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Start Over Author "Iannelli G" Topic cardiology and cardiovascular medicine
16 results on '"Iannelli G"'

1. Impact of different values of prosthesis–patient mismatch on outcome in male patients with aortic valve replacement

Author

Mannacio VA, Mannacio L, Antignano A, Pinna GB, Giordano R, Mottola M, Iannelli G., IANNELLI, GABRIELE, Mannacio, Va, Mannacio, L, Antignano, A, Pinna, Gb, Giordano, R, Mottola, M, Iannelli, G., and Iannelli, Gabriele

Subjects
Male, medicine.medical_specialty, Time Factors, Databases, Factual, medicine.medical_treatment, 030204 cardiovascular system & hematology, Prosthesis Design, Prosthesis, Ventricular Function, Left, Left ventricular mass, 03 medical and health sciences, 0302 clinical medicine, Aortic valve replacement, Risk Factors, Internal medicine, Humans, Medicine, In patient, Aged, Retrospective Studies, Heart Valve Prosthesis Implantation, Ventricular Remodeling, business.industry, Effective orifice area, Aortic Valve Stenosis, General Medicine, Middle Aged, medicine.disease, Aortic valve replacement Prosthesis-patient mismatch Risk stratification Surgery Ventricular hypertrophy, Surgery, Treatment Outcome, 030228 respiratory system, Male patient, Aortic Valve, Heart Valve Prosthesis, Cardiology, Hypertrophy, Left Ventricular, Cardiology and Cardiovascular Medicine, business
Abstract

Aims Mortality and left ventricular mass (LVM) recovery/regression after aortic valve replacement in patients with prosthesis-patient mismatch (PPM) is controversial. This study evaluated the impact of different values of indexed effective orifice area (EOAi) in male patients on mortality and indexed LVM (ILVM) recovery/regression. Method The study recruited 376 male patients with and without PPM after aortic valve replacement with different EOAi cut-off values. Results At EOAi 0.85 cm2/m2 or less, 295 patients had PPM (78.5%). ILVM recovery occurred in 60.5% of no-PPM patients versus 46.1% of patients with PPM (P = 0.003), and ILVM regression was 35 versus 25% (P < 0.001). Time for ILVM regression was shorter in no-PPM group. At EOAi 0.75 cm2/m2 or less, 201 patients had PPM (53.4%). ILVM recovery occurred in 55.4% of no-PPM patients versus 45.2% of patients with PPM (P = 0.06), regression was 32 versus 29% (P = 0.09). Time for ILVM regression was similar between groups. Regardless the cut-off value for PPM definition, mortality was similar. Conclusion LVM recovery/regression, but not mortality, was different at different EOAi. The cut-off value at EOAi 0.75 cm2/m2 or less guaranteed a more balanced patient distribution between groups and the best compromise between specificity and sensitivity

Published
2017

2. Glomerular filtration rate: A prognostic marker in atrial fibrillation—A subanalysis of the AntiThrombotic Agents Atrial Fibrillation

