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Your search keyword '"Andrea Bezzeccheri"' showing total 11 results
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11 results on '"Andrea Bezzeccheri"'

1. Challenges and Open Issues in Transcatheter Mitral Valve Implantation: Smooth Seas Do Not Make Skillful Sailors

Author

Giulio Russo, Francesco Maisano, Gianluca Massaro, Giuseppe Terlizzese, Enrica Mariano, Michela Bonanni, Andrea Matteucci, Andrea Bezzeccheri, Daniela Benedetto, Gaetano Chiricolo, Eugenio Martuscelli, and Giuseppe Massimo Sangiorgi

Subjects
transcatheter mitral valve repair, transcatheter mitral valve implantation, mitral regurgitation, valve-in-valve, valve-in-ring, valve-in-MAC, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

According to the European and American guidelines, surgery represents the treatment of choice for mitral valve (MV) disease. However, a number of patients are deemed unsuitable for surgery due to a prohibitive/high operative risk. In such cases, transcatheter therapies aiming at MV repair have been proven to be a valuable alternative and have been recently introduced in the latest American guidelines on valvular heart disease. Indeed, percutaneous repair techniques, particularly transcatheter edge-to-edge, have gained a broad experience and demonstrated to be safe and effective. However, given the complexity and heterogeneity of MV anatomy and pathology, transcatheter MV implantation (TMVI) has grown as a possible alternative to percutaneous MV repair. Current data about TMVI are still limited and come from different settings: valve-in-native MV, valve-in-valve (ViV), valve-in-ring (ViR), and valve-in-mitral annular calcification. Preliminary data are promising although several open issues still need to be addressed. This paper provides a comprehensive review of the available devices in the different clinical settings, to discuss potentialities, limitations, and future directions for TMVI.

Published
2022
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2. Takotsubo Syndrome: The Secret Crosstalk between Heart and Brain

Author

Sofia Schino, Andrea Bezzeccheri, Alessandro Russo, Michela Bonanni, Joseph Cosma, Giuseppe Sangiorgi, Gaetano Chiricolo, Eugenio Martuscelli, Francesco Santoro, and Enrica Giuliana Mariano

Subjects
takotsubo, cardiomyopathy, broken heart syndrome, stress-induced cardiomyopathy, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

An acute, transient episode of left ventricular dysfunction characterizes Takotsubo syndrome. It represents about 2% of all cases of acute coronary syndrome (ACS), and occurs predominantly in postmenopausal women, generally following a significant physical or emotional stressor. It can be diagnosed based on clinical symptoms and the absence of coronary artery disease on angiography. Ventriculography remains the gold standard for the diagnosis. Despite its transitory characteristic Takotsubo syndrome should not be considered a benign condition since complications occur in almost half of the patients, and the mortality rate reaches 4–5%. Lately, it has been revealed that Takotsubo syndrome can also lead to permanent myocardial damage due to the massive release of catecholamines that leads to myocardial dysfunction. Different mechanisms have been advanced to explain this fascinating syndrome, such as plaque rupture and thrombosis, coronary spasm, microcirculatory dysfunction, catecholamine toxicity, and activation of myocardial survival pathways. Here are still several issues with Takotsubo syndrome that need to be investigated: the complex relationship between the heart and the brain, the risk of permanent myocardial damage, and the impairment of cardiomyocyte. Our review aims to elucidate the pathophysiology and the mechanisms underlying this complex disease to manage the diagnostic and therapeutic algorithms to create a functional synergy between physicians and patients.

Published
2023
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3. The Impact of Gitelman Syndrome on Cardiovascular Disease: From Physiopathology to Clinical Management

Author

Andrea Bezzeccheri, Gianluca Di Giovanni, Martina Belli, Rocco Mollace, Lucy Barone, Massimiliano Macrini, Alessio Di Landro, and Saverio Muscoli

Subjects
gitelman syndrome, sudden cardiac death, metabolic alkalosis, hypokalemia, hypomagnesemia, hypocalciuria, arrhythmia, heart failure, hypotension, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Gitelman syndrome (GS), or congenital hypokalemic hypomagnesemia hypocalciuria with metabolic alkalosis, is a congenital inherited tubulopathy. This tubulopathy is associated with disorders of water-electrolyte homeostasis, such as metabolic alkalosis, hypokalemia, hyponatremia, hypomagnesemia and hypocalciuria. GS has an autosomal recessive inheritance. The loss-of-function mutation involves the gene that codifies for thiazide-sensitive sodium-chloride co-transporter located in the distal convoluted tubule. The physiopathology of the syndrome is characterized by activation of the renin-angiotensin-aldosterone system (RAAS) with a low plasmatic concentration of angiotensin-II. Despite hyper-activation of RAAS, average or low blood pressure is detected in association with low peripheral resistance and reduced response to vasopressors. Clinical findings are brief episodes of fatigue, syncope, vertigo, ataxia and blurred vision; sudden cardiac death might occur. This review aims to give insight into cardiovascular implications and management of GS.

