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8. Patients younger than 70 undergoing transcatheter aortic valve implantation: Procedural outcomes and mid-term survival

Author

Ancona, M, Toscano, E, Moroni, F, Ferri, L, Russo, F, Bellini, B, Sorropago, A, Mula, C, Festorazzi, C, Gamardella, M, Vella, C, Beneduce, A, Romano, V, Belluschi, I, Buzzatti, N, Agricola, E, Montorfano, M, Ancona M. B., Toscano E., Moroni F., Ferri L. A., Russo F., Bellini B., Sorropago A., Mula C., Festorazzi C., Gamardella M., Vella C., Beneduce A., Romano V., Belluschi I., Buzzatti N., Agricola E., Montorfano M., Ancona, M, Toscano, E, Moroni, F, Ferri, L, Russo, F, Bellini, B, Sorropago, A, Mula, C, Festorazzi, C, Gamardella, M, Vella, C, Beneduce, A, Romano, V, Belluschi, I, Buzzatti, N, Agricola, E, Montorfano, M, Ancona M. B., Toscano E., Moroni F., Ferri L. A., Russo F., Bellini B., Sorropago A., Mula C., Festorazzi C., Gamardella M., Vella C., Beneduce A., Romano V., Belluschi I., Buzzatti N., Agricola E., and Montorfano M.

Abstract

Introduction: Based on recent data, the indication for transcatheter aortic valve implantation (TAVI) is expanding to individuals at lower surgical risk, who are generally younger than subjects historically treated for severe aortic stenosis. Indeed, younger patients have traditionally been under-represented in current TAVI literature. The aim of the present study is to report about clinical features, procedural outcomes and mid-term outcomes of patients younger than 70 who underwent TAVI in a single high-volume center. Materials and methods: Consecutive patients younger than 70 years of age who underwent TAVI for severe, symptomatic aortic stenosis between 2007 and 2019 at a single, tertiary referral center have been included in this retrospective study. Procedural and mid-term outcomes were analyzed, comparing 1st generation with 2nd generation devices. Results: Between 2007 and 2019, 1740 TAVI procedures were performed in our center. Among these, one hundred twenty-nine (7.4%) patients were younger than 70 years at the time of the intervention and were included in the present analysis. Fifty-eight patients (45%) were implanted with a 1st generation prosthesis while seventy-one patients (55%) were implanted with a 2nd generation device. Reasons which lead to a transcatheter approach in this population were: previous CABG (27.9%); porcelain aorta (24%); severe left ventricular systolic dysfunction (21.7%); prior chest radiation (19.4%); severe lung disease (8.5%); hemodynamic instability (7.0%); advanced liver disease (4.6%) and active cancer (3.9%). Overall device success rate was 89%, with no differences among 1st and 2nd generation devices. Threeyears all-cause mortality was 34%, with no difference among the two groups. Low incidence of aortic-valve re-intervention was observed at mid-term follow-up (late valve re-intervention = 2.3%). Conclusions: TAVI in young patient with appropriate indication for intervention is a safe procedure, associated with low rate of

Published
2021

11. Myval versus alternative balloon- and self-expandable transcatheter heart valves: A central core lab analysis of conduction disturbances

Author

Santos-Martinez, S., Halim, J., Castro-Mejia, A., De Marco, F., Trani, Carlo, Martin, P., Infusino, Fabio, Ancona, M., Moreno, R., den Heijer, P., Nombela-Franco, L., Bedogni, Francesco, Sardella, G., Montorfano, M., Revilla-Orodea, A., Delgado-Arana, J. R., Barrero, A., Gomez-Salvador, I., Ijsselmuiden, A. J. J., Redondo, A., Gutierrez, H., Serrador, A., Serruys, P. W., Roman, J. A. S., Amat-Santos, I. J., Trani C. (ORCID:0000-0001-9777-013X), Infusino F., Bedogni F., Santos-Martinez, S., Halim, J., Castro-Mejia, A., De Marco, F., Trani, Carlo, Martin, P., Infusino, Fabio, Ancona, M., Moreno, R., den Heijer, P., Nombela-Franco, L., Bedogni, Francesco, Sardella, G., Montorfano, M., Revilla-Orodea, A., Delgado-Arana, J. R., Barrero, A., Gomez-Salvador, I., Ijsselmuiden, A. J. J., Redondo, A., Gutierrez, H., Serrador, A., Serruys, P. W., Roman, J. A. S., Amat-Santos, I. J., Trani C. (ORCID:0000-0001-9777-013X), Infusino F., and Bedogni F.