Author

Proietti, Riccardo, Gonzini, Lucio, Pizzimenti, Giovanni, Ledda, Antonietta, Sanna, Pietro, Alturki, Ahmed, Russo, Vincenzo, Lencioni, Mauro, Siciliano, R., Boffa, M., Bazzanini, F., Di Nucci, G., Fonti, S., De Franceschi, T., Davio, P., Alagna, G., Cipollini, F., Arma, P., Gunnellini, M. G., Dottori, M., Paulillo, D., Giudice, M., Sicuro, M., Lenti, S., Iannelli, G., Notarstefano, P., Galiotto, M., Apolloni, Enzo, Molini, G., Massarelli, L., Di Iorio, P., Scandurra, F., Candelmo, F., Iodice, P., Laureano, R., Perlangeli, S., Praticò, A., Lucchesi, Q., Conese, V., Scalera, G., Palma, F., De Antoni, M. E., Beltramello, G., Carbonella, M., Capone, A., Bianchi, V., Zerella, F., Masina, M., Boggian, G., Pancaldi, L. G., Brucato, A. L., Scialfa, S., Ferrari, P., Gavazzi, A., Santoro, E., Bertinieri, G., Caragnano, V., Zaccaroni, S., Marchetti, G., Urbinati, S., Belmonte, G., Giannoni, C., Panuccio, D., Pedone, V., Colletta, M., Di Pasquale, G., Cemin, R., Paffoni, P. R. C., Pezzotti, Chiara, Capretti, M., Lamari, A. L., Maugeri, S., Moretti, R., Ganga, R., Mascia, P., Caddori, A., Cusumano, S., Alletto, M., DE VINCENZO, Ciro, Musacchio, E., Stendardo, A., Cantarella, SALVATORE ALFREDO, Ferrari, V., Bassano, F., PERRONE CAPANO, Carla, Piccinni, G. C., Catanzaro, M., Vinciguerra, A., Lusiani, L., De Caro, G., Scarcia, M., Scarcia, Aurora, Losi, E., Gaddi, O., Lo Sciuto, A., Cascio Ingurgio, N., Vignai, E., Romano, M., Borzì, V., Bellanuova, I. A., Felis, S., Gulizia, M. M., Francese, G. M., Artale, S., Mazzuca, S., Perticone, F., Tirotta, D., Talini, E., Ventrella, F., Iosa, G., Cuccurullo, O., Bertello, P. D., Benemio, G., Garognoli, O., Arcelli, G., Prosciutti, L., De Matthaeis, G., Quattrini, C., Calcagno, S., Canestrini, S., Franco, A., Pastorelli, R., Acquati, F., Botto, G. L., Sitta, N., Migliacci, R., Cosmi, F., Tarquini, B., Chiappetta, P., Sprovieri, M. F., Macrì, G., Bertolazzi, S., Spotti, Alessia, Pirelli, S., Marasco, M. F., Elia, Martina, Gambino, G. M., Fenoglio, L., Gelmini, G. P., Ziacchi, V., Rigon, N., Petix, N. R., Zipoli, A., Caiolo, A., Marino, E., Scattolin, G., Gerini, S., Parisi, G., Tavernese, G., Conti, Alessandro, Ferrante, Federico, Morettini, A., Alterini, B., Rocchi, Federico, Nozzoli, C., Goedecke, L., Seravalle, C., Cuomo, A., Panettieri, I., Pellegrino, P., Di Biase, M., Savarese, G., Patriarchi, F., Bondì, Giuseppina, Rossini, Elena, Nello, S., Ranieri, A. T., Gelonesi, F. N., Costantini, M., Dugnani, M., Ria, L., Mussardo, V., Zanini, G., Morgante, O., Fazio, G., Lo, G., Castello, C., Moroni, L. A., Costa, S., Domenicucci, S., Venzano, C., Loiacono, L., Ortuso, R., Esposito, L., Cuzzucrea, D. G., Fiammengo, F., Selva, E., Gestra, R., Alessandri, M., Nuzzi, G., Porrino, L., Parise, P., Capponi, E. A., Mandorla, S., Politi, Caterina, Olivieri, Claudia, Gurioli, L., Agostinelli, P., Striuli, R., Petrarca, Massimo, Corsini, Francesca, Orlandini, F., Badolati, S., Colarusso, D., Vertullo, V., Pelaggi, P., Campagna, G., Haupt, E., Parente, F., Milanese, G., Magliari, F., Morando, G., Guarise, P., Mazzone, A., Palumbo, G., Lambelet, P., Camaiti, A., Pasquinelli, P., Frediani, L., Vituliano, A., Brunelleschi, G., Lisi, C., La Torre, P. P. A., Villella, A., Rimoldi, A., Russo, V., Di Summa, F., Reggiani, A., Raimondo, F. C., Disalvo, D., Borrello, V. M., Magnante, A., Stellitano, E., Procopio, L., Franculli, F., Serafini, Filippo, Tondo, C., Fiorentini, C., Manfredini, R., Robbiolo, L., Pizzimenti, G., VASQUEZ LOPEZ, LUIDER FERNEY, Piangiamore, A., Tosi, P., Donà, G., Bacchiega, E., Malavasi, V., Modena, M. G., Divella, C., Marengo, C., Montanari, P., Manicardi, V., Abate, L., Cuccuini, A., Magni, S., Vincenti, A., Spinelli, M., Mortara, A., Specchia, G., Silvestri, N., Silvestri, Oriana, Piscopo, G., Muscherà, R., Gallucci, F., Cannavale, A., Bresciani, A., Perrone Filardi, P., Fontanella, Andrea, Iannuzzo, D., Lucà, S., Zuccoli, A., Rinaldi, P., Ferri, G., Barbieri, E., Grasselli, S., Rossi, A., Agosti, S., Sanna, GIAN PAOLO, Casu, G., Orecchioni, G., Da Silva Carvalho, P. C., POZZI MUCELLI, Roberto, Salvati, Fabio, Bendini, M. G., Giordano, G., Pellegrini, F., Pighini, G., Tremolada, F., Zanin, L., Ledda, A., Floresta, A. M., Enia, F., Nicolosi, G., Ingrillì, F., D'Angelo, A., Musacchio, D., Savastano, Silvia, Magnani, Leonardo, Capitelli, M., Cioni, Giovanni, Aloisi, B., De Finis, A., Vacri, A., Costantini, V., Guercini, F., Zingarini, G., Nardoni, M. C., Teghini, L., Panigada, G., Di Marco, S., Vergoni, W., Paonessa, K., Artom, A., Bigliardi, M., Riccardi, R., Riva, L., Marandino, A., Barsotti, L., Ginocchio, G., Marchese, Dario, Tintori, G., Annese, M., Breschi, R., Manini, M., Scopelliti, Giulia, Pastore, A., Spirito, G., Amato, A., Del Bianco, F., Ongari, M., Fiorencis, R., Querci, F., Martone, V. D., Molero, U., Fiusti, R., Giovannini, T., D'Arienzo, E., Cellamare, G., Placci, A., Gulli, G., Ruggeri, A., Pulitanò, G., Iori, I., Ingianni, N., Saporito, D., Marconi, GIAN MARIA, Grossi, Alice, Grosseto, D., Ciamei, M., Mete, F., Russo, F., Bianchi, C., Costantino, S., Manfellotto, D., Risa, M. P., Azzolini, P., Conversano, L., Santini, M., Macchiusi, A., Francia, P., Pietrantonio, F., Biscione, F., Magliano, G., Fedele, Francesca, Salituri, S., Salituri, F., Zamboni, S., Rossetti, C., Roncon, Leonora, Delucchi, M., De Benedictis, M., Vitolo, A., Anselmi, Michela, Celino, T., Moretti, V., Cuccurullo, M., Castelli, G., Martino, G., Pierandrei, G., Carella, A. M., Tonizzo, M., Nassi, R., Tarducci, R., Fronticelli Baldelli, M., Commisso, B., Lazzarini, D., Matarazzo, M. M., Novati, P., Petacchi, R., Maninchedda, P., Melandri, F., Bellesi, P., Sacchetti, C., Grandi, M., Cattana, A., Tassara, R., Menardo, G., Aykut, V., Chesi, G., Reverzani, A., Galgano, Angela, Bartone, B., Stornello, M., Muscio, G., Gemmiti, M. P., Alfonsi, F., Fontana, D., Astarita, C., Gaspardo, G., La Brocca, A., Rillo, M., Pascente, T., Pirozzi, M. R., Addis, L., De Siati, P., Beato, E., Iannaccone, V., Barabani, M., Castronuovo, M., Battaia, L., Biscottini, B., Boccali, A., Marengo, S., Dallerba, R., Diana, A., Coser, Alessandra, Pauletto, P., Calzolari, V., Olivari, Z., De Masi De Luca, G., Accogli, M., Gerloni, R., Cattin, Laura, Vitali Serdoz, L., Sinagra, G., Bulfoni, A., DE BIASIO, Melissa, Proclemer, A., Miserocchi, F., Marazzi, R., SALERNO URIARTE, JORGE