additional, Galiè, Nazzareno, additional, and Pacini, Davide, additional

Published
2021
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37. Percutaneous Pulmonary Artery Venting via Jugular Vein While on Peripheral Extracorporeal Life Support

Author

Loforte, Antonio, primary, Baiocchi, Massimo, additional, Dal Checco, Erika, additional, Gliozzi, Gregorio, additional, Fiorentino, Mariafrancesca, additional, Lo Coco, Valeria, additional, Martin Suarez, Sofia, additional, Marrozzini, Cinzia, additional, Biffi, Mauro, additional, Marinelli, Giuseppe, additional, and Pacini, Davide, additional

Published
2020
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38. orthotopic Heart Transplantation : Bicaval Versus Biatrial Surgical Technique

Author

Martin-Suarez, Sofia

Subjects
Medical / Cardiology
Abstract

In 1967, the first cardiac transplantation was performed in South Africa by Christiaan Barnard, becoming one of the most pioneering events of the human history, comparable to the first step on the moon, 2 years later. Even if Barnard became extremely famous because of this outstanding operation, behind this event there were years and years of studies, experimentations and hard work done by others, in particular by Lower and Shumway. The initial technique, still called ‘standard technique’ is the biatrial one. In the late 1980s, alternatives like the ‘bicaval technique’ were developed in order to get a more anatomical result. In the present chapter, we will throw the reader into the early years of the cardiac transplantation era, describing all the efforts made by the “fathers” of the cardiac surgery in order to standardize techniques inherited by the modern surgeons. Afterwards, we will present a review of the literature to answer the question if the biatrial technique should still be called “standard technique”.

Published
2018

39. Histopathological comparison of intramural coronary artery remodeling and myocardial fibrosis in obstructive versus end-stage hypertrophic cardiomyopathy

Author

Foà, Alberto, primary, Agostini, Valentina, additional, Rapezzi, Claudio, additional, Olivotto, Iacopo, additional, Corti, Barbara, additional, Potena, Luciano, additional, Biagini, Elena, additional, Martin Suarez, Sofia, additional, Rotellini, Matteo, additional, Cecchi, Franco, additional, Stefano, Pierluigi, additional, Coppini, Raffaele, additional, Ferrantini, Cecilia, additional, Bacchi Reggiani, Maria L., additional, and Leone, Ornella, additional

Published
2019
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41. Clinical relevance of the International Society for Heart and Lung Transplantation consensus classification of primary graft dysfunction after heart transplantation: Epidemiology, risk factors, and outcomes

Author

Sabatino, Mario, primary, Vitale, Giuseppe, additional, Manfredini, Valentina, additional, Masetti, Marco, additional, Borgese, Laura, additional, Maria Raffa, Giuseppe, additional, Loforte, Antonio, additional, Martin Suarez, Sofia, additional, Falletta, Calogero, additional, Marinelli, Giuseppe, additional, Clemenza, Francesco, additional, Grigioni, Francesco, additional, and Potena, Luciano, additional

Published
2017
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43. Percutaneous Pulmonary Artery Venting viaJugular Vein While on Peripheral Extracorporeal Life Support

Author

Loforte, Antonio, Baiocchi, Massimo, Dal Checco, Erika, Gliozzi, Gregorio, Fiorentino, Mariafrancesca, Lo Coco, Valeria, Martin Suarez, Sofia, Marrozzini, Cinzia, Biffi, Mauro, Marinelli, Giuseppe, and Pacini, Davide

Abstract

Peripheral extracorporeal membrane oxygenation (ECMO) setting remains a valid option to treat cardiogenic shock (CS). We investigated a percutaneous approach to unload the left ventricle (LV) while on veno-arterial (v-a) peripheral ECMO support. Between 2017 and 2018, eight patients (three females, mean age: 49.6 years old, and five males, mean age: 58 years old, respectively) suffered refractory CS due to acute myocardial infarction (n = 4), acute myocarditis (n = 2), acute decompensation on chronic heart failure (n = 1), and primary graft failure after heart transplantation (Htx) (n = 1), respectively. After a multidisciplinary CS team discussion, it was decided to proceed with peripheral v-a ECMO placement and percutaneous LV venting viaright internal jugular vein access to drain the pulmonary artery (PA), in the hybrid operating room. In a single postcardiotomy case, the PA trunk was vented centrally. Mean ECMO support time was 8.5 days. Seven (87.5%) patients were successfully weaned from ECMO and one (12.5%) successfully bridged to Htx. All patients were successfully discharged after treatment except for a single case who died due to sepsis. In case of not recommended usage of LV apical venting, the adoption of v-a peripheral ECMO support associated with percutaneous PA drainage enables the rapid onset of extracorporeal life support with an effective biventricular unloading.

