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Your search keyword '"Riccardo Bonato"' showing total 7 results
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7 results on '"Riccardo Bonato"'

1. Increased Arginase Expression and Decreased Nitric Oxide in Pig Donor Lungs after Normothermic Ex Vivo Lung Perfusion

Author

Farshad Tavasoli, Mingyao Liu, Tiago Machuca, Riccardo Bonato, David R. Grant, Marcelo Cypel, Shaf Keshavjee, and Hartmut Grasemann

Subjects
lung transplantation, ex vivo lung perfusion, nitric oxide, arginase, Microbiology, QR1-502
Abstract

An established pig lung transplantation model was used to study the effects of cold ischemia time, normothermic acellular ex vivo lung perfusion (EVLP) and reperfusion after lung transplantation on l-arginine/NO metabolism in lung tissue. Lung tissue homogenates were analyzed for NO metabolite (NOx) concentrations by chemiluminescent NO-analyzer technique, and l-arginine, l-ornithine, l-citrulline and asymmetric dimethylarginine (ADMA) quantified using liquid chromatography-mass spectrometry (LC-MS/MS). The expression of arginase and nitric oxide synthase (NOS) isoforms in lung was measured by real-time polymerase chain reaction. EVLP preservation resulted in a significant decrease in concentrations of NOx and l-citrulline, both products of NOS, at the end of EVLP and after reperfusion following transplantation, compared to control, respectively. The ratio of l-ornithine over l-citrulline, a marker of the balance between l-arginine metabolizing enzymes, was increased in the EVLP group prior to reperfusion. The expression of both arginase isoforms was increased from baseline 1 h post reperfusion in EVLP but not in the no-EVLP group. These data suggest that EVLP results in a shift of the l-arginine balance towards arginase, leading to NO deficiency in the lung. The arginase/NOS balance may, therefore, represent a therapeutic target to improve lung quality during EVLP and, subsequently, transplant outcomes.

Published
2020
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2. Hemodynamic performance and clinical outcome of pericardial Perimount Magna and Porcine Hancock-II valves in aortic position

Author

Riccardo Bonato, Enrico Ferrari, Elena Caporali, Catherine Klersy, University of Zurich, and Ferrari, Enrico

Subjects
Pulmonary and Respiratory Medicine, Male, medicine.medical_specialty, Swine, Heart Valve Diseases, Hemodynamics, 610 Medicine & health, Hospital mortality, 030204 cardiovascular system & hematology, Prosthesis Design, 11171 Cardiocentro Ticino, 2705 Cardiology and Cardiovascular Medicine, Pacemaker implantation, 03 medical and health sciences, 0302 clinical medicine, Aortic valve replacement, Medicine, Endocarditis, Animals, Humans, Aged, Retrospective Studies, Bioprosthesis, Heart Valve Prosthesis Implantation, business.industry, Mean age, Perioperative, medicine.disease, Confidence interval, Surgery, 2746 Surgery, 030228 respiratory system, 2740 Pulmonary and Respiratory Medicine, Echocardiography, Heart Valve Prosthesis, Female, Cardiology and Cardiovascular Medicine, business, Pericardium, Follow-Up Studies
Abstract

Background We investigated hospital and midterm outcome of patients operated for an aortic valve replacement (AVR) with a pericardial Perimount or a Porcine Hancock-II valve. Methods We analyzed 353 patients with Perimount Magna (n = 189) or Hancock-II valves (n = 164). Echocardiographic data, hospital outcome, and follow-up were collected and compared. The role of the type of valve on perioperative and midterm outcome was investigated. Results Mean age was 75.3 ± 6.8 and 74.3 ± 7.1 years (P = .17) for Perimount and Hancock-II group, respectively. Fifty-four Perimount (28.6%) and 24 patients with Hancock-II (14.6%) required urgent procedures (P = .002), including six type-A dissections and five endocarditis. EuroSCORE-II was 3.1 ± 2.7% (Perimount) and 2.7 ± 2.2% (Hancock-II). Combined procedures were performed in 115 Perimount (60.8%) and 71 patients with Hancock (43.3%); redo procedures counted for 1% and 2.4%, respectively (P = .42). Mean valve size was 23.2 ± 1.8 mm for pericardial and 23.6 ± 1.9 mm for porcine valves (P = .08). Hospital mortality (6.3% vs 2.4%; P = .05), kidney failure (11.6% vs 9.8%; P = .73), and new pacemaker implantation rates (6.3% vs 3.0%; P = .21) were higher in the Perimount group reflecting the fact that more urgent, combined, and critical procedures were implanted with a Perimount Magna. Overall, 51 patients died over 60 months (34 Perimount, 17 Hancock), corresponding to a mortality of 5.3 per 100-persons year (95% confidence interval [CI]: 3.8-7.4) and 3.0 (95% CI: 1.8-4.8), respectively. Survival at 5 years was 76% (95% CI: 68-82) and 83% (95% CI: 74-89) in the Perimount and Hancock groups (log-rank test; P = .099). Conclusions We confirm a good clinical outcome of patients with AVR with modern pericardial or a porcine bioprosthesis. Despite better hemodynamic, the Perimount does not improve the midterm clinical outcome compared with the porcine valve.

Published
2019

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