Abstract

Background: Several studies have compared surface electrocardiographic changes following different self-expandable (SE) (Evolut (Medtronic, USA); Acurate (Boston Scientific, USA); Portico (Abbott, USA); and Allegra (NVT, Germany)) and balloon-expandable (BE) Sapien-3 (Edwards Lifesciences, USA) transcatheter heart valves. We aimed to compare these prosthesis with the novel Myval BE prosthesis (Meril Life, India). Methods: Academic European registry of consecutive patients with severe aortic stenosis who received any of the 6 aforementioned valves. Baseline, post-procedural, and discharge 12‐leads electrocardiograms (ECG) were centrally analyzed and compared. Results: A total of 1131 patients were included: 135 Myval (11.9%), 290 Sapien-3 (25.6%), 298 Evolut (26.3%), 180 Acurate (15.9%), 125 Portico (11.1%), and 103 Allegra (9.1%). There were no baseline differences in intraventricular conduction disturbances rate. Compared to the novel BE Myval, there were similar procedural and in-hospital outcomes. Similar rates of early new permanent pacemaker implant (PPI) were observed amongst Myval (7.4%), Sapien-3 (13.4%), and Acurate (9.1%), but Evolut, Portico, and Allegra presented significantly higher rates (18.5%, p = 0.003; 29.5% p < 0.001 and 22%, p = 0.001, respectively). Central analysis of ECGs, unraveled significant prolongation of the PR segment with Evolut, Portico and Allegra whereas Evolut, Acurate, and Portico showed significant QRS widening compared to Myval. However, at discharge no differences in PR segment duration were observed while, Evolut, and Portico– but not Acurate, Allegra or Sapien-3 – still presented significant widening of QRS segment compared to Myval. Conclusions: After blinded central ECG analysis, the novel Myval balloon-expandable prosthesis was associated with a low rate of early conduction disturbances.

Published
2022

12. ST-Elevation Myocardial Infarction in Patients With COVID-19

Author

Stefanini, G. G., Montorfano, M., Trabattoni, D., Andreini, D., Ferrante, G., Ancona, M., Metra, M., Curello, S., Maffeo, D., Pero, G., Cacucci, M., Assanelli, E., Bellini, B., Russo, F., Ielasi, A., Tespili, M., Danzi, G. B., Vandoni, P., Bollati, M., Barbieri, L., Oreglia, J., Lettieri, C., Cremonesi, A., Carugo, S., Reimers, B., Condorelli, G., and Chieffo, A.

Subjects
Male, medicine.medical_specialty, 2019-20 coronavirus outbreak, Coronavirus disease 2019 (COVID-19), Pneumonia, Viral, coronavirus, Coronary Angiography, medicine.disease_cause, Betacoronavirus, Risk Factors, St elevation myocardial infarction, Physiology (medical), Internal medicine, Correspondence, Pandemic, Research Letter, 80 and over, Humans, Medicine, In patient, Viral, Pandemics, Aged, Coronavirus, Aged, 80 and over, biology, SARS-CoV-2, business.industry, COVID-19, Pneumonia, Middle Aged, biology.organism_classification, ST elevation myocardial infarction, Echocardiography, Cardiology, Female, Coronavirus Infections, ST Elevation Myocardial Infarction, Cardiology and Cardiovascular Medicine, business
Published
2020

14. Transcatheter aortic valve implantation for aortic regurgitation in patients with left ventricular assist device

Author

Ancona M. B., Moroni F., Romano V., Agricola E., Esposito A., Ajello S., De Bonis M., Cappelletti A. M., Zangrillo A., Scandroglio A. M., Montorfano M, Ancona, M. B., Moroni, F., Romano, V., Agricola, E., Esposito, A., Ajello, S., De Bonis, M., Cappelletti, A. M., Zangrillo, A., Scandroglio, A. M., and Montorfano, M

Abstract

Aortic valve regurgitation is a not negligible complication of prolonged support with continuous-flow left ventricular assist device (LVAD) and is associated with recurrence of heart failure and reduced survival. Transcatheter aortic valve implantation has been described as a feasible option in this setting, usually with self-expanding prosthesis. Giving the absence of valvular calcification, a proper prosthesis oversizing should be guaranteed in order to achieve sufficient sealing and avoid prosthesis migration or paravalvular leak. Current self-expanding prosthesis may be too small to fit aortic annulus anatomies without calcification and with the need of significant oversize. We report the first case of 32 mm balloon expandable Myval prosthesis implantation in a patient with LVAD-related aortic regurgitation. Large balloon-expandable prosthesis can be considered when a significant oversize is needed.

Published
2021

19. Correction to: Predictors of high residual gradient after transcatheter aortic valve replacement in bicuspid aortic valve stenosis (Clinical Research in Cardiology, (2021), 10.1007/s00392-020-01793-9)

Author

Bugani, G., Pagnesi, M., Tchetche, D., Kim, W. -K., Khokhar, A., Sinning, J. -M., Landes, U., Kornowski, R., Codner, P., De Backer, O., Nickenig, G., Ielasi, A., De Biase, C., Sondergaard, L., De Marco, F., Ancona, M., Montorfano, M., Regazzoli, D., Stefanini, G., Toggweiler, S., Tamburino, C., Imme, S., Tarantini, G., Sievert, H., Schafer, U., Kempfert, J., Woehrle, J., Tespili, M., Laricchia, A., Latib, A., Giannini, F., Colombo, A., and Mangieri, A.