Published
2022
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4. Cutting balloon to optimize predilation for stent implantation: The COPS randomized trial

Author

Antonio Mangieri, Roberto Nerla, Fausto Castriota, Bernhard Reimers, Damiano Regazzoli, Pier P. Leone, Gabriele L. Gasparini, Arif A. Khokhar, Alessandra Laricchia, Francesco Giannini, Fulvio Casale, Andrea Bezzeccheri, Carlo Briguori, and Antonio Colombo

Subjects
Radiology, Nuclear Medicine and imaging, General Medicine, Cardiology and Cardiovascular Medicine
Published
2023
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5. Trends and outcomes in transcatheter aortic valve implantation in Belgium: a 13-year single centre experience

Author

Andrea Bezzeccheri, Paul Vermeersch, Stefan Verheye, Adriaan Wilgenhof, Yannick Willemen, Giovanni Maria Vescovo, Benjamin Scott, Carl Convens, Carlo Zivelonghi, and Pierfrancesco Agostoni

Subjects
General Medicine, Cardiology and Cardiovascular Medicine
Abstract

Transcatheter aortic valve implantation (TAVI) has been adopted as an alternative to surgery in severe aortic stenosis treatment, even in low-intermediate risk. The aim of this study is to retrospectively report our single-centre 13-year TAVI experience with emphasis on learning curve, referral indication and trends in outcomes over time.We included 361 consecutive patients who underwent TAVI from January 2008 to December 2020, grouped according to similar per-year volume of procedures: G1 (2008-2014), G2 (2015-2017) and G3 (2018-2020).The number of procedures increased (group size: 59Favourable trends were observed across the groups, with an improvement in periprocedural outcomes and cardiovascular mortality at 1-year. These improvements could depend on increased expertise because mortality reduction was noted only after reaching a significant procedure volume. A trend towards lower risk patients selection was present in our cohort, as previously described worldwide.

Published
2022
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6. Feasibility, safety and predictors of a successful 'blind wiring' antegrade approach in the percutaneous treatment of chronic coronary total occlusions

Author

Giovanni M. VESCOVO, Pavel SOMOV, Carlo ZIVELONGHI, Andrea BEZZECCHERI, Benjamin SCOTT, Adriaan WILGENHOF, Yannick WILLEMEN, Carl CONVENS, Stefan VERHEYE, Paul VERMEERSCH, and Pierfrancesco AGOSTONI

Subjects
Cardiology and Cardiovascular Medicine
Abstract

Antegrade wiring using only antegrade guiding catheter without contralateral injection (defined as "blind antegrade wiring") may represent a valid initial treatment strategy for selected chronic coronary total occlusions (CTOs) due to the potentially lower risk of vascular complications. A careful selection of lesions eligible for this strategy as well as an accurate balance between the likelihood of success and failure is paramount. The aim of the study is to determine the rate of successful revascularization, the potential predictors of failure and the incidence of major complications, when using a "blind antegrade wiring" technique.In this multicentric study, consecutive patients with CTO undergoing percutaneous coronary intervention (PCI) were retrospectively screened. All cases approached using "blind antegrade wiring" technique were included.Out of 155 consecutive CTO-PCIs, 94 involved initial "blind antegrade wiring" strategy. Successful revascularization by means of "blind antegrade wiring" technique was achieved in 73 (78%) patients. Final successful revascularization was obtained in 19 of the remaining 21 procedures with "blind antegrade wiring" failure using other techniques (by adding a second contralateral guiding catheter; 98% total successful revascularization). Logistic regression analysis identified higher J-CTO score as the only predictor of "blind antegrade wiring" failure. One complication occurred (wire-based coronary perforation)."Blind antegrade wiring" may be considered as initial strategy for selected CTO-PCI, mainly for CTOs with low J-CTO score. This strategy would allow in a substantial number of cases to avoid "a priori" dual injection, keeping it as secondary strategy in case of "blind antegrade wiring" failure.

Published
2023
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8. Minimalistic hybrid approach for the percutaneous treatment of chronic coronary total occlusions: An in-depth analysis of the whole algorithm

Author

Adriaan Wilgenhof, Giovanni Maria Vescovo, Andrea Bezzeccheri, Benjamin Scott, Paul Vermeersch, Carl Convens, Stefan Verheye, Carlo Zivelonghi, and Pierfrancesco Agostoni

Subjects
Percutaneous Coronary Intervention, Treatment Outcome, Coronary Occlusion, Risk Factors, Chronic Disease, Humans, Radiology, Nuclear Medicine and imaging, General Medicine, Registries, Cardiology and Cardiovascular Medicine, Coronary Angiography, Algorithms, Retrospective Studies
Abstract

The minimalistic hybrid approach (MHA) is an algorithm to perform chronic total occlusion (CTO) percutaneous coronary intervention (PCI). The current study aims to evaluate the distribution of patients among the five different treatment strategies, the different techniques used in each strategy, the overall procedural success, and the safety of the MHA algorithm.Data from a consecutive series of patients with a CTO who underwent elective PCI between February 2019 and July 2021 were prospectively collected and retrospectively analyzed.One hundred and forty-three CTOPCI in 135 patients were approached according to the MHA algorithm: 134 CTO (93.7%) were successfully recanalized and 9 procedures failed. About half of the procedures (48.3%) were approached using strategy A: antegrade "blind wiring" with contralateral retrograde options, making this the most popular strategy. A total of 89 procedures (62.2%) were completed with a single guiding catheter; in 86 (96.6%) a forearm approach was used. The remaining 54 cases were performed with dual access; in the majority of these patients (90.7%), a bilateral forearm approach was used. The only reason to use the femoral access was inadequate forearm access. One hundred and fifty-four out of 197 (78.2%) access sites were 6 French sheaths.MHA is a stepwise approach focused on the forearm approach to reduce the number of access sites and catheter size used in CTOPCI while maintaining proficiency and safety. Operators should be warned that this approach should be adopted only by experienced CTO operators who master all the strategies of the classic hybrid algorithm and the forearm approach.

Published
2022

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