Published
2020
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44. Role of Intra‐Aortic Balloon Pump and Extracorporeal Membrane Oxygenation in Early Graft Failure After Cardiac Transplantation

Author

Loforte, Antonio, primary, Murana, Giacomo, additional, Cefarelli, Mariano, additional, Jafrancesco, Giuliano, additional, Sabatino, Mario, additional, Martin Suarez, Sofia, additional, Pilato, Emanuele, additional, Pacini, Davide, additional, Grigioni, Francesco, additional, Bartolomeo, Roberto Di, additional, and Marinelli, Giuseppe, additional

Published
2016
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46. Therapeutic alternatives in chronic thromboembolic pulmonary hypertension: from pulmonary endarterectomy to balloon pulmonary angioplasty to medical therapy. State of the art from a multidisciplinary team

Author

Sofia Martin-Suarez, Antonio Loforte, Giulio Giovanni Cavalli, Gregorio Gliozzi, Luca Botta, Carlo Mariani, Valentina Orioli, Daniela Votano, Antonino Costantino, Valeria Santamaria, Sara Tassi, Costanza Fiaschini, Francesco Campanini, Massimiliano Palazzini, Barbara Rossi, Nicolò Antonino Barbera, Fabio Niro, Alessandra Manes, Francesco Saia, Fabio Dardi, Nazzareno Galiè, Davide Pacini, Martin-Suarez, Sofia, Loforte, Antonino, Cavalli, Giulio Giovanni, Gliozzi, Gregorio, Botta, Luca, Mariani, Carlo, Orioli, Valentina, Votano, Daniela, Costantino, Antonino, Santamaria, Valeria, Tassi, Sara, Fiaschini, Costanza, Campanini, Francesco, Palazzini, Massimiliano, Rossi, Barbara, Barbera, Niccolo' Antonino, Niro, Fabio, Manes, Alessandra, Saia, Francesco, Dardi, Fabio, Galie', Nazzareno, and Pacini, Davide

Subjects
Keynote Lecture Series, Pulmonary hypertension, pulmonary endarterectomy, hypothermia, balloon angioplasty, vasodilator, Surgery, Cardiology and Cardiovascular Medicine
Abstract

Chronic thromboembolic pulmonary hypertension (CTEPH) is a rare disease with a very complex pathophysiology differing from other causes of pulmonary hypertension (PH). It is an infrequent consequence of acute pulmonary embolism that is frequently misdiagnosed. Pathogenesis has been related to coagulation abnormalities, infection or inflammation, although these disturbances can be absent in many cases. The hallmarks of CTEPH are thrombotic occlusion of pulmonary vessels, variable degree of ventricular dysfunction and secondary microvascular arteriopathy. The definition of CTEPH also includes an increase in mean pulmonary arterial pressure of more than 25 mmHg with a normal pulmonary capillary wedge of less than 15 mmHg. It is classified as World Health Organization group 4 PH, and is the only type that can be surgically cured by pulmonary endarterectomy (PEA). This operation needs to be carried out by a team with strong expertise, from the diagnostic and decisional pathway to the operation itself. However, because the disease has a very heterogeneous phenotype in terms of anatomy, degree of PH and the lack of a standard patient profile, not all cases of CTEPH can be treated by PEA. As a result, PH-directed medical therapy traditionally used for the other types of PH has been proposed and is utilized in CTEPH patients. Since 2015, we have been witnessing the rebirth of balloon pulmonary angioplasty, a technique first performed in 2001 but has since fallen out fashion due to major complications. The refinement of such techniques has allowed its safe utilization as a salvage therapy in inoperable patients. In the present keynote lecture, we will describe these therapeutic approaches and results.