Published
2021

20. Next-generation balloon-expandable Myval transcatheter heart valve in low-risk aortic stenosis patients

Author

Garcia-Gomez, M., Delgado-Arana, J. R., Halim, J., De Marco, F., Trani, C., Martin, P., Won-Keun, K., Montorfano, M., den Heijer, P., Bedogni, F., Sardella, G., IJsselmuiden, A. J. J., Campante Teles, R., Aristizabal-Duque, C. H., Gordillo, X., Santos-Martinez, S., Barrero, A., Gomez-Salvador, I., Ancona, M., Redondo, A., Roman, J. A. S., Amat-Santos, I. J., Trani C. (ORCID:0000-0001-9777-013X), Bedogni F., Garcia-Gomez, M., Delgado-Arana, J. R., Halim, J., De Marco, F., Trani, C., Martin, P., Won-Keun, K., Montorfano, M., den Heijer, P., Bedogni, F., Sardella, G., IJsselmuiden, A. J. J., Campante Teles, R., Aristizabal-Duque, C. H., Gordillo, X., Santos-Martinez, S., Barrero, A., Gomez-Salvador, I., Ancona, M., Redondo, A., Roman, J. A. S., Amat-Santos, I. J., Trani C. (ORCID:0000-0001-9777-013X), and Bedogni F.

Abstract

Objectives: We aimed to describe hemodynamic performance and clinical outcomes at 30-day follow-up of the balloon-expandable (BE) Myval transcatheter heart valve (THV) in low-risk patients. Background: The results of the next-generation BE Myval THV in low-risk aortic stenosis (AS) patients are still unknown. Methods: Retrospective registry performed in nine European centers including patients with low predicted operative mortality risk according to Society of thoracic surgeons (STS) and European system for cardiac operative risk evaluation (EuroSCORE-II) scores. Results: Between September 2019 and February 2021, a total of 100 patients (51% males, mean age 80 ± 6.5 years) were included. Mean STS score and EuroSCORE-II were 2.4 ± 0.8% and 2.2 ± 0.7%, respectively. Intermediate sizes were used in 39% (21.5 mm: 8%, 24.5 mm: 15%, 27.5 mm: 15%). There were no cases of valve embolization, coronary artery occlusion, annulus rupture, or procedural death. A definitive pacemaker implantation was needed in eight patients (8%). At 30-day follow-up aortic valve area (0.7 ± 0.2 vs. 2.1 ± 0.6 cm2) and mean aortic valve gradient (43.4 ± 11.1 vs. 9.0 ± 3.7 mmHg) improved significantly (p < 0.001). Moderate aortic regurgitation occurred in 4%. Endpoints of early safety and clinical efficacy were 3 and 1%, respectively. Conclusions: Hemodynamic performance and 30-day clinical outcomes of the BE Myval THV in low-risk AS patients were favorable. Longer-term follow-up is warranted.

Published
2021

21. Timing of Impella implantation and outcomes in cardiogenic shock or high-risk percutaneous coronary revascularization

Author

Tarantini, Giuseppe, Masiero, Giuliano, Burzotta, Francesco, Pazzanese, V., Briguori, C., Trani, Carlo, Piva, T., De Marco, F., Di Biasi, M., Pagnotta, P., Mojoli, M., Casu, G., Giustino, G., Lorenzoni, Gianni, Montorfano, M., Ancona, M. B., Pappalardo, F., Chieffo, A., Tarantini G., Masiero G., Burzotta F. (ORCID:0000-0002-6569-9401), Trani C. (ORCID:0000-0001-9777-013X), Lorenzoni G., Tarantini, Giuseppe, Masiero, Giuliano, Burzotta, Francesco, Pazzanese, V., Briguori, C., Trani, Carlo, Piva, T., De Marco, F., Di Biasi, M., Pagnotta, P., Mojoli, M., Casu, G., Giustino, G., Lorenzoni, Gianni, Montorfano, M., Ancona, M. B., Pappalardo, F., Chieffo, A., Tarantini G., Masiero G., Burzotta F. (ORCID:0000-0002-6569-9401), Trani C. (ORCID:0000-0001-9777-013X), and Lorenzoni G.