ANTONIO, Levantesi, G., Olivetti, P., Capuano, A., Bertoncelli, M. C., Molinaro, N., Anastasio, L., Teti, G., Vescovo, G. A., Muriago, M., Incao, F., Lettica, G. V., Nieswandt, V., Osti, R., Tafi, A., Proietti, Riccardo, Gonzini, Lucio, Pizzimenti, Giovanni, Ledda, Antonietta, Sanna, Pietro, Alturki, Ahmed, Russo, Vincenzo, Lencioni, Mauro, Siciliano, R., Boffa, M., Bazzanini, F., Di Nucci, G., Fonti, S., De Franceschi, T., Davio, P., Alagna, G., Cipollini, F., Arma, P., Gunnellini, M. G., Dottori, M., Paulillo, D., Giudice, M., Sicuro, M., Lenti, S., Iannelli, G., Notarstefano, P., Galiotto, M., Apolloni, E., Molini, G., Massarelli, L., Di Iorio, P., Scandurra, F., Candelmo, F., Iodice, P., Laureano, R., Perlangeli, S., Praticò, A., Lucchesi, Q., Conese, V., Scalera, G., Palma, F., De Antoni, M. E., Beltramello, G., Carbonella, M., Capone, A., Bianchi, V., Zerella, F., Masina, M., Boggian, G., Pancaldi, L. G., Brucato, A. L., Scialfa, S., Ferrari, P., Gavazzi, A., Santoro, E., Bertinieri, G., Caragnano, V., Zaccaroni, S., Marchetti, G., Urbinati, S., Belmonte, G., Giannoni, C., Panuccio, D., Pedone, V., Colletta, M., Di Pasquale, G., Cemin, R., Paffoni, P. R. C., Pezzotti, C., Capretti, M., Lamari, A. L., Maugeri, S., Moretti, R., Ganga, R., Mascia, P., Caddori, A., Cusumano, S., Alletto, M., De Vincenzo, C., Musacchio, E., Stendardo, A., Cantarella, S. A., Ferrari, V., Bassano, F., Perrone, C., Piccinni, G. C., Catanzaro, M., Vinciguerra, A., Lusiani, L., De Caro, G., Scarcia, M., Scarcia, A., Losi, E., Gaddi, O., Lo Sciuto, A., Cascio Ingurgio, N., Vignai, E., Romano, M., Borzì, V., Bellanuova, I. A., Felis, S., Gulizia, M. M., Francese, G. M., Artale, S., Mazzuca, S., Perticone, F., Tirotta, D., Talini, E., Ventrella, F., Iosa, G., Cuccurullo, O., Bertello, P. D., Benemio, G., Garognoli, O., Arcelli, G., Prosciutti, L., De Matthaeis, G., Quattrini, C., Calcagno, S., Canestrini, S., Franco, A., Pastorelli, R., Acquati, F., Botto, G. L., Sitta, N., Migliacci, R., Cosmi, F., Tarquini, B., Chiappetta, P., Sprovieri, M. F., Macrì, G., Bertolazzi, S., Spotti, A., Pirelli, S., Marasco, M. F., Elia, M., Gambino, G. M., Fenoglio, L., Gelmini, G. P., Ziacchi, V., Rigon, N., Petix, N. R., Zipoli, A., Caiolo, A., Marino, E., Scattolin, G., Gerini, S., Parisi, G., Tavernese, G., Conti, A., Ferrante, F., Morettini, A., Alterini, B., Rocchi, F., Nozzoli, C., Goedecke, L., Seravalle, C., Cuomo, A., Panettieri, I., Pellegrino, P., Di Biase, M., Savarese, G., Patriarchi, F., Bondi, G., Rossini, E., Nello, S., Ranieri, A. T., Gelonesi, F. N., Costantini, M., Dugnani, M., Ria, L., Mussardo, V., Zanini, G., Morgante, O., Fazio, G., Lo, G., Castello, C., Moroni, L. A., Costa, S., Domenicucci, S., Venzano, C., Loiacono, L., Ortuso, R., Esposito, L., Cuzzucrea, D. G., Fiammengo, F., Selva, E., Gestra, R., Alessandri, M., Nuzzi, G., Porrino, L., Parise, P., Capponi, E. A., Mandorla, S., Politi, C., Olivieri, C., Gurioli, L., Agostinelli, P., Striuli, R., Petrarca, M., Corsini, F., Orlandini, F., Badolati, S., Colarusso, D., Vertullo, V., Pelaggi, P., Campagna, G., Haupt, E., Parente, F., Milanese, G., Magliari, F., Morando, G., Guarise, P., Mazzone, A., Palumbo, G., Lambelet, P., Camaiti, A., Pasquinelli, P., Frediani, L., Vituliano, A., Brunelleschi, G., Lisi, C., La Torre, P. P. A., Villella, A., Rimoldi, A., Russo, V., Di Summa, F., Reggiani, A., Raimondo, F. C., Disalvo, D., Borrello, V. M., Magnante, A., Stellitano, E., Procopio, L., Franculli, F., Serafini, F., Tondo, C., Fiorentini, C., Manfredini, R., Robbiolo, L., Pizzimenti, G., Vasquez, L., Piangiamore, A., Tosi, P., Donà, G., Bacchiega, E., Malavasi, V., Modena, M. G., Divella, C., Marengo, C., Montanari, P., Manicardi, V., Abate, L., Cuccuini, A., Magni, S., Vincenti, A., Spinelli, M., Mortara, A., Specchia, G., Silvestri, N., Silvestri, O., Piscopo, G., Muscherà, R., Gallucci, F., Cannavale, A., Bresciani, A., Perrone Filardi, P., Fontanella, A., Iannuzzo, D., Lucà, S., Zuccoli, A., Rinaldi, P., Ferri, G., Barbieri, E., Grasselli, S., Rossi, A., Agosti, S., Sanna, P., Casu, G., Orecchioni, G., Da Silva Carvalho, P. C., Pozzi, R., Salvati, F., Bendini, M. G., Giordano, G., Pellegrini, F., Pighini, G., Tremolada, F., Zanin, L., Ledda, A., Floresta, A. M., Enia, F., Nicolosi, G., Ingrillì, F., D'Angelo, A., Musacchio, D., Savastano, S., Magnani, L., Capitelli, M., Cioni, G., Aloisi, B., De Finis, A., Vacri, A., Costantini, V., Guercini, F., Zingarini, G., Nardoni, M. C., Teghini, L., Panigada, G., Di Marco, S., Vergoni, W., Paonessa, K., Artom, A., Bigliardi, M., Riccardi, R., Riva, L., Marandino, A., Barsotti, L., Ginocchio, G., Marchese, D., Tintori, G., Annese, M., Breschi, R., Manini, M., Scopelliti, G., Pastore, A., Spirito, G., Amato, A., Del Bianco, F., Ongari, M., Fiorencis, R., Querci, F., Martone, V. D., Molero, U., Fiusti, R., Giovannini, T., D'Arienzo, E., Cellamare, G., Placci, A., Gulli, G., Ruggeri, A., Pulitanò, G., Iori, I., Ingianni, N., Saporito, D., Marconi, M., Grossi, A., Grosseto, D., Ciamei, M., Mete, F., Russo, F., Bianchi, C., Costantino, S., Manfellotto, D., Risa, M. P., Azzolini, P., Conversano, L., Santini, M., Macchiusi, A., Francia, P., Pietrantonio, F., Biscione, F., Magliano, G., Fedele, F., Salituri, S., Salituri, F., Zamboni, S., Rossetti, C., Roncon, L., Delucchi, M., De Benedictis, M., Vitolo, A., Anselmi, M., Celino, T., Moretti, V., Cuccurullo, M., Castelli, G., Martino, G., Pierandrei, G., Carella, A. M., Tonizzo, M., Nassi, R., Tarducci, R., Fronticelli Baldelli, M., Commisso, B., Lazzarini, D., Matarazzo, M. M., Novati, P., Petacchi, R., Maninchedda, P., Melandri, F., Bellesi, P., Sacchetti, C., Grandi, M., Cattana, A., Tassara, R., Menardo, G., Aykut, V., Chesi, G., Reverzani, A., Galgano, A., Bartone, B., Stornello, M., Muscio, G., Gemmiti, M. P., Alfonsi, F., Fontana, D., Astarita, C., Gaspardo, G., La Brocca, A., Rillo, M., Pascente, T., Pirozzi, M. R., Addis, L., De Siati, P., Beato, E., Iannaccone, V., Barabani, M., Castronuovo, M., Battaia, L., Biscottini, B., Boccali, A., Marengo, S., Dallerba, R., Diana, A., Coser, A., Pauletto, P., Calzolari, V., Olivari, Z., De Masi De Luca, G., Accogli, M., Gerloni, R., Cattin, L., Vitali Serdoz, L., Sinagra, G., Bulfoni, A., De Biasio, M., Proclemer, A., Miserocchi, F., Marazzi, R., Salerno Uriarte, J. A., Levantesi, G., Olivetti, P., Capuano, A., Bertoncelli, M. C., Molinaro, N., Anastasio, L., Teti, G., Vescovo, G. A., Muriago, M., Incao, F., Lettica, G. V., Nieswandt, V., Osti, R., and Tafi, A.