Published
2022

47. The Role of Extracorporeal Membrane Oxygenation Support after Pulmonary Thrombo-Endarterectomy

Author

Loforte, Antonio, Martin-Suarez, Sofia, Pacini, Davide, Galiè, Nazzareno, Botta, Luca, Mariani, Carlo, Cavalli, Giulio Giovanni, and Gliozzi, Gregorio

Subjects
Medical
Abstract

Chronic thromboembolic pulmonary hypertension (CTEPH) is a rare consequence of acute or chronic pulmonary embolism. Pulmonary endarterectomy (PEA) is the gold standard treatment: expert centers are able to offer this challenging procedure with low in-hospital mortality, excellent hemodynamic results, and significant improvement in exercise tolerance and quality of life. Despite careful preoperative selection and increasing technical experience in PEA, some patients may suffer from life-threatening complications requiring extracorporeal life support (ECLS). ECLS is necessary in case of heart failure, respiratory failure, or both. According to different indications and timing, cardiopulmonary failure after PEA should be managed with a tailored approach: veno-venous or veno-arterial support, and central or peripheral cannulation. In the present chapter, causes, management strategies, and outcomes of perioperative ECLS for PEA are discussed.

Published
2022

48. AVR in patients with anomalous course of the circumflex artery without prosthetic downsizing

Author

Alessandro Leone, Luca Botta, Ciro Amodio, Carlo Savini, Sofia Martin-Suarez, Vincenzo Pagano, Luca Di Marco, Antonio Loforte, Davide Pacini, Botta L., Amodio C., Pagano V., Di Marco L., Leone A., Loforte A., Martin Suarez Sofia., Savini C., and Pacini D.

Subjects
Pulmonary and Respiratory Medicine, Aortic valve, medicine.medical_specialty, Coronary Vessel Anomalies, aortic valve surgery, 030204 cardiovascular system & hematology, Prosthesis Design, Coronary Vessel Anomalie, 03 medical and health sciences, Blood Vessel Prosthesis Implantation, 0302 clinical medicine, anomalous coronary origin, circumflex artery, Aortic Valve, Coronary Vessels, Heart Valve Prosthesis Implantation, Humans, Blood Vessel Prosthesis, medicine.artery, Internal medicine, medicine, In patient, Cardiac skeleton, Circumflex, Surgical treatment, Coronary Vessel, business.industry, Blood Vessel Prosthesi, medicine.anatomical_structure, 030228 respiratory system, Right coronary artery, cardiovascular system, Cardiology, LEFT CIRCUMFLEX CORONARY ARTERY, Surgery, Cardiology and Cardiovascular Medicine, business, Human, Artery
Abstract

An anomalous origin of the left circumflex coronary artery that arises as a side branch of the right coronary artery and encircles the aortic annulus is usually an incidental finding. However, in patients undergoing aortic valve/root procedures, its existence can significantly complicate the surgical treatment. We report our operative strategy with three different prostheses without valve downsizing.

Published
2020

49. Differences in cardiac phenotype and natural history of laminopathies with and without neuromuscular onset

Author

Rita Rinaldi, Maria Letizia Bacchi Reggiani, Maddalena Graziosi, Raffaello Ditaranto, Giovanna Lattanzi, Matteo Ziacchi, Giovanni Vitale, Mauro Biffi, Giuseppe Boriani, Ferdinando Pasquale, Luciano Potena, Massimiliano Lorenzini, Alessandra Berardini, Claudio Rapezzi, Sofia Martin Suarez, Elena Biagini, Ditaranto, Raffaello, Boriani, Giuseppe, Biffi, Mauro, Lorenzini, Massimiliano, Graziosi, Maddalena, Ziacchi, Matteo, Pasquale, Ferdinando, Vitale, Giovanni, Berardini, Alessandra, Rinaldi, Rita, Lattanzi, Giovanna, Potena, Luciano, Martin Suarez, Sofia, Bacchi Reggiani, Maria Letizia, Rapezzi, Claudio, and Biagini, Elena

Subjects
Male, 0301 basic medicine, Ventricular Tachyarrhythmias, medicine.medical_treatment, Neuromuscular disorder, Cardiomyopathy, lcsh:Medicine, Laminopathy, 030204 cardiovascular system & hematology, Electrocardiography, 0302 clinical medicine, Pharmacology (medical), Prospective Studies, Child, Genetics (clinical), Heart transplantation, Heart, Atrial fibrillation, Neuromuscular Diseases, General Medicine, Middle Aged, Lamin Type A, Ventricular tachycardias, Natural history, Cardiology, Female, Adult, Familial cardiomyopathies, medicine.medical_specialty, Adolescent, Familial cardiomyopathie, Mutation, Missense, NO, Young Adult, 03 medical and health sciences, Internal medicine, medicine, Humans, Bradyarrhythmias, Emerin, Lamin, Neuromuscular disorders, In patient, Retrospective Studies, business.industry, Research, lcsh:R, medicine.disease, Bradyarrhythmia, 030104 developmental biology, Laminin, Cardiac phenotype, business
Abstract