Abstract

Objective: To evaluate the role of the microaxial percutaneous mechanical circulatory support device (Impella® pump) implantation pre-percutaneous coronary intervention (PCI) versus during/after PCI in cardiogenic shock (CS) and high-risk PCI populations. Background: A better understanding of the safety and effectiveness of the Impella and the role of timing of this support initiation in specific clinical settings is of utmost clinical relevance. Methods: A total of 365 patients treated with Impella 2.5/CP in the 17 centers of the IMP-IT Registry were included. Through propensity-score weighting (PSW) analysis, 1-year clinical outcomes were assessed separately in CS and HR-PCI patients, stratified by timing of Impella support. Results: Pre-procedural insertion was associated with an improvement in 1-year survival in patients with CS due to acute myocardial infarction (AMI) treated with PCI (p =.04 before PSW, p =.009 after PSW) and HR-PCI (p <.01 both before and after PSW). Among patients undergoing HR-PCI, early Impella support was also associated with a lower rate of the composite of mortality, re-hospitalization for heart failure, and need for left-ventricular assist device/heart transplantation at 1-year (p =.04 before PSW, p =.01 after PSW). Furthermore, Impella use during/after PCI was associated with an increased in-hospital life-threatening and severe bleeding among patients with AMI-CS receiving PCI (7 vs. 16%, p =.1) and HR-PCI (1 vs. 9%, p =.02). Conclusions: Our findings suggested a survival benefit and reduced rates of major bleeding when a pre-PCI Impella implantation instead of during-after procedure was used in the setting of HR-PCI and AMI-CS.

Published
2021

23. Smart District Heating: Hypothesis to Convert Existing Utility Substations

Author

Ancona M., Branchini L., De Pascale A., Melino F., and Ancona M., Branchini L., De Pascale A., Melino F.

Subjects
smart district heating
Abstract

New generation of district heating had introduced the concept of smart thermal grids, consisting in the bidirectional heat exchange between network and final users. In this context, users substations represent key points for the optimal integration between district heating networks and distributed generators. In this paper several schemes for smart users substations will be presented and the actions required to convert existing substations will be evaluated through a technical analysis.

Published
2019

24. Modelling and Validation of a Small Scale Hybrid Photovoltaic-Battery-Electrolyzer System

Author

Ancona M., Bianchi M., Branchini L., Catena F., De Pascale A., Melino F., Peretto A., and Ancona M., Bianchi M., Branchini L., Catena F., De Pascale A., Melino F., Peretto A.

Subjects
hydrogen storage
Abstract

In this study, the behaviour of a small-scale hybrid energy system is predicted by means of a developed calculation model. In more detail, the experimental setup consists of photovoltaic panels, batteries and an electrolyzer; the mathematical sub-models for each device are provided. These sub-models have been validated by means of experimental data, recorded during laboratory tests. The results show that each sub-model reproduces very well the experimental data and then the whole system model can be applied to identify the optimal management strategy of a solar-to-hydrogen micro-scale system.

Published
2019

25. Patterns of Regional Myocardial Perfusion Following Coronary Sinus Reducer Implantation

Author

Giannini F., Palmisano A., Baldetti L., Benedetti G., Ponticelli F., Rancoita P. M. V., Ruparelia N., Gallone G., Ancona M., Mangieri A., Tzanis G., De Cobelli F., Del Maschio A., Colombo A., Esposito A., Giannini, F., Palmisano, A., Baldetti, L., Benedetti, G., Ponticelli, F., Rancoita, P. M. V., Ruparelia, N., Gallone, G., Ancona, M., Mangieri, A., Tzanis, G., De Cobelli, F., Del Maschio, A., Colombo, A., and Esposito, A.

Subjects
magnetic resonance, myocardial ischemia, coronary sinu, canada, informed consent
Published
2019

26. Predictors of Left Ventricular Outflow Tract Obstruction After Transcatheter Mitral Valve Replacement

Author

Yoon SH, Bleiziffer S, Latib A, Eschenbach L, Ancona M, Vincent F, Kim WK, Unbehaum A, Asami M, Dhoble A, Silaschi M, Frangieh AH, Veulemans V, Tang GHL, Kuwata S, Rampat R, Schmidt T, Patel AJ, Nicz PFG, Nombela-Franco L, Kini A, Kitamura M, Sharma R, Chakravarty T, Hildick-Smith D, Arnold M, de Brito FS, Jr., Jensen C, Jung C, Jilaihawi H, Smalling RW, Maisano F, Kasel AM, Treede H, Kempfert J, Pilgrim T, Kar S, Bapat V, Whisenant BK, Van Belle E, Delgado V, Modine T, Bax JJ, Makkar RR, Yoon, Sh, Bleiziffer, S, Latib, A, Eschenbach, L, Ancona, M, Vincent, F, Kim, Wk, Unbehaum, A, Asami, M, Dhoble, A, Silaschi, M, Frangieh, Ah, Veulemans, V, Tang, Ghl, Kuwata, S, Rampat, R, Schmidt, T, Patel, Aj, Nicz, Pfg, Nombela-Franco, L, Kini, A, Kitamura, M, Sharma, R, Chakravarty, T, Hildick-Smith, D, Arnold, M, de Brito, F, J, R., Jensen, C, Jung, C, Jilaihawi, H, Smalling, Rw, Maisano, F, Kasel, Am, Treede, H, Kempfert, J, Pilgrim, T, Kar, S, Bapat, V, Whisenant, Bk, Van Belle, E, Delgado, V, Modine, T, Bax, Jj, and Makkar, Rr