Subjects
Male, medicine.medical_specialty, Time Factors, Clinical Investigations, Renal function, 030204 cardiovascular system & hematology, Risk Assessment, 03 medical and health sciences, 0302 clinical medicine, Fibrinolytic Agents, Risk Factors, atrial fibrillation, glomerular filtration rate, mortality, Cardiology and Cardiovascular Medicine, Internal medicine, Antithrombotic, medicine, Humans, In patient, 030212 general & internal medicine, Renal Insufficiency, Cardiovascular mortality, Aged, Retrospective Studies, business.industry, Incidence, Atrial fibrillation, General Medicine, medicine.disease, Prognosis, Survival Rate, Italy, Hospital admission, Atrial Fibrillation, Female, Follow-Up Studies, Glomerular Filtration Rate, Morbidity, Cardiology, business
Abstract

OBJECTIVE: An increased cardiovascular mortality and morbidity has been widely reported in patients with atrial fibrillation (AF). In this study, a subanalysis of the AntiThrombotic Agents Atrial Fibrillation (ATA‐AF) is performed with the aim to evaluate estimated glomerular filtration rate (eGFR) as an independent prognostic marker of cardiovascular mortality and morbidity in patients with AF. METHODS AND RESULTS: The ATA‐AF study enrolled 7148 patients with AF, in 360 Italian centers. The eGFR was calculated from data reported in patient notes or hospital database. This post‐hoc analysis included 1097 AF patients with eGFR data available and 1‐year clinical follow‐up. The endpoint was assessed as cardiovascular mortality and/or hospital admission for cardiovascular causes at follow‐up. Patients were also divided in two groups according to the eGFR (

Published
2018

3. Pericardial effusion after pediatric cardiac surgery: A single-center study

Author

Raffaele Giordano, Vito Mannacio, Gabriele Iannelli, Emanuele Pilato, Gaetano Di Palma, Giuseppe Comentale, Ettorino Di Tommaso, Massimiliano Cantinotti, Luigi Di Tommaso, Giordano, R., Comentale, G., Tommaso, L. D., Tommaso, E. D., Mannacio, V. A., Pilato, E., Iannelli, G., Palma, G., and Cantinotti, M.

Subjects
Heart Defects, Congenital, Pulmonary and Respiratory Medicine, medicine.medical_specialty, medicine.medical_treatment, 030204 cardiovascular system & hematology, Critical Care and Intensive Care Medicine, Asymptomatic, Pericardial effusion, Pericardial, Pericardial Effusion, Fontan procedure, 03 medical and health sciences, Postoperative Complications, 0302 clinical medicine, Risk Factors, Pericarditis, Humans, Medicine, Cardiac Surgical Procedures, Risk factor, Child, Retrospective Studies, Tetralogy of Fallot, Pediatric, business.industry, Perioperative, medicine.disease, Surgery, Cardiac surgery, 030228 respiratory system, medicine.symptom, Cardiology and Cardiovascular Medicine, business, Pulmonary atresia
Abstract

Background Postoperative pericardial effusion (pPE) still remains a frequent complication after congenital heart surgery and it usually leads to an increased morbidity and re-hospitalization rate. There are only few published papers about pPE clinical course or large randomized studies that analyze its prevalence or preoperative risk factors. In this regard, we report a single-center 10-years retrospective analysis of prevalence, outcomes and risk factors of postoperative pericardial effusion after congenital heart surgery. Methods A retrospective analysis was carried out on 624 patients who underwent congenital heart surgery from January 2010 to December 2019. Study population was divided in two groups basing of the presence of pPE during the first 30 days after the surgery and their perioperative data were compared. Univariate and multivariate analysis were used to find possible risk factors for pPE developing. Results Ninety-four patients were enrolled in pPE group and 530 in ¬ pPE group. Pericardial effusion was assessed as “mild” in 57 patients (60,6%), as “moderate” in 25 (26,6%), and as “severe” in 12 patients (12,8%). Total correction of Tetralogy of Fallot/Pulmonary atresia seems to be associated with a higher prevalence of pPE in the “Infant” subgroup, while atrial septal defect showed to be a risk factor among “Toddler”. In addition, pPE was proved to be much more frequent in Fontan patients in all studied subgroups. Univariate and multivariate analysis revealed that total drain amount, Fontan procedure, postoperative Warfarin therapy, Redo-operations and surgical correction of Tetralogy of Fallot/Pulmonary atresia seem to be risk factors for pPE. Postoperative pericardial effusion was diagnosed between the 4th and the 28th postoperative day but in 88,3% of the cases (83/94) it occurred before the 14th day after the operation. In 58 patients, pPE was clinically silent. Conclusions Postoperative pericardial effusion was detected in 88.3% of cases within the first 14 days after the operation. About 69% of these patients were asymptomatic therefore it suggests that routinely echocardiogram after intensive care unit discharge could be a useful tool to screen clinically silent pPE at an early stage, especially in high-risk or unstable patients.

