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4 results on '"Bancone C"'

3. Incidence and prognostic impact of bleeding and transfusion after coronary surgery in low-risk patients

Author

Giuseppe Santarpino, Marco Zanobini, Tuomas Tauriainen, Filiberto Serraino, Carmelo Dominici, Riccardo Gherli, Marisa De Feo, Fausto Biancari, Francesco Musumeci, Francesca Fiorentino, Francesco Santini, Daniel Reichart, Sidney Chocron, Giuseppe Gatti, Antonio Salsano, Ciro Bancone, Francesco Nicolini, Antonino S. Rubino, Karl Bounader, Theodor Fischlein, Giuseppe Faggian, Giovanni Mariscalco, Matteo Saccocci, Jean Philippe Verhoye, Peter Svenarud, Luca Maschietto, Saverio Nardella, Vito G. Ruggieri, Francesco Onorati, Andrea Perrotti, Eeva-Maija Kinnunen, Magnus Dalén, Tiziano Gherli, Ilaria Franzese, Carmelo Mignosa, Daniele Maselli, Kinnunen, Em, De Feo, M, Reichart, D, Tauriainen, T, Gatti, G, Onorati, F, Maschietto, L, Bancone, C, Fiorentino, F, Chocron, S, Bounader, K, Dalén, M, Svenarud, P, Faggian, G, Franzese, I, Santarpino, G, Fischlein, T, Maselli, D, Dominici, C, Nardella, S, Gherli, R, Musumeci, F, Rubino, A, Mignosa, C, Mariscalco, G, Serraino, Fg, Santini, F, Salsano, A, Nicolini, F, Gherli, T, Zanobini, M, Saccocci, M, Ruggieri, Vg, Philippe Verhoye, J, Perrotti, A, and Biancari, F.

Subjects
Excessive Bleeding, Male, Registrie, medicine.medical_specialty, Blood transfusion, Blood management, Prognosi, medicine.medical_treatment, Tertiary Care Center, Immunology, 030204 cardiovascular system & hematology, Postoperative Hemorrhage, Tertiary Care Centers, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Aged, Coronary Artery Bypass, Europe, Female, Humans, Incidence, Male, Middle Aged, Postoperative Hemorrhage, Prognosis, Prospective Studies, Risk Factors, Tertiary Care Centers, Blood Transfusion, Registries, Medicine, Humans, Immunology and Allergy, Blood Transfusion, Prospective Studies, Registries, Coronary Artery Bypass, Adverse effect, Prospective cohort study, Stroke, Aged, business.industry, Coronary Artery Bypa, Incidence, Risk Factor, Perioperative, Hematology, Middle Aged, medicine.disease, Prognosis, Surgery, Cardiac surgery, Europe, Prospective Studie, Female, 030228 respiratory system, business, Human
Abstract

BACKGROUND Excessive bleeding and blood transfusion are associated with adverse outcome after cardiac surgery, but their mechanistic effects are difficult to disentangle in patients with increased operative risk. This study aimed to evaluate the incidence and prognostic impact of bleeding and transfusion of blood products in low-risk patients undergoing coronary artery bypass grafting (CABG). STUDY DESIGN AND METHODS Sixteen tertiary European centers of cardiac surgery contributed to the prospective European registry of CABG (E-CABG). The severity of bleeding was defined by the E-CABG bleeding severity classification and universal definition of perioperative bleeding (UDPB) classification. RESULTS Of 1213 patients with EuroSCORE II of less than 2% (mean, 1.1 ± 0.4%), 18.5% suffered from mild bleeding (E-CABG bleeding Grade 1) and 3.4% experienced severe bleeding (E-CABG bleeding Grade 2-3). Similarly, 19.7% had UDPB Class 2 and 5.9% had UDPB Classes 3 and 4. Mild and severe bleeding defined by the E-CABG and UDPB classifications were associated with an increased risk of several adverse events as adjusted by multiple covariates. The risk of death, stroke, and acute kidney injury was particularly increased in patients with severe bleeding. CONCLUSION Severe bleeding is rather uncommon in low-risk patients undergoing CABG, but it is associated with an increased risk of major adverse events. Prevention of excessive perioperative bleeding and patient blood management may improve the outcome of cardiac surgery also in low-risk patients.

Published
2017

4. A novel approach to the quantification of aortic root in vivo structural mechanics.

Author

Votta E, Presicce M, Della Corte A, Dellegrottaglie S, Bancone C, Sturla F, and Redaelli A

Subjects
Adult, Aortic Valve anatomy & histology, Aortic Valve physiology, Female, Finite Element Analysis, Humans, Magnetic Resonance Imaging, Male, Models, Cardiovascular, Aorta anatomy & histology, Aorta physiology, Biomechanical Phenomena
Abstract

Understanding aortic root in vivo biomechanics can help in elucidating key mechanisms involved in aortic root pathologies and in the outcome of their surgical treatment. Numerical models can provide useful quantitative information. For this to be reliable, detailed aortic root anatomy should be captured. Also, since the aortic root is never unloaded throughout the cardiac cycle, the modeled geometry should be consistent with the in vivo loads acting on it. Achieving such consistency is still a challenge, which was tackled only by few numerical studies. Here we propose and describe in detail a new approach to the finite element modeling of aortic root in vivo structural mechanics. Our approach exploits the anatomical information yielded by magnetic resonance imaging by reconstructing the 3-dimensional end-diastolic geometry of the aortic root and makes the reconstructed geometry consistent with end-diastolic loading conditions through the estimation of the corresponding prestresses field. We implemented our approach through a semiautomated modeling pipeline, and we applied it to quantify aortic root biomechanics in 4 healthy participants. Computed results highlighted that including prestresses into the model allowed for pressurizing the aortic root to the end-diastolic pressure while matching the image-based ground truth data. Aortic root dynamics, tissues strains, and stresses computed at relevant time points through the cardiac cycle were consistent with a broad set of data from previous computational and in vivo studies, strongly suggesting the potential of the method. Also, results highlighted the major role played by the anatomy in driving aortic root biomechanics., (Copyright © 2016 John Wiley & Sons, Ltd.)

Published
2017
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