28 results on '"Bruno Borrello"'
Search Results
2. Transapical combined transcatheter aortic valve-in-valve implant and ascending aorta endovascular repair
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Andrea Agostinelli, Alan Gallingani, Bruno Borrello, and Francesco Nicolini
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Transcatheter Aortic Valve Replacement ,Pulmonary and Respiratory Medicine ,Treatment Outcome ,Aortic Valve ,Heart Valve Prosthesis ,Endovascular Procedures ,cardiovascular system ,Humans ,Surgery ,Middle Aged ,Prosthesis Design ,Cardiology and Cardiovascular Medicine ,Aorta - Abstract
We report the case of a 64-year-old patient who previously had an aortic valve replacement with a stentless aortic valve and an ascending aorta replacement for a DeBakey type II aortic dissection. The patient was referred to us for symptomatic aortic regurgitation related to bioprosthesis degeneration and a pseudoaneurysm at the distal anastomotic site of the vascular graft. Due to the presence of several comorbidities, the patient had a combined transapical transcatheter aortic valve-in-valve implant and an ascending aorta endovascular repair. more...
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- 2022
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Catalog
3. When 3D echocardiography truly makes the difference: a case report of mitral annular ring dehiscence
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Daniele, Sartorio, Bruno, Borrello, Domenico, Tuttolomondo, Massimo, De Filippo, and Nicola, Gaibazzi
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Male ,Mitral Valve Annuloplasty ,Echocardiography, Three-Dimensional ,Humans ,Mitral Valve ,Mitral Valve Insufficiency ,Echocardiography, Transesophageal ,Aged - Abstract
Real time 3D echocardiography has an established incremental diagnostic value over 2D imaging, especially during transesophageal evaluation of native and prosthetic heart valves. A 66 years old male patient, with an history of previous cardiac surgery for mitral annuloplasty and recurrent fever, came to the attention of our echo lab with an indication for transesophageal echocardiography after previous inconclusive transthoracic echocardiograms. Real time 3D echocardiography and 3D color doppler imaging resulted of outmost importance to clarify the presence of annular ring dehiscence, previously not well defined from 2D echocardiography imaging. more...
- Published
- 2021
4. Everything in the 'right' place: multifocal transient ST segment elevation in patient with single coronary artery arising from the right Valsalva sinus
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Sergio, Suma, Claudia, Buffa, Emilia, Solinas, Bruno, Borrello, Nicola, Gaibazzi, Tiziano, Gherli, and Luigi, Vignali
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Aged, 80 and over ,chest pain ,Coronary Vessel Anomalies ,Case Report ,coronary anomaly ,Sinus of Valsalva ,Coronary Angiography ,congenital heart disease ,ischemic heart disease ,Electrocardiography ,Humans ,Female ,Coronary Artery Bypass ,coronary artery disease ,cardiac surgery - Abstract
Single coronary artery (SCA) is a rare coronary anomaly that occurs with an incidence of 0.024%. We report the case of an 83-year-old woman with a Lipton’s type 3 SCA, which is the rarest anomaly within this group, occurring only in the 0.004% of general population. The clinical presentation of this patient was chest pain at rest with multifocal transient ST segment elevation as a marker of multifocal ischemia secondary to severe three vessels coronary artery disease (CAD). This patient was proposed for coronary artery bypass grafting (CABG) with an excellent mid-term outcome. (www.actabiomedica.it) more...