Published
2021

4. New Oral Anticoagulants Versus Warfarin in Atrial Fibrillation After Early Postoperative Period in Patients With Bioprosthetic Aortic Valve

Author

Pasquale Mastroroberto, Luigi Mannacio, Gabriele Iannelli, Carlo Zebele, Ciro Mauro, Vito Mannacio, Anita Antignano, Francesco Musumeci, Mannacio, V. A., Mannacio, L., Antignano, A., Mauro, C., Mastroroberto, P., Musumeci, F., Zebele, C., and Iannelli, G.

Subjects
Pulmonary and Respiratory Medicine, Aortic valve, Male, medicine.medical_specialty, medicine.drug_class, Administration, Oral, law.invention, Randomized controlled trial, Aortic valve replacement, law, Internal medicine, Atrial Fibrillation, Medicine, Humans, Stroke, Bioprosthesi, Aged, Retrospective Studies, Bioprosthesis, Aged, 80 and over, Heart Valve Prosthesis Implantation, business.industry, Hazard ratio, Warfarin, Anticoagulant, Anticoagulants, Atrial fibrillation, Vitamin K antagonist, Middle Aged, medicine.disease, medicine.anatomical_structure, Aortic Valve, Cardiology, Surgery, Female, Cardiology and Cardiovascular Medicine, business, medicine.drug, Human
Abstract

Background: The efficacy of novel nonvitamin K antagonist oral anticoagulants (NOACs) in nonvalvular atrial fibrillation (AF) to prevent stroke is well assessed, but NOACs use in AF that occurs after bioprosthetic aortic valve replacement (AVR) is not endorsed. This retrospective real-world study evaluated the efficacy and safety of NOACs prescribed no earlier than 4 months after AVR as an alternative to warfarin in patients with AF. Methods: We pooled 1032 patients from the databases of 5 centers. Ischemic/embolic events and major bleeding rates were compared between 340 patients assuming NOACs and 692 prescribed warfarin. Propensity score matching was performed to avoid the bias between groups. Results: The NOACs vs warfarin embolic/ischemic rate was 13.5% (46 of 340) vs 22.7% (157 of 692), respectively, (hazard ratio [HR], 0.5; 95% confidence interval [CI], 0.37-0.75; P < .001), and the incidence rate was 3.7% vs 6.9% patients/year, respectively (log-rank test P = .009). The major bleeding rate was 7.3% (25 of 340) vs 13% (90 of 692) (HR, 0.5; 95% CI, 0.33-0.84; P = .007), and the incidence rate was 2% vs 4% patients/year (log-rank test P = .002.) After propensity score matching, the NOACs vs warfarin embolic/ischemic rate was 13.1% (42 of 321) vs 21.8% (70 of 321) (HR, 0.6; 95% CI, 0.4-0.9; P = .02), and the incidence rate was 4.1% vs 6.7% patients/year (log rank test P = .01). The major bleeding rate was 7.8% (25 of /321) vs 13.7% (44 of 321) (HR, 0.5; 95% CI, 0.31-0.86; P = .01), and the incidence rate was 2.4% vs 4.2% patients/year (log-rank P = .01). Conclusions: In a real-word study, NOACs use overcomes the indications provided by guidelines. This study evidenced that NOACs use in patients who developed AF after bioprosthetic AVR was more effective in prevention of thromboembolism and safe in reduction of major bleeding events compared with warfarin.

Published
2022

5. Right thoracotomy for aortic valve replacement in the adolescents with bicuspid aortic valve

Author

Luigi Di Tommaso, Gabriele Iannelli, Giuseppe Comentale, Massimiliano Cantinotti, Raffaele Giordano, Gaetano Di Palma, Emanuele Pilato, Giordano, R., Cantinotti, M., Comentale, G., Di Tommaso, L., Iannelli, G., Pilato, E., and Palma, G.

Subjects
Male, medicine.medical_specialty, Adolescent, medicine.medical_treatment, Heart Valve Diseases, Length of hospitalization, pediatric cardiac surgery, thoracotomy, 030204 cardiovascular system & hematology, law.invention, 03 medical and health sciences, 0302 clinical medicine, Bicuspid aortic valve, Aortic prosthesis, Bicuspid Aortic Valve Disease, Aortic valve replacement, law, 030225 pediatrics, Cardiopulmonary bypass, Humans, Minimally Invasive Surgical Procedures, Medicine, Radiology, Nuclear Medicine and imaging, Thoracotomy, Retrospective Studies, Heart Valve Prosthesis Implantation, business.industry, Mean age, General Medicine, medicine.disease, Sternotomy, Intensive care unit, Surgery, Treatment Outcome, Echocardiography, Aortic Valve, Pediatrics, Perinatology and Child Health, Female, aortic, Cardiology and Cardiovascular Medicine, business, Follow-Up Studies
Abstract

Background In this study, we compared our experience about early and midterm follow-up outcomes for right anterolateral minithoracotomy (RAMT) vs full sternotomy (FS) in surgical aortic valve replacement (AVR) among adolescents with bicuspid aortic valve (BAV). Methods Patients were retrospectively enrolled from January 2008 to December 2017. Inclusion criteria were patients with BAV who had to undergo to AVR. They were divided in two groups: RAMT and FS. The choice of RAMT was based on individual surgeon's preferences or when expressly requested by patient that was informed of nonconventional approach. Results We enrolled 61 patients, 23 in RAMT group and 38 in FS group. The mean age was 15.6 ± 1.7 years for RAMT group and 16.1 ± 1.5 years for FS group (P = .23). The RAMT group had a higher prevalence of female gender (P = .04). The patients in the RAMT group had longer cardiopulmonary bypass (115.2 ± 18.5 vs 102.2 ± 16.5 min; P = .006) and cross-clamp time (78.6 ± 18.1 vs 74.3 ± 15.2 min; P = .01). No patients required intraoperative conversion to FS. No differences were found in ventilation times, postoperative intensive care unit (ICU), and hospital length of stay for both groups. Follow-up echocardiograms were available for all patients at median of 5.2 years (range 0.5-9.6 years, median 5.4 years for RAMT and 5.1 for FS) and no patient required reoperation for aortic prosthesis malfunction. Conclusions Our study shows that RAMT is safe and effective as FS. Although the RAMT operation takes slightly more operation time, it is not associated with major adverse effects.