Objective To investigate differences in cardiac manifestations of patients affected by laminopathy, according to the presence or absence of neuromuscular involvement at presentation. Methods We prospectively analyzed 40 consecutive patients with a diagnosis of laminopathy followed at a single centre between 1998 and 2017. Additionally, reports of clinical evaluations and tests prior to referral at our centre were retrospectively evaluated. Results Clinical onset was cardiac in 26 cases and neuromuscular in 14. Patients with neuromuscular presentation experienced first symptoms earlier in life (11 vs 39 years; p p = 0.013] and 30 vs 44 years [p = 0.086] respectively), despite a similar overall prevalence of AF (57% vs 65%; p = 0.735) and atrio-ventricular (A-V) block (50% vs 65%; p = 0.500). Those with a neuromuscular presentation developed a cardiomyopathy less frequently (43% vs 73%; p = 0.089) and had a lower rate of sustained ventricular tachyarrhythmias (7% vs 23%; p = 0.387). In patients with neuromuscular onset rhythm disturbances occurred usually before evidence of cardiomyopathy. Despite these differences, the need for heart transplantation and median age at intervention were similar in the two groups (29% vs 23% [p = 0.717] and 43 vs 46 years [p = 0.593] respectively). Conclusions In patients with laminopathy, the type of disease onset was a marker for a different natural history. Specifically, patients with neuromuscular presentation had an earlier cardiac involvement, characterized by a linear and progressive evolution from rhythm disorders (AF and/or A-V block) to cardiomyopathy.

Published
2019

50. Impact of Current Donor Scores Calculation on Heart Transplantation Outcomes

Author

S. Martin Suarez, Luciano Potena, Antonio Loforte, Mariafrancesca Fiorentino, Davide Pacini, Marco Masetti, Giacomo Murana, Luca Botta, Gregorio Gliozzi, Murana, G, Fiorentino, M, Gliozzi, G, Botta, L, Martin Suarez Sofia, Masetti, M, Potena, L, Pacini, D, and Loforte, A

Subjects
Pulmonary and Respiratory Medicine, Heart transplantation, Transplantation, education.field_of_study, medicine.medical_specialty, biology, business.industry, medicine.medical_treatment, Population, Gold standard, heart donor scoring systems, medicine.disease, Troponin, Extracorporeal, Heart failure, Internal medicine, Life support, Cohort, medicine, biology.protein, Surgery, Cardiology and Cardiovascular Medicine, education, business
Abstract

Purpose Heart transplantation (Htx) remains the gold standard as treatment of patients with advanced heart failure. Donor and recipient characteristics have changed dramatically in recent years, leading to more complex decision-making regarding organ acceptance and postoperative management. Primary aim of the study was to identify donor risk factors variables impacting on in-hospital mortality, early graft failure and follow-up mortality; secondary objective was to validate the available international donor risk scores. Methods Between January 2000 and December 2017, 461 adult patients underwent Htx. UNOS, RADIAL and Eurotransplant scores have been calculated. Clinical features and donor risk scores have been tested in order to identify pre-, intra- and post-operative risk variables and eventually validate the scores on our population. Results Post-Htx extracorporeal life support (ECLS) was used in 11.1% (51/461). Of the donor related factors, peak of troponine (p 240 minutes (p=0.037) influenced EGF occurrence. The Eurotransplant donor score didn't impact on outcomes, the RADIAL significantly influenced both on early (p=0.02) and late mortality (p=0.004) while the UNOS on late mortality only (p=0.03). On the multivariate model, after adjustment per cohort of scores, noradrenaline infusion resulted to be an independent predictor of in-hospital mortality in the Eurotransplant score >17 population, recipient pre-Htx ECLS and BMI >30 were independent predictors of EGF in the UNOS score >6 population, and recipient age >60 was predictor of late mortality in the RADIAL score >5 (figure 1). Conclusion Actual heart donor scoring systems do not fully behave as reliable predictors of transplant outcomes. Therefore, every transplant institution should consider developing a local donor scoring systemto provide their own standard graft selection thus preserving the outcomes.

Published
2020

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