- Published
- 2020
5. Attenuation of peri-vascular fat at computed tomography to measure inflammation in ascending aorta aneurysms
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Bruno Borrello, Carmine Siniscalchi, Daniele Sartorio, Fiorenza Napolitano, Francesco Nicolini, A. Palumbo, Domenico Tuttolomondo, and Nicola Gaibazzi
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Inflammation ,medicine.medical_specialty ,medicine.diagnostic_test ,Epidemiology ,business.industry ,Attenuation ,Peri ,Measure (physics) ,Computed tomography ,Aortic Aneurysm ,Aortic Dissection ,Text mining ,medicine.artery ,Ascending aorta ,medicine ,Humans ,Radiology ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,Tomography, X-Ray Computed ,Aorta - Published
- 2020
6. Blunt traumatic injury to the thoracic aorta treated with thoracic endovascular aortic repair: a single-centre 20-year experience
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Bruno Borrello, Tiziano Gherli, Davide Carino, Andrea Agostinelli, Francesco Nicolini, Carla Marcato, and Annalisa Volpi
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Adult ,Male ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Thoracic Injuries ,Aortic injury ,Aorta, Thoracic ,030204 cardiovascular system & hematology ,Wounds, Nonpenetrating ,Aortic repair ,Young Adult ,03 medical and health sciences ,Injury Severity Score ,0302 clinical medicine ,Blunt ,medicine.artery ,medicine ,Humans ,Thoracic aorta ,Aged ,Retrospective Studies ,Aorta ,business.industry ,Endovascular Procedures ,Middle Aged ,Vascular System Injuries ,Surgery ,Single centre ,Treatment Outcome ,Traumatic injury ,030228 respiratory system ,cardiovascular system ,Female ,Stents ,Cardiology and Cardiovascular Medicine ,business ,Follow-Up Studies ,Forecasting - Abstract
OBJECTIVES Blunt thoracic aortic injury can be treated with thoracic endovascular aortic repair (TEVAR) with excellent short and mid-term outcomes. However, few data are available about the long-term results. Our goal was to report our single-centre, 20-year experience using TEVAR to treat blunt thoracic aortic injury. METHODS We retrospectively reviewed our institutional database to identify all patients treated with TEVAR for traumatic lesions of the aortic isthmus. We identified 35 patients since 1998. Patients' charts were analysed for preoperative characteristics, intraoperative variables and short-term outcomes. Information about the long-term follow-up was collected by analysing cross-sectional images and via phone calls. Follow-up was 100% complete. Rates of survival and of freedom from aortic redo were estimated using Kaplan-Meier methods. RESULTS Twenty-nine patients were men (82%). The median age was 42 years (range 22-79 years) and the mean injury severity score was 38 (±13). The endovascular procedure was successfully carried out in all patients. The left subclavian artery was intentionally overstented in 11 patients (31%). Two patients died perioperatively (5.7%). The estimated survival was 92% and 87% at 5 and 10 years, respectively, with no aorta-related deaths. The estimated freedom from aortic redo was 96% and 91% at 5 and 10 years, respectively. CONCLUSIONS Our data corroborate the excellent results of the endovascular treatment of blunt thoracic aortic injury when follow-up is extended to 20 years. New-generation devices, which are more comfortable and have smaller diameters, may further improve the results of TEVAR in treating traumatic aortic injury. Surveillance with cross-sectional imaging remains mandatory. more...
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- 2018
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7. Vertebral Doppler Bunny Waveform Suggesting Subclavian Stenosis and Influencing Coronary Artery Bypass Technique
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Stefania Graziuso, Bruno Borrello, Nicola Gaibazzi, Stefano Coli, Alessandro Palumbo, and Sergio Suma
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medicine.medical_specialty ,business.industry ,Subclavian stenosis ,symbols.namesake ,Text mining ,medicine.anatomical_structure ,Internal medicine ,Cardiology ,medicine ,symbols ,Waveform ,Cardiology and Cardiovascular Medicine ,business ,Doppler effect ,Images in Cardiovascular Medicine ,Artery - Published
- 2020
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8. Primary Endovascular Repair of the Ascending Aorta
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Francesco Nicolini, Bruno Borrello, Alessandro Maria Budillon, Davide Carino, and Andrea Agostinelli
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,medicine.medical_treatment ,Aortic Valve Insufficiency ,030204 cardiovascular system & hematology ,03 medical and health sciences ,Blood Vessel Prosthesis Implantation ,0302 clinical medicine ,medicine.artery ,Ascending aorta ,medicine ,Humans ,030212 general & internal medicine ,Aorta ,Aged, 80 and over ,business.industry ,Open surgery ,Endovascular Procedures ,Stent ,General Medicine ,Surgery ,Blood Vessel Prosthesis ,surgical procedures, operative ,Fluoroscopy ,cardiovascular system ,Female ,Stents ,Cardiology and Cardiovascular Medicine ,business ,Tomography, X-Ray Computed - Abstract
Different case series have been published demonstrating the feasibility of endovascular repair of the ascending aorta in selected patients deemed unfit for open surgery. However, the use of commercially available stent graft in the ascending aorta remains off-label, and their excessive length often prevents their deployment in the ascending aorta. Here we report a case of successful primary endovascular repair of the ascending aorta using a physician modified off-the-shelf device. more...