Published
2019

27. Outcomes of transcatheter mitral valve replacement for degenerated bioprostheses, failed annuloplasty rings, and mitral annular calcification

Author

Yoon SH, Whisenant BK, Bleiziffer S, Delgado V, Dhoble A, Schofer N, Eschenbach L, Bansal E, Murdoch DJ, Ancona M, Schmidt T, Yzeiraj E, Vincent F, Niikura H, Kim WK, Asami M, Unbehaun A, Hirji S, Fujita B, Silaschi M, Tang GHL, Kuwata S, Wong SC, Frangieh AH, Barker CM, Davies JE, Lauten A, Deuschl F, Nombela-Franco L, Rampat R, Nicz PFG, Masson JB, Wijeysundera HC, Sievert H, Blackman DJ, Gutierrez-Ibanes E, Sugiyama D, Chakravarty T, Hildick-Smith D, de Brito FS, Jr., Jensen C, Jung C, Smalling RW, Arnold M, Redwood S, Kasel AM, Maisano F, Treede H, Ensminger SM, Kar S, Kaneko T, Pilgrim T, Sorajja P, Van Belle E, Prendergast BD, Bapat V, Modine T, Schofer J, Frerker C, Kempfert J, Attizzani GF, Latib A, Schaefer U, Webb JG, Bax JJ, Makkar RR, Yoon, Sh, Whisenant, Bk, Bleiziffer, S, Delgado, V, Dhoble, A, Schofer, N, Eschenbach, L, Bansal, E, Murdoch, Dj, Ancona, M, Schmidt, T, Yzeiraj, E, Vincent, F, Niikura, H, Kim, Wk, Asami, M, Unbehaun, A, Hirji, S, Fujita, B, Silaschi, M, Tang, Ghl, Kuwata, S, Wong, Sc, Frangieh, Ah, Barker, Cm, Davies, Je, Lauten, A, Deuschl, F, Nombela-Franco, L, Rampat, R, Nicz, Pfg, Masson, Jb, Wijeysundera, Hc, Sievert, H, Blackman, Dj, Gutierrez-Ibanes, E, Sugiyama, D, Chakravarty, T, Hildick-Smith, D, de Brito, F, J, R., Jensen, C, Jung, C, Smalling, Rw, Arnold, M, Redwood, S, Kasel, Am, Maisano, F, Treede, H, Ensminger, Sm, Kar, S, Kaneko, T, Pilgrim, T, Sorajja, P, Van Belle, E, Prendergast, Bd, Bapat, V, Modine, T, Schofer, J, Frerker, C, Kempfert, J, Attizzani, Gf, Latib, A, Schaefer, U, Webb, Jg, Bax, Jj, and Makkar, Rr

Published
2019

28. Coronary Protection to Prevent Coronary Obstruction During TAVR: A Multicenter International Registry

Author

Palmerini, T., Chakravarty, T., Saia, F., Bruno, A. G., Bacchi-Reggiani, M. -L., Marrozzini, C., Patel, C., Patel, V., Testa, L., Bedogni, F., Ancona, M., Montorfano, M., Chieffo, A., Olivares, P., Bartorelli, A. L., Buscaglia, A., Porto, I., Nickenig, G., Grube, E., Sinning, J. -M., De Carlo, M., Petronio, A. S., Barbanti, M., Tamburino, C., Iadanza, A., Burzotta, F., Trani, C., Fraccaro, C., Tarantini, G., Aranzulla, T. C., De Benedictis, M., Pagnotta, P., Stefanini, G. G., Miura, M., Taramasso, M., Kang, J. -H., Kim, H. -S., Codner, P., Kornowski, R., Pelliccia, F., Vignali, L., Taglieri, N., Ghetti, G., Leone, A., Galie, N., and Makkar, R.

Subjects
Male, Time Factors, Computed Tomography Angiography, Coronary Angiography, Prosthesis Design, Transcatheter Aortic Valve Replacement, Percutaneous Coronary Intervention, Risk Factors, coronary obstruction, stent thrombosis, transcatheter aortic valve replacement, 80 and over, Humans, Registries, Aged, Retrospective Studies, Aged, 80 and over, Aortic Valve, Coronary Stenosis, Female, Stents, Treatment Outcome, Coronary Vessels, Heart Valve Prosthesis, Settore MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE
Abstract

The aim of this study was to investigate the safety and efficacy of coronary protection by preventive coronary wiring and stenting across the coronary ostia in patients at high risk for coronary obstruction after transcatheter aortic valve replacement (TAVR).Coronary obstruction following TAVR is a life-threatening complication with high procedural and short-term mortality.Data were collected retrospectively from a multicenter international registry between April 2011 and February 2019.Among 236 patients undergoing coronary protection with preventive coronary wiring, 143 had eventually stents implanted across the coronary ostia after valve deployment. At 3-year follow-up, rates of cardiac death were 7.8% in patients receiving stents and 15.7% in those not receiving stents (adjusted hazard ratio: 0.42; 95% confidence interval: 0.14 to 1.28; p = 0.13). There were 2 definite stent thromboses (0.9%) in patients receiving stents, both occurring after TAVR in "valve-in-valve" procedures. In patients not receiving stents, there were 4 delayed coronary occlusions (DCOs) (4.3%), occurring from 5 min to 6 h after wire removal. Three cases occurred in valve-in-valve procedures and 1 in a native aortic valve procedure. Distance between the virtual transcatheter valve and the protected coronary ostia 4 mm was present in 75.0% of patients with DCO compared with 30.4% of patients without DCO (p = 0.19).In patients undergoing TAVR at high risk for coronary obstruction, preventive stent implantation across the coronary ostia is associated with good mid-term survival rates and low rates of stent thrombosis. Patients undergoing coronary protection with wire only have a considerable risk for DCO.

Published
2020

29. Observational multicentre registry of patients treated with IMPella mechanical circulatory support device in Italy: The IMP-IT registry

Author

Chieffo, A., Ancona, M. B., Burzotta, Francesco, Pazzanese, V., Briguori, C., Trani, Carlo, Piva, T., De Marco, F., Di Biasi, M., Pagnotta, P., Casucci, Giovanni F, Giustino, G., Montorfano, M., Pappalardo, F., Tarantini, G., Burzotta F. (ORCID:0000-0002-6569-9401), Trani C. (ORCID:0000-0001-9777-013X), Casu G., Chieffo, A., Ancona, M. B., Burzotta, Francesco, Pazzanese, V., Briguori, C., Trani, Carlo, Piva, T., De Marco, F., Di Biasi, M., Pagnotta, P., Casucci, Giovanni F, Giustino, G., Montorfano, M., Pappalardo, F., Tarantini, G., Burzotta F. (ORCID:0000-0002-6569-9401), Trani C. (ORCID:0000-0001-9777-013X), and Casu G.

Abstract

Aims: The aim of this study was to investigate nationwide trends and clinical outcomes of the Impella device for cardiogenic shock (CS) and high-risk percutaneous coronary intervention (HR-PCI). Methods and results: The IMP-IT study was a multicentre observational national registry which enrolled all patients treated with Impella 2.5, Impella CP, Impella 5.0 and Impella RP, both for CS and HR-PCI indications, across 17 Italian centres from 2004 to June 2018. A total of 406 patients were included: 229 had CS (56.4%) and 177 underwent HR-PCI (43.6%). The use of Impella increased significantly during the study period (average annual percent change 39.8%, 95% confidence interval: 30.4 to 49.9; p<0.0001) for both indications. The Impella 2.5 was the most commonly used device (N=242; 59.6%). Rates of in-hospital and one-year all-cause death in patients with CS were 46.9% and 57.0%, respectively; 18.5% underwent left ventricular assist device implantation or heart transplant at one year. Rates of in-hospital and one-year allcause death in patients who underwent HR-PCI were 5.7% and 15.6%, respectively. Rates of device-related complications were 37.1% and 10.7% in the setting of CS and HR-PCI, respectively. Conclusions: Use of the Impella for CS and HR-PCI is increasing substantially in Italy, despite relatively high rates of device-related complications.

Published
2020

39. Realizzazione di un banco prova per la caratterizzazione sperimentale di un sistema energetico micro-ORC

Author

Ancona M. A., Bianchi M., Branchini L., De Pascale A., Melino F., Orlandini V., OTTAVIANO, SAVERIO, Peretto A., Pinelli M., Spina P. R., Suman A., Zampieri G., Ancona, M. A., Bianchi, M., Branchini, L., De Pascale, A., Melino, F., Orlandini, V., Ottaviano, S., Peretto, A., Pinelli, M., Spina, P. R., Suman, A., and Zampieri, G.

Subjects
ORC, test, banco prova
Abstract

L’articolo descrive il sistema micro-ORC a banco prova nei laboratori del DIN dell’Università di Bologna. Vengono presentati i layout dell’impianto in analisi e descritti brevemente i componenti principali. Sono quindi riportati gli strumenti implementati per la misura delle grandezze termo-fluidodinamiche che caratterizzano il ciclo, nonché il software di acquisizione ed elaborazione dei dati. Infine vengono mostrate le relazioni utilizzate per il calcolo dei principali indici di prestazione.

Published
2017

40. The International Multicenter TriValve Registry: Which Patients Are Undergoing Transcatheter Tricuspid Repair?

Author

Taramasso M, Hahn RT, Alessandrini H, Latib A, Attinger-Toller A, Braun D, Brochet E, Connelly KA, Denti P, Deuschl F, Englmaier A, Fam N, Frerker C, Hausleiter J, Juliard JM, Kaple R, Kreidel F, Kuck KH, Kuwata S, Ancona M, Malasa M, Nazif T, Nickenig G, Nietlispach F, Pozzoli A, Schafer U, Schofer J, Schueler R, Tang G, Vahanian A, Webb JG, Yzeiraj E, Maisano F, Leon MB, Taramasso, M, Hahn, Rt, Alessandrini, H, Latib, A, Attinger-Toller, A, Braun, D, Brochet, E, Connelly, Ka, Denti, P, Deuschl, F, Englmaier, A, Fam, N, Frerker, C, Hausleiter, J, Juliard, Jm, Kaple, R, Kreidel, F, Kuck, Kh, Kuwata, S, Ancona, M, Malasa, M, Nazif, T, Nickenig, G, Nietlispach, F, Pozzoli, A, Schafer, U, Schofer, J, Schueler, R, Tang, G, Vahanian, A, Webb, Jg, Yzeiraj, E, Maisano, F, and Leon, Mb

Published
2017

41. Efficient construction of LR(k) states and tables

Author

Ancona, M., Dodero, G., Gianuzzi, V., and Morgavi, M.

Subjects
Grammars, Parsing, Algorithm Analysis, New Technique, Program Development Techniques, Scientific Research, Tables
Published
1991

42. Application of Different Modeling Approaches to a District Heating Network.

Author

Ancona, M. A., Branchini, L., De Lorenzi, A., De Pascale, A., Gambarotta, A., Melino, F., and Morini, M.

Subjects
*ELECTRIC heating systems, *HEAT transfer fluids, *HEAT, *HEAT losses, *ELECTRIC power distribution equipment, *ELECTRIC power consumption, *PLANT size
Abstract

The diffusion of district heating (DH) technologies is closely related to the improvement in design and management techniques. Holistic modeling of DH networks represents one of the most promising tools in this regard, since it is aimed at both identifying the size of new plants and optimizing existing ones, with a significant reduction in the time, costs and complexity of real-field tests. The aim of this work is to present the application of two innovative modeling procedures to a real case, i.e. a branch of the Parma University Campus network with a length of about 2 km, 12 connected buildings and an overall heating requirement of 11.2 MW. The first procedure is based on a dedicated library of energy system components developed by the authors in the Matlab®/Simulink® environment, which can be used to assemble models of systems and grids following different configurations. Power generation, conversion and distribution systems together with buildings and generic users can be simulated, considering the thermal and pressure losses of the heat transfer fluid. Typical disturbances can be considered, e.g. solar irradiance, environmental temperature variations and metabolic heat gain from people. Furthermore, a realistic control strategy has been applied to valve opening and boiler operation, in order to fulfil the heat demand profile of buildings in terms of indoor temperatures. Results show that the simulation tool provides a detailed representation of the real system behavior and allows for a comprehensive analysis of the evolution of the main thermodynamic parameters of the heat transfer fluid. The second procedure is based on a tool able to simulate a complex energy distribution network considering the contemporary flows of electrical, thermal and cooling energy. This approach allows both the energy distribution and its generation to be optimized by adopting an optimization procedure based on a genetic algorithm that allows for the load allocation of all the generation systems minimizing the costs of energy production and the associated environmental impact. The results of this second approach, applied to the case study of the Parma University Campus network, show a decrease in electricity consumption for pumping coupled with a reduction in CO2 emissions. The two approaches allow a complete description of a complex smart grid by considering all its aspects from the optimal load distribution of the energy systems up to the implementation of control strategies for the management of the room temperatures at the final users. [ABSTRACT FROM AUTHOR]

Published
2019
Full Text
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43. Complex Energy Networks Optimization for Renewables Exploitation and Efficiency Increase.

Author

Ancona, M. A., Branchini, L., De Pascale, A., Di Pietra, B., Melino, F., Puglisi, G., and Zanghirella, F.

Subjects
*ELECTRIC generators, *ELECTRIC heating systems, *ELECTRIC power distribution grids, *INDUSTRIAL costs, *HEAT pumps, *RENEWABLE energy sources, *NATURAL gas, *GENETIC algorithms
Abstract

In the next years energy grids are expected to become increasingly complex, due to the integration between traditional fossil-fueled production systems, renewable energy generators and storage technologies. In order to maximize renewables exploitation, to minimize the economic costs and to optimize the generations systems operation, a possible solution is represented by the integration of electrical grids and district heating networks. To this purpose, the energy systems typology and size optimization, as well as the networks’ optimal management, are the challenges aspects. In this context, the aim of this paper is the optimization of both the energy generation mix and the yearly operation of a complex energy network including electrical, thermal and cooling distribution. With this purpose, in this study a real district heating network currently served by a cogeneration unit and four natural gas boilers has been considered. Several scenarios have been simulated considering the addition of different energy systems – such as heat pumps, renewable generators (electrical and/or thermal) and cooling machines – and a whole year of operation has been analyzed with an in-house developed software, based on genetic algorithms and aimed at the minimization of the total cost of energy production. The results have been compared to the reference case, representing the current configuration and operation of the network, allowing to define the optimal solution, which enables to reduce the yearly operation costs of the production plant. [ABSTRACT FROM AUTHOR]

Published
2019
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44. Smart District Heating: Cogeneration and Solar Systems Integration to Convert an Existing Utility Substation.

Author

Ancona, M. A., Branchini, L., De Pascale, A., and Melino, F.

Subjects
*SYSTEM integration, *SOLAR heating, *SOLAR system, *ELECTRIC heating systems, *HEAT, *ELECTRIC power distribution grids, *COGENERATION of electric power & heat, *DISTRIBUTED power generation
Abstract

The new goals towards efficiency increase, pollutant emissions and fossil fuel reduction had led to an increasing diffusion of district heating networks. New generations of district heating had introduced the concept of smart thermal grids, consisting in the bidirectional thermal energy exchange between network and final users and aiming at replicating the concept of electric smart grid in the heat sector. With this purpose, the integration between district heating networks and distributed generation systems becomes essential and the optimization of the utility substations is a key point. This study aims at the elaboration of possible solutions for the conversion of an existing utility substation in order to enable a bidirectional thermal energy exchange. Two different configurations will be proposed and analyzed, considering different distributed generation systems to be installed at the final user. The operation model of these cases will be defined with the purpose of optimizing the thermal exchange. Furthermore, the actions required for the conversion of the existing utility substation will be evaluated through a technical analysis, in order to define the novel substation potentialities. Based on the obtained results, the preliminary technical schematic of the converted utility substations have been designed and discussed. [ABSTRACT FROM AUTHOR]

Published
2019
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45. 23-10 New Frontiers and Challenges in Polygeneration Grids (Tutorial Session)

Author

Branchini L., Ancona M. A., Melino F., De Pascale A., Morini M., and Branchini L., Ancona M.A., Melino F., De Pascale A., Morini M.

Subjects
power-to-gas, polygeneration grid, district heating
Abstract

the proposed tutorial would like to highlight the potential of polygeneration in the sustainable energy development, as well as associated challenges. In details, the first attempt of the tutorial is to introduce the concept of a polygeneration grid and its main characteristics. Once defined the framework, the role of renewable energies and associated issues, with particular interest to non-programmable sources (such as solar and wind) will be discussed. To accommodate the presence of non-programmable renewables and their intermittent and unreliable nature, storage devices and energy carriers are fundamentals. Both state-of-art and innovative storage technologies will be sort throughout the tutorial. As innovative and promising way to convert electrical power into gaseous energy carriers, the Power-to-Gas (P2G) system will be discussed. In particular, the P2G process links the power grid with the gas grid by converting surplus power into a grid compatible gas via a two-step process: hydrogen production by water electrolysis and its conversion with an external CO2 source to CH4 via methanation. The synthetic fuel generated can be used as a substitute for natural gas or other fossil fuels in a diverse range of applications (e.g. in the industry, mobility and heating sectors and also for electricity generation). Focusing on thermal aspect, Smart District Heating concept will also play an important role by developing future smart energy integrating systems. In the current energy scenario, indeed, it is important to consider a possible integration between networks and distributed generation systems – i.e to realize a bidirectional energy flux at the utilities, replying the concept of electrical smart grid in the thermal energy field. To this purpose, several thermal energy distributed generation systems, such as solar thermal panels or micro-Combined Heat and Power (micro-CHP) generators, can be considered. In this context, the users substations structure and the network management play a fundamental role, as will be discussed during the tutorial. Finally, another central aspect that characterizes multi-input/multi-output energy grids, that will be stressed and discussed during the tutorial, is the optimal load allocation. Indeed, the coupling of various generation technologies, operating with different performance both at design and off-design conditions, requires a proper optimal management strategy since different mix of production can meet the user demand (electrical, thermal and cooling). The operational management has to follow a strategy aiming at some objective like maximization of renewable energy share, minimization of operational cost, minimization of environmental emission etc. Thus, focusing on this issue, an introduction on optimal load allocation techniques (such as genetic algorithm, mixed integer linear programming etc.) is presented.

Published
2018

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