Published
2018

6. Status of coronary disease and results from early endovascular aneurysm repair after preventive percutaneous coronary revascularization

Author

Michele Mottola, Raffaele Giordano, Luigi Mannacio, Vito Mannacio, Giovanni Battista Pinna, Gabriele Iannelli, Emilio Mileo, Anita Antignano, Mario Monaco, Mannacio, V. A., Mannacio, L., Antignano, A., Monaco, M., Mileo, E., Pinna, G. B., Giordano, R., Mottola, M., and Iannelli, G.

Subjects
Pulmonary and Respiratory Medicine, medicine.medical_specialty, Percutaneous, medicine.medical_treatment, Coronary Artery Disease, 030204 cardiovascular system & hematology, Endovascular aneurysm repair, Coronary artery disease, 03 medical and health sciences, Aortic aneurysm, Blood Vessel Prosthesis Implantation, 0302 clinical medicine, Aneurysm, Percutaneous Coronary Intervention, Risk Factors, Internal medicine, medicine, Humans, cardiovascular diseases, Retrospective Studies, business.industry, Endovascular Procedures, Percutaneous coronary intervention, medicine.disease, Abdominal aortic aneurysm, aortic aneurysm, coronary artery disease, endovascular procedures, percutaneous coronary intervention, risk assessment, Treatment Outcome, 030228 respiratory system, Conventional PCI, Cardiology, Surgery, Cardiology and Cardiovascular Medicine, business, Aortic Aneurysm, Abdominal
Abstract

Background The incidence of coronary artery disease (CAD) is high in patients with an aortic aneurysm but preoperative routine coronary angiography and preventive coronary revascularization are not recommended to reduce cardiac events in patients with severe CAD. Aim This study evaluated the safeness and efficacy of preventive percutaneous coronary intervention (PCI) in patients with severe CAD scheduled for endovascular aneurysm repair (EVAR). Methods All patients with descending thoracic aneurysm (DTA) or abdominal aortic aneurysm (AAA) scheduled for EVAR underwent preliminary coronary angiography. Based on coronary angiography results, 917 patients (40.7%) had significant CAD and were treated by percutaneous coronary intervention (PCI; CAD group) and 1337 patients (59.3%) were without or with mild/moderate CAD and were considered as controls (no-CAD group). To evaluate the safeness and efficacy of preventive PCI in patients with severe CAD undergoing EVAR, groups were compared for hospital and 12-month cardiac adverse events. Results CAD was present in 1210 patients (53.6%): significant in 917 patients (38%) and mild to moderate in 293 patients (5.3%). Hospital and 12-month cardiac events occurred in 15 (1.6%) and 13 (1.4%) CAD group patients and in 9 (0.7%) and 8 (0.4%) no-CAD group patients (p = .05 and p = .08), respectively. Hospital and 12-month cardiac deaths occurred in 3 (0.3%) and 2 (0.2%) CAD group patients and in 3 (0.2%) and 2 (0.2%) no-CAD group patients (p = .9 and p = .9), respectively. Conclusion The strategy to treat severe CAD preoperatively by PCI and early subsequent EVAR brings a similar outcome to that in patients without or with mild/moderate CAD.

Published
2020

7. Paraneoplatic Obstruction of Descending Thoracic Aorta: A New Indication for Endovascular Surgery?

Author

Luigi Di Tommaso, Ettorino Di Tommaso, Gabriele Iannelli, Raffaele Giordano, Di Tommaso, L, Di Tommaso, E, Giordano, R, and Iannelli, G.

Subjects
Pulmonary and Respiratory Medicine, Male, medicine.medical_specialty, Paraneoplastic Syndromes, Endovascular surgery, Less invasive, Aortic Diseases, Computed tomography, Aorta, Thoracic, Arterial Occlusive Diseases, 030204 cardiovascular system & hematology, Aortic repair, Undifferentiated Pleomorphic Sarcoma, 03 medical and health sciences, 0302 clinical medicine, medicine.artery, Rare case, medicine, Thoracic aorta, Humans, Retroperitoneal Neoplasms, medicine.diagnostic_test, business.industry, Endovascular Procedures, Angiography, Sarcoma, Emergency department, Middle Aged, Surgery, 030228 respiratory system, cardiovascular system, Cardiology and Cardiovascular Medicine, business, Tomography, X-Ray Computed
Abstract

We describe the rare case of a 61-year-old man admitted to our emergency department with visceral-organ and lower-limb malperfusion because of an unknown retroperitoneal high-grade undifferentiated pleomorphic sarcoma and a severe paraneoplastic obstruction of the descending thoracic aorta, treated with thoracic endovascular aortic repair. The postoperative period was uneventful, and the patient was discharged within 4 days. At 6-month follow-up, computed tomography showed complete patency of the descending thoracic aorta. This single case experience shows that thoracic endovascular aortic repair can be a less invasive and effective off-label alternative to exclude infiltrated or obstructed descending thoracic aorta, thus avoiding conventional surgery.

Published
2018

8. The Fate of the Tricuspid Valve After the Transatrial Closure of the Ventricular Septal Defect

Author

Massimiliano Cantinotti, Giuseppe Comentale, Andrea Tozzi, Raffaele Giordano, Emanuele Pilato, Gaetano Di Palma, Luigi Di Tommaso, Gabriele Iannelli, Giordano, R., Cantinotti, M., Di Tommaso, L., Comentale, G., Tozzi, A., Pilato, E., Iannelli, G., and Palma, G.

Subjects
Pulmonary and Respiratory Medicine, Heart Septal Defects, Ventricular, Male, congenital, hereditary, and neonatal diseases and abnormalities, medicine.medical_specialty, Time Factors, Regurgitation (circulation), 030204 cardiovascular system & hematology, Risk Assessment, law.invention, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, law, medicine, Cardiopulmonary bypass, Humans, cardiovascular diseases, Heart Atria, Cardiac Surgical Procedures, Retrospective Studies, Heart septal defect, Tricuspid valve, business.industry, Infant, Retrospective cohort study, Perioperative, Recovery of Function, medicine.disease, Surgery, medicine.anatomical_structure, Treatment Outcome, 030228 respiratory system, Italy, Echocardiography, Child, Preschool, cardiovascular system, Female, Patient Safety, Tricuspid Valve, business, Cardiology and Cardiovascular Medicine, Atrioventricular block, Shunt (electrical), Follow-Up Studies
Abstract

Background The transatrial repair of the ventricular septal defect (VSD) requires an adequate exposure of its rim. We retrospectively evaluated the effect of using the tricuspid valve incision (TVI) technique, with detachment or radial incision, on the postoperative outcome of children undergoing surgical VSD repair. Methods From January 2008 to September 2017, we retrospectively enrolled 141 patients, divided into two groups: 97 patients (68.8%) underwent TVI and 44 patients (31.2%) did not undergo TVI. All patients received an echocardiogram upon discharge from the hospital and after 1 month, 3 months, 6 months, and 1 year from the treatment. Results No perioperative or late deaths occurred. TVI was associated with a slightly longer cardiopulmonary bypass and cross-clamp time, but there were no differences in the surgical outcome between the two groups. Moreover, no differences occurred concerning residual VSD, atrioventricular block, or tricuspid regurgitation at discharge. Echocardiograms at follow-up were available for 134 patients (95%) with a median of 5.3 years (range, 0.5 to 9.3 years), and the degree of tricuspid regurgitation did not differ between groups. No patient required reoperation for tricuspid regurgitation or residual interventricular shunt. Finally, no difference was found when the two TVI subgroups were compared. Conclusions TVI should be used whenever intraoperative exposure of VSD is compromised to avoid a residual shunt and atrioventricular block. Here we show that this procedure does not significantly compromise tricuspid function, although a large, multicenter, randomized controlled trial is advised to validate this hypothesis.

Published
2018

9. OC25 ENDOVASCULAR SURGERY FOR TRAUMATIC AORTIC RUPTURE

Author

Gabriele Iannelli, L Di Tommaso, A. Mariniello, Giuseppe Comentale, F. Scigliano, C. La Storia, V. de Amicis, A. Iavazzo, Comentale, G., Di Tommaso, L., Scigliano, F., Mariniello, A., Iavazzo, A., De Amicis, V., La Storia, C., and Iannelli, G.

Subjects
Traumatic aortic rupture, medicine.medical_specialty, business.industry, Endovascular surgery, Medicine, General Medicine, Cardiology and Cardiovascular Medicine, business, medicine.disease, Surgery
Published
2018

10. OC24 ENDOVASCULAR SURGERY FOR ACUTE THORACIC AORTIC SYNDROMES

Author

Raffaele Smimmo, E. Di Tommaso, Gabriele Iannelli, Emanuele Pilato, A. Saccenti, Raffaele Giordano, L. Di Tommaso, A. Iavazzo, Di Tommaso, E, Di Tommaso, L, Iavazzo, A, Smimmo, R, Giordano, R, Pilato, E, Saccenti, A, and Iannelli, G

Subjects
medicine.medical_specialty, business.industry, Endovascular surgery, medicine, General Medicine, Cardiology and Cardiovascular Medicine, business, Surgery
Published
2018

11. RF88 TRANSFEMORAL BARE-METAL STENT FOR TREATMENT OF RESIDUAL AORTIC ARCH DISSECTION AFTER SURGICAL REPAIR OF ACUTE TYPE A AORTIC DISSECTION

Author

Luigi Mannacio, E. Di Tommaso, Raffaele Giordano, G. Castellano, E. Malio, Gabriele Iannelli, A. Mariniello, L. Di Tommaso, Mariniello, A, Di Tommaso, L, Di Tommaso, E, Giordano, R, Malio, E, Mannacio, L, Castellano, G, and Iannelli, G

Subjects
Aortic arch, Surgical repair, Aortic dissection, Bare-metal stent, medicine.medical_specialty, business.industry, General Medicine, Dissection (medical), medicine.disease, Surgery, Acute type, medicine.artery, medicine, Cardiology and Cardiovascular Medicine, business
Published
2018

12. Complicated acute type B aortic dissection involving the arch: Treatment by simultaneous hybrid approach under local anesthesia

Author

Luigi Di Tommaso, Federico Piscione, Gabriele Iannelli, Mario Monaco, Iannelli, G., Monaco, M., Di Tommaso, L., Piscione, F., Iannelli, Gabriele, M., Monaco, Tommaso, L. D., and F., Piscione

Subjects
Male, Pulmonary and Respiratory Medicine, Chest Pain, medicine.medical_specialty, Risk Assessment, Follow-Up Studie, Blood Vessel Prosthesis Implantation, Aneurysm, Dissecting, Humans, Medicine, Local anesthesia, Arch, Emergency Treatment, Aortic dissection, Aortic Aneurysm, Thoracic, business.industry, Angioplasty, Angiography, Middle Aged, Hybrid approach, medicine.disease, Surgery, Aortic Dissection, Treatment Outcome, Acute type, Anesthesia, Emergency Service, Hospital, Cardiology and Cardiovascular Medicine, business, Follow-Up Studies, STENT-GRAFT, hybrid approach, Anesthesia, Local, Human
Abstract

We herein report the case of a high-risk patient with complicated acute type B aortic dissection (B-AD) involving the arch up to both common iliac arteries. The patient was treated by a simultaneous hybrid approach accomplished with local anesthesia.

Published
2008

13. Endovascular Stent Grafts as a Safe Secondary Option for Paraanastomotic Abdominal Aortic Aneurysm

Author

Giovanna Sarno, Mario Monaco, Federico Piscione, L. Di Tommaso, Gabriele Iannelli, Tommaso, L. D., M., Monaco, F., Piscione, G., Sarno, Iannelli, Gabriele, Di Tommaso, L., Monaco, M., Piscione, F., Sarno, G., and Iannelli, G.

Subjects
Male, Time Factors, medicine.medical_treatment, Severity of Illness Index, Aortic aneurysm, Surgical, Nuclear Medicine and Imaging, 80 and over, Major complication, Treatment Failure, Medicine(all), Aged, 80 and over, Abdominal aorta, Anastomosis, Surgical, PROSTHETIC RECONSTRUCTION, Middle Aged, Abdominal aortic aneurysm, Aortic Aneurysm, surgical procedures, operative, Treatment Outcome, Paraanastomotic aneurysm, cardiovascular system, Open repair, Female, Stents, Radiology, Cardiology and Cardiovascular Medicine, Human, Reoperation, medicine.medical_specialty, Time Factor, Anastomosis, Endovascular surgery, Follow-Up Studie, Blood Vessel Prosthesis Implantation, medicine.artery, medicine, Humans, Abdominal, cardiovascular diseases, Aged, REPAIR, Aortic Aneurysm, Abdominal, Follow-Up Studies, Angioplasty, Radiology, Nuclear Medicine and Imaging, Surgery, business.industry, Stent, medicine.disease, Radiography, business, Complication
Abstract

Objective: To describe our experience of endovascular repair of paraanastomotic aortic aneurysm. Methods and results: From March 2001 to December 2004 we identified 6 patients with a paraanastomotic aortic aneurysms following previous open repair of abdominal aortic aneurysm. All patients were treated with endovascular surgery under epidural anaesthesia. There were no major complications, surgical conversions or deaths. Four patients received a bifurcated aortic stent-graft, and two an aorto-uniliac stent-graft followed by a femoro-femoral bypass. At follow-up (mean 26.1 ± 10.2 months) there were no deaths, endoleaks or graft migrations observed. Conclusion: Endovascular surgery, avoiding general anesthesia and re-laparotomy, is the ideal technique for treatment of this complication resulting from failed primary conventional AAA repair. © 2006 Elsevier Ltd. All rights reserved.

Published
2007

14. Endovascular treatment of right-sided subclavian artery aneurysm in a congenitally malformed aortic arch

Author

Gabriele Iannelli, Mario Monaco, Luigi Di Tommaso, Federico Piscione, Iannelli, Gabriele, Tommaso, L. D., M., Monaco, F., Piscione, Iannelli, G., Di Tommaso, L., Monaco, M., and Piscione, F.

Subjects
Adult, Thorax, Aortic arch, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Subclavian Artery, Right subclavian artery, Aorta, Thoracic, Blood Vessel Prosthesis Implantation, Aortic aneurysm, medicine.artery, Stent, medicine, Humans, Endovascular treatment, Aorta, medicine.diagnostic_test, business.industry, Angiography, Digital Subtraction, Intracranial Aneurysm, medicine.disease, Surgery, Angiography, Subclavian artery aneurysm, Female, Stents, Radiology, business, Cardiology and Cardiovascular Medicine, Human
Abstract

Encouraging results obtained with endovascular treatment of subclavian artery aneurysms (SAAs)(1) led us to use this technique as an alternative to conventional operation in a young female patient with an intrathoracic SAA on the right side complicated by a left-sided cervical aortic arch and agenesis of the left common carotid and vertebral arteries.

Published
2005

15. Selective carotid cannulation at the neck: A satisfactory option for reoperation for aneurysms of the ascending aorta and arch

Author

Luigi Di Tommaso, Nicola Spampinato, Donato Triggiani, Mario Monaco, Gabriele Iannelli, Iannelli, G., Di Tommaso, L., Monaco, M., Triggiani, D., and Spampinato, N.

Subjects
Male, Sampling Studie, Time Factors, Arterial disease, Aorta, Thoracic, Aortic aneurysm, Recurrence, Retrospective Studie, Arch, Aorta, Angiography, medicine.anatomical_structure, Treatment Outcome, Cerebrovascular Circulation, Circulatory system, Cardiology, Female, Cardiology and Cardiovascular Medicine, Vascular Surgical Procedures, Blood vessel, Human, Pulmonary and Respiratory Medicine, Reoperation, medicine.medical_specialty, Oxygenator, Time Factor, Carotid Artery, Common, Oxygenators, Aortic disease, Risk Assessment, Sampling Studies, Catheterization, Follow-Up Studie, medicine.artery, Internal medicine, Ascending aorta, medicine, Humans, Retrospective Studies, Vascular Surgical Procedure, Aortic Aneurysm, Thoracic, Vascular disease, business.industry, medicine.disease, Surgery, business, Tomography, X-Ray Computed, Neck, Follow-Up Studies
Published
2004

16. Thoracic aortic emergencies: impact of endovascular surgery

Author

Federico Piscione, Massimo Chiariello, Gabriele Iannelli, Luigi Di Tommaso, Mario Monaco, Nicola Spampinato, Iannelli, G., Piscione, F., Di Tommaso, L., Monaco, M., Chiariello, M., Spampinato, N., Iannelli, Gabriele, F., Piscione, Tommaso, L. D., M., Monaco, M., Chiariello, and N., Spampinato

Subjects
Male, medicine.medical_treatment, STENT, Aorta, Thoracic, Wounds, Nonpenetrating, Aortic aneurysm, Postoperative Complications, RUPTURE, Thoracic aorta, DISSECTION, RISK, Aortic dissection, Aged, 80 and over, medicine.diagnostic_test, Middle Aged, Survival Rate, Cardiothoracic surgery, PLACEMENT, cardiovascular system, Female, Stents, Radiology, Cardiology and Cardiovascular Medicine, Pulmonary and Respiratory Medicine, Adult, medicine.medical_specialty, Aortography, Aortic Rupture, Thoracic aortic aneurysm, Blood Vessel Prosthesis Implantation, Aneurysm, Angioplasty, medicine.artery, MANAGEMENT, medicine, Humans, ANEURYSMS, Aged, REPAIR, Aortic Aneurysm, Thoracic, Rupture, Spontaneous, business.industry, GRAFT, medicine.disease, Surgery, Aortic Dissection, Emergencies, business, Angioplasty, Balloon, Follow-Up Studies
Abstract

Background. Conventional surgery for thoracic aortic emergencies, such as contained or free rupture of thoracic aortic aneurysms, acute type B dissections, and traumatic rupture of the thoracic aorta, is frequently associated with a high rate of mortality and morbidity. To obviate this risk, endovascular surgery is considered to be a valid alternative procedure. Methods. From March 2001 to July 2002, 15 of 22 patients with acute thoracic aortic syndromes were submitted to endovascular surgery: 3 patients (20%) for traumatic rupture, 4 patients (26.7%) for contained or free rupture of thoracic aortic aneurysm, and 8 patients (53.3%) for acute type B dissection evolving to rupture. Computed tomographic scan was diagnostic in all patients. The stent grafts were introduced through the femoral artery. Results. In the endovascular group there were no perioperative deaths or open conversions. The intraoperative angiography and computed tomographic scan performed on discharge showed no significant endoleaks and successful sealing of the aortic dissection. Average intensive care unit and hospital stay was 1.7 +/- 0.8 and 5.9 +/- 3.0 days. Follow-up ranged between 4 and 23 months and included clinical examinations and serial computed tomographic scan at 3, 6, and 12 months, and every 6 months thereafter. One 84-year-old patient with thoracic aortic aneurysm died of pneumonia 78 days after endovascular surgery. Only one type 1 endoleak was noted in the first patient with traumatic rupture, 3 months after the procedure. Conclusions. Endovascular surgery is a safe technique, showing encouraging early and midterm results and allowing for prompt treatment of associated lesions in complex multitrauma patients. (C) 2004 by The Society of Thoracic Surgeons.

Published
2003

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