- Published
- 2018
9. The use of RemoweLL oxygenator-integrated device in the prevention of the complications related to aortic valve surgery in the elderly patient: Preliminary results
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Maria Vincenza Di Chicco, Florida Gripshi, Matteo Ricci, Davide Carino, Alberto Molardi, Francesco Nicolini, Bruno Borrello, Tiziano Gherli, and Matteo Goldoni
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Male ,medicine.medical_specialty ,Epidemiology ,Heart Valve Diseases ,030204 cardiovascular system & hematology ,Oxygenators ,law.invention ,03 medical and health sciences ,Leukocyte Count ,0302 clinical medicine ,Postoperative Complications ,Aortic valve replacement ,law ,Risk Factors ,Clinical endpoint ,medicine ,Cardiopulmonary bypass ,Chi-square test ,Humans ,Prospective Studies ,Oxygenator ,Aged ,Heart Valve Prosthesis Implantation ,business.industry ,Repeated measures design ,Equipment Design ,medicine.disease ,Intensive care unit ,Cardiac surgery ,Treatment Outcome ,030228 respiratory system ,Elective Surgical Procedures ,Anesthesia ,Aortic Valve ,Cytokines ,Female ,Leukocyte Reduction Procedures ,Cardiology and Cardiovascular Medicine ,business ,Follow-Up Studies - Abstract
Background The effects of fat microembolization due to cardiopulmonary bypass are well known in cardiac surgery. Our aim is to evaluate the use of the RemoweLL device (Eurosets, Medolla, Italy) during elective aortic valve replacement in elderly patients (>70 years old) to rate its biochemical and clinical effects. The RemoweLL device is an oxygenator-integrated reservoir which combines two strategies for fat emboli and leucocytes removal: filtration and supernatant elimination. Methods Forty-four elderly patients were enrolled and assigned randomly to a Group A (standard device) and a Group B (RemoweLL). Biochemical effects were evaluated by blood samples, which were tested for white blood cells, neutrophils, protein SP-100 and interleukin 6 besides standard lab tests. Our clinical endpoints were any type of neurological, cardiac, respiratory, gastrointestinal or renal complications, and length of stay in the intensive care unit. Statistical analysis was carried out with chi square test for non-parametric data; t test and analysis of variance for repeated measures were used for parametric data. Results Group B showed lower levels of white blood cells, neutrophils, interleukin 6 and protein SP-100 immediately and 24 hours after the operation. Group B also showed a lower amount of neurocognitive type II dysfunction even if the length of stay in the ICU did not change. Conclusions The RemoweLL system is safe and effective in reducing inflammatory response to cardiopulmonary bypass and it could be a useful tool in minimizing negative effects of cardiopulmonary bypass; however, it does not seem to have any effect on elderly patients’ hospital stay. more...
- Published
- 2018
10. Transapical access for thoracic endovascular aortic repair to elephant trunk completion
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Bruno Borrello, Andrea Agostinelli, Francesco Nicolini, and Davide Carino
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Pulmonary and Respiratory Medicine ,Aortic arch ,Male ,medicine.medical_specialty ,Elephant trunks ,Computed Tomography Angiography ,Severe disease ,Aorta, Thoracic ,030204 cardiovascular system & hematology ,Aortic repair ,03 medical and health sciences ,Blood Vessel Prosthesis Implantation ,0302 clinical medicine ,medicine.artery ,medicine ,Thoracic aorta ,Humans ,030212 general & internal medicine ,Aged ,Extensive Disease ,Aortic Aneurysm, Thoracic ,business.industry ,Endovascular Procedures ,Surgery ,Blood Vessel Prosthesis ,Treatment Outcome ,Landing zone ,cardiovascular system ,Cardiology and Cardiovascular Medicine ,business ,Transapical approach - Abstract
The 2-stage elephant trunk procedure is widely used to treat extensive disease of the aortic arch and descending thoracic aorta. The 2nd stage of the procedure can be accomplished with both a standard surgical procedure and a retrograde transfemoral endovascular approach using the dangling graft as proximal landing zone. However, in some patients, severe disease of iliofemoral vessels can prevent standard retrograde thoracic endovascular aortic repair (TEVAR). In such cases, an alternative route to gain endovascular access must be used. Herein, we report a case of anterograde cardiac transapical approach for TEVAR as a 2nd stage of an elephant trunk procedure. more...
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- 2017
11. Thoracic Endovascular Aortic Repair Through Cardiac Apex in the Setting of Thoracic Aortic Rupture
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Giorgio Romano, Carla Marcato, Bruno Borrello, Tiziano Gherli, Andrea Agostinelli, Luigi Vignali, Davide Carino, A. Palumbo, and Francesco Nicolini
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Aortic Rupture ,medicine.medical_treatment ,Aorta, Thoracic ,Femoral artery ,030204 cardiovascular system & hematology ,Prosthesis Design ,Aortic repair ,03 medical and health sciences ,Aortic aneurysm ,0302 clinical medicine ,Blood vessel prosthesis ,medicine.artery ,medicine ,Humans ,Aortic rupture ,Aged ,Aorta ,Aortic Aneurysm, Thoracic ,business.industry ,Endovascular Procedures ,Stent ,medicine.disease ,Blood Vessel Prosthesis ,Surgery ,surgical procedures, operative ,Thoracotomy ,030228 respiratory system ,Cardiothoracic surgery ,cardiovascular system ,Stents ,Cardiology and Cardiovascular Medicine ,business - Abstract
Treatment of thoracic aortic rupture poses a substantial challenge for the aortic surgeon. The advent of thoracic endovascular aortic repair (TEVAR) revolutionized the treatment of this heterogeneous group of diseases. Some patients suitable for TEVAR, however, present severe peripheral vascular diseases that can prevent standard retrograde delivery of the stent graft through the femoral artery. In this report, we present a case series of 5 patients with thoracic aortic rupture successfully treated with cardiac transapical TEVAR. more...
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- 2018
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12. In-hospital extracorporeal cardiopulmonary resuscitation (ECPR) after prolonged out-of-hospital cardiac arrest (OHCA). A case report
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Tullio Manca, Giorgia Paoli, Bruno Borrello, Tiziano Gherli, Andrea Ramelli, Antonella Vezzani, Francesco Nicolini, Gaetano Gargiulo, Moscatelli Andrea, and Andrea Agostinelli
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medicine.medical_specialty ,business.industry ,Emergency medicine ,Emergency Medicine ,Medicine ,Extracorporeal cardiopulmonary resuscitation ,Emergency Nursing ,Cardiology and Cardiovascular Medicine ,business ,Out of hospital cardiac arrest - Published
- 2018
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13. The rise of new technologies for aortic valve stenosis: A comparison of sutureless and transcatheter aortic valve implantation
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Mauro Rinaldi, Claudia Filippini, Mauro Cassese, Marco Aiello, Pierluigi Stefàno, Ugolino Livi, Filippo Rapetto, Ottavio Alfieri, Bruno Borrello, Davide Gabbieri, Antonino S. Rubino, Fausto Biancari, Theodor Fischlein, Carlo Savini, Laura Besola, Augusto D'Onofrio, Stefano Salizzoni, Marco Agrifoglio, Antonio Colombo, Giuseppe Tarantini, Carmelo Mignosa, Giuseppe Gatti, Magnus Dalén, Bart Meuris, Gino Gerosa, D'Onofrio, Augusto, Salizzoni, Stefano, Rubino, A, Besola, Laura, Filippini, Claudia, Alfieri, Ottavio, Colombo, Antonio, Agrifoglio, Marco, Fischlein, Theodor, Rapetto, Filippo, Tarantini, Giuseppe, Dalèn, Magnu, Gabbieri, Davide, Meuris, Bart, Savini, Carlo, Gatti, Giuseppe, Aiello Marco, Luigi, Biancari, Fausto, Livi, Ugolino, Stefàno Pier, Luigi, Cassese, Mauro, Borrello, Bruno, Rinaldi, Mauro, Mignosa, Carmelo, and Gerosa, Gino more...
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Male ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Percutaneous ,Transcatheter aortic ,heart valve replacement ,030204 cardiovascular system & hematology ,Transcatheter Aortic Valve Replacement ,03 medical and health sciences ,0302 clinical medicine ,Aortic valve replacement ,Internal medicine ,medicine ,Humans ,aortic valve replacement ,Aged ,Aged, 80 and over ,Heart Valve Prosthesis Implantation ,heart valve replacement sutureless ,business.industry ,Incidence (epidemiology) ,Medicine (all) ,EuroSCORE ,Aortic Valve Stenosis ,medicine.disease ,heart valve replacement suturele ,Surgery ,percutaneou ,percutaneous ,transapical ,Cardiology and Cardiovascular Medicine ,030228 respiratory system ,Paravalvular leakage ,Aortic valve stenosis ,Propensity score matching ,Cardiology ,Female ,business - Abstract
Objective: Transcatheter aortic valve implantation (TAVI) and sutureless aortic valve replacement (SU-AVR) are suitable alternatives to conventional surgery. The aim of this study is to compare early outcomes of patients undergoing TAVI and SU-AVR.Methods: Data were analyzed on patients who underwent TAVI and patients who underwent SU-AVR. Two matched cohorts (TAVI vs SU-AVR) were created using propensity scores; all analyses were repeated for transapical TAVI and transfemoral TAVI, separately. Outcomes were defined according to Valve Academic Research Consortium-2 criteria.Results: A total of 2177 patients were included in the analysis: 1885 (86.6%) treated with TAVI; 292 (13.4%) treated with SU-AVR. Mortality in unmatched TAVI and SU-AVR patients was 7.1% and 2.1%, respectively, at 30 days, and 12.9% and 4.6%, respectively, at 1 year. No differences were found in 30-day mortality in the 214 matched patient pairs (3.7% vs 2.3%; P = .4), but patients treated with TAVI showed a lower incidence of device success (85.9% vs 98.6%; P < .001) and pacemaker implantation (2.8% vs 9.4%; P = .005), and a higher incidence of any paravalvular leakage (PVL).Conclusions: SU-AVR is associated with better device success and a lower incidence of PVL, compared with TAVI. Nevertheless, patients treated with SU-AVR were more likely to receive a permanent pacemaker. SU-AVR and TAVI provide good results in patients who have severe symptomatic aortic valve stenosis. Given the multiple therapeutic options available, patients may receive the treatment that is most appropriate for their clinical and anatomical characteristics. more...
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- 2016
14. EP06 ANTEGRADE TRANSAPICAL TEVAR IN ACUTE AORTIC RUPTURE
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Andrea Agostinelli, A. Molardi, Bruno Borrello, F. Gripshi, Francesco Nicolini, and Davide Carino
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medicine.medical_specialty ,business.industry ,medicine ,General Medicine ,Cardiology and Cardiovascular Medicine ,Aortic rupture ,business ,Surgery - Published
- 2018
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15. Abstracts for The European Society for Cardiovascular Surgery 53rd International Congress, Ljubljana, Slovenia, June 2--5, 2004
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Tiziano Gherli, Igino Spaggiari, Cesare Beghi, Budillon Am, Fragnito C, Bruno Borrello, S Saccani, and Andrea Agostinelli
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Pulmonary and Respiratory Medicine ,Aortic dissection ,Aortic arch ,medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Stent ,medicine.disease ,Surgery ,medicine.artery ,Ascending aorta ,medicine ,Cardiology and Cardiovascular Medicine ,business - Published
- 2004
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16. Ascending aortic graft thrombosis from an endoluminal candida albicans infection
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Francesco, Nicolini, Alessandro Maria, Budillon, Bruno, Borrello, and Tiziano, Gherli
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Male ,Fatal Outcome ,Prosthesis-Related Infections ,Aortic Aneurysm, Thoracic ,Candida albicans ,Candidiasis ,Graft Occlusion, Vascular ,Humans ,Thrombosis ,Tomography, X-Ray Computed ,Aneurysm, Infected ,Aged - Published
- 2014
17. Aortic valve regurgitation secondary to ectopia and atresia of the left main coronary artery
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Francesco, Nicolini, Domenico, Corradi, Andrea, Agostinelli, Bruno, Borrello, and Tiziano, Gherli
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Heart Valve Prosthesis Implantation ,Male ,Treatment Outcome ,Aortic Valve ,Coronary Vessel Anomalies ,Aortic Valve Insufficiency ,Humans ,Coronary Artery Bypass ,Middle Aged ,Coronary Angiography ,Severity of Illness Index ,Echocardiography, Transesophageal ,Echocardiography, Doppler, Color - Abstract
Congenital atresia of the LMCA is an extremely rare anomaly which is often clinically complicated by silent angina, myocardial infarction, failure to thrive, or sudden cardiac death. Moreover, the atretic and ectopic origin of the LMCA associated with aortic valve anomalies is an even rarer condition. Herein, the case is described of a patient with a very rare association between the ectopic and atretic left main coronary artery (LMCA) and severe aortic valve regurgitation. more...
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- 2014
18. Ascending aortic graft thrombosis from an endoluminalcandida albicansinfection: Figure 1
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Tiziano Gherli, Alessandro Maria Budillon, Francesco Nicolini, and Bruno Borrello
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Aorta ,biology ,business.industry ,General Medicine ,medicine.disease ,biology.organism_classification ,Thrombosis ,Surgery ,Aortic aneurysm ,Aneurysm ,Cardiothoracic surgery ,medicine.artery ,medicine ,Thoracic aorta ,Prosthesis-Related Infection ,Cardiology and Cardiovascular Medicine ,Candida albicans ,business - Published
- 2015
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19. Giant ascending aorta saccular aneurysm in a patient affected by Turner syndrome
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Andrea Agostinelli, Tiziano Gherli, Francesco Nicolini, and Bruno Borrello
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Pulmonary and Respiratory Medicine ,Aortic arch ,Adult ,Turner Syndrome ,Aortography ,Pseudoaneurysm ,Aneurysm ,medicine.artery ,Ascending aorta ,Medicine ,Humans ,cardiovascular diseases ,Subclavian artery ,Aorta ,business.industry ,Extracorporeal circulation ,General Medicine ,Anatomy ,medicine.disease ,Right pulmonary artery ,Aortic Aneurysm ,cardiovascular system ,Surgery ,Female ,Cardiology and Cardiovascular Medicine ,business ,Tomography, X-Ray Computed - Abstract
Figure 1: A CT scan showing a huge saccular aneurysm of the ascending aorta (maximum axial diameter 14 × 12 cm) (A–C and H, white asterisks) with a wide neck on the left anterolateral wall (B, black asterisk). The pseudoaneurysm lumen was thrombus-filled (B–G, white arrows), with diffuse calcifications on the wall (C and E, red arrowheads). The aneurysm caused compression of the left main bronchus (D, red arrow) and the right pulmonary artery (RPA in B and D). The resulting dislocation of the aortic arch (AA in E–G), with severe reduction of its lumen (9 × 22 mm), particularly between the brachiocephalic trunk and left subclavian artery (BT and SA in G). Intraoperative findings confirmed the diagnosis (H). Surgery was performed after arterial and venous cannulation of femoral vessels and start of hypothermic extracorporeal circulation before chest opening. Surgical correction consisted in ascending aorta and hemiarch prosthetic replacement. RPA: right pulmonary artery; AA: aortic arch; BT: brachiocephalic trunk; SA: subclavian artery. more...
- Published
- 2013
20. New technologies for the treatment of type a aortic dissection: a case report
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Francesco Nicolini, Pietro Larini, Andrea Agostinelli, Tiziano Gherli, Bruno Borrello, S Saccani, and Carla Marcato
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Surgical adhesive ,Aorta, Thoracic ,Aortic repair ,Risk Assessment ,Severity of Illness Index ,Blood Vessel Prosthesis Implantation ,medicine.artery ,medicine ,Humans ,Prospective randomized study ,Aged ,Aortic dissection ,Aorta ,Aortic Aneurysm, Thoracic ,business.industry ,Graft Survival ,Angiography ,A protein ,medicine.disease ,Combined Modality Therapy ,Surgery ,Cardiac surgery ,Aortic Dissection ,Treatment Outcome ,Female ,Stents ,business ,Cardiology and Cardiovascular Medicine ,Vascular Surgical Procedures ,Follow-Up Studies - Abstract
4. Spotnitz W, Burks S. Use of tissue sealants in cardiac surgery. In: Franco K, Verrier E, editors. Advanced therapy in cardiac surgery. Hamilton, Ontario: BC Decker; 2003. p. 9-10. 5. Coselli JS, Bavaria JE, Fehrenbacher J, Stowe CL, Macheers SK, Gundry SR. Prospective randomized study of a protein-based tissue adhesive used as a hemostatic and structural adjunct in cardiac and vascular anastomotic repair procedures. J Am Coll Surg. 2003;197: 243-52; discussion 252-3. 6. Hewitt CW, Marra SW, Kann BR, Tran HS, Puc MM, Chrzanowski FA, et al. BioGlue surgical adhesive for thoracic aortic repair during coagulopathy: efficacy and histopathology. Ann Thorac Surg. 2000; 71:1609-12. 7. Raanani E, Latter DA, Errett LE, Bonneau DB, Leclerc Y, Salasidis more...
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- 2004
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21. Saccular ascending aorta aneurysm: report of an unusual presentation
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Francesco Nicolini, Cesare Beghi, Tiziano Gherli, and Bruno Borrello
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Acute coronary syndrome ,Coronary Angiography ,Aortography ,Angina Pectoris ,Diagnosis, Differential ,Blood Vessel Prosthesis Implantation ,Left coronary artery ,Aneurysm ,Internal medicine ,medicine.artery ,Ascending aorta ,Berry Aneurysm ,Medicine ,Humans ,cardiovascular diseases ,Acute Coronary Syndrome ,Aged ,Cardiopulmonary Bypass ,business.industry ,medicine.disease ,Aortic Aneurysm ,medicine.anatomical_structure ,Treatment Outcome ,cardiovascular system ,Cardiology ,Heart Arrest, Induced ,Cardiac Imaging Techniques ,Surgery ,Female ,Radiology ,Presentation (obstetrics) ,Cardiology and Cardiovascular Medicine ,business ,Tomography, X-Ray Computed ,Artery - Abstract
We describe an unusual presentation of a large saccular aneurysm of the ascending aorta, mimicking an acute coronary syndrome. The compression of the aneurysm on the left main coronary artery was probably the cause of these confusing symptoms. Our experience confirms the fundamental role of modern cardiac imaging techniques in the differential diagnosis of these unusual cases and in the planning of the correct surgical procedure. more...
- Published
- 2008
22. Mitral valve annuloplasty and myocardial revascularization in the treatment of ischemic dilated cardiomyopathy
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Bruno Borrello, Andrea Colli, C Fragnito, Andrea Agostinelli, Giampaolo Zoffoli, Cesare Beghi, Tiziano Gherli, Giovanni Cagnoni, and Francesco Nicolini
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Cardiomyopathy, Dilated ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,Myocardial Ischemia ,Dilated cardiomyopathy ,Coronary artery bypass grafting ,Revascularization ,Severity of Illness Index ,Ventricular Dysfunction, Left ,Mitral valve annuloplasty ,Internal medicine ,medicine ,Humans ,Myocardial infarction ,Hospital Mortality ,Coronary Artery Bypass ,Internal Mammary-Coronary Artery Anastomosis ,Aged ,Heart Valve Prosthesis Implantation ,Ejection fraction ,business.industry ,Mitral valve regurgitation ,Cardiology and Cardiovascular Medicine ,Mitral Valve Insufficiency ,Stroke Volume ,Canadian Cardiovascular Society ,Middle Aged ,medicine.disease ,Surgery ,Cardiac surgery ,Survival Rate ,Treatment Outcome ,Italy ,Echocardiography ,Cardiology ,Female ,business ,Follow-Up Studies - Abstract
The aim of this study was to examine perioperative mortality and morbidity and midterm results in patients undergoing coronary bypass graft and mitral valve annuloplasty with advanced dilated cardiomyopathy. Sixty-one patients with ischemic dilated cardiomyopathy underwent coronary artery bypass grafting and mitral valve annuloplasty between January 1998 and December 2003. Patients eligible for revascularization that presented a mild or more severe mitral valve regurgitation at echocardiography (effective regurgitant orifice0.2 cm(2)) were considered for annuloplasty with a Cosgrove ring. New York Heart Association class (NYHA) III/IV was present in 40 patients (66%) and Canadian Cardiovascular Society class III-IV in 19 (31%). A previous acute myocardial infarction was reported in 48 patients (79%). The mean number of graft anastomoses was 2.5 +/- 0.7 and the left internal mammary artery was used in 49 patients (80%). In-hospital mortality was 4.9% (3 patients), due to unsuccessful weaning from cardiopulmonary bypass, multiple organ failure, and stroke, respectively. Left ventricle ejection fraction improved from 28.9% +/- 5.2% preoperatively to 35.4% +/- 8.1% at follow-up (P = 0.0001) and a significant reduction in NYHA III/IV was detected: from 40 patients preoperatively (66%) to 14 (31%) at follow-up (P = 0.031). Midterm cardiac-related mortality rate was 3.4%. In our experience combined coronary artery bypass grafting and ring annuloplasty for ischemic dilated cardiomyopathy can be performed with acceptable risks for in-hospital mortality and morbidity. Midterm results show a good survival rate and a durable functional improvement in this subset of patients. more...
- Published
- 2006
23. Acute coronary syndromes without persistent st-segment elevation: advances in surgical revascularization
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Giampaolo, Zoffoli, Francesco, Nicolini, Cesare, Beghi, Alessandro Maria, Budillon, Andrea, Agostinelli, Bruno, Borrello, Giovanni, Cagnoni, Guido, Frassetto, Claudio, Fragnito, and Tiziano, Gherli
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Male ,Electrocardiography ,Acute Disease ,Myocardial Infarction ,Humans ,Female ,Angina, Unstable ,Syndrome ,Coronary Artery Bypass ,Aged - Abstract
Coronary artery bypass grafting (CABG) still plays a fundamental role in the management of acute coronary syndromes. The aim of this study is to report the experience of our center in the treatment of patients with acute coronary sindromes without persistent ST elevation urgently operated on with CABG, and to discuss surgical problems related. Two-hundred and six patients were urgently operated on for CABG for acute coronary syndromes without persistent ST-segment elevation from January 2001 to February 2003. The majority of them had three vessel coronary disease (72%) and left main stem disease occurred in 20% of the patients. Mean LVEF (left ventricular ejection fraction) was 54 +/- 12% whereas 9% of the patients had a LVEF40%. Twenty-one patients (10%) received glycoprotein IIb/IIIa receptor inhibitors and 35 (17%) received intravenous heparin therapy before surgery. Mean interval time between the onset of symptoms and surgery was 16 +/- 10 days (range 4-50). In-hospital mortality was 2% (4 patients). Perioperative AMI (acute myocardial infarction) occurred in 4% (8 patients) and a transient low cardiac output syndrome in 27 patients (13%). Bleeding requiring surgery occurred in 1% of the patients. Transient respiratory insufficiency was present in 12 patients (6%) and acute renal failure in 8 patients (4%). Mean I.C.U. time was 2.4 days (1-17). Urgent CABG for acute coronary syndromes shows a low risk for in-hospital mortality and morbidity. In acute patients arterial grafts are not detrimental for the outcome, but are recommended in the absence of contraindications to improve long-term results. In spite of recent developments in cardioplegic cardiac arrest, optimal myocardial protection against perioperative myocardial infarction still remains a challenge. more...
- Published
- 2005
24. Aortic valve periprosthetic leakage: anatomic observations and surgical results
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Andrea Colli, Tiziano Gherli, Roberto Lorusso, Bruno Borrello, Teresa Grimaldi, Francesco Nicolini, Giuseppe De Cicco, Cesare Beghi, Alessandro Maria Budillon, and C Fragnito
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Reoperation ,Pulmonary and Respiratory Medicine ,Aortic valve ,medicine.medical_specialty ,Time Factors ,medicine.medical_treatment ,Aortic Valve Insufficiency ,Periprosthetic ,Prosthesis ,Aortic valve replacement ,medicine ,Humans ,Cardiac skeleton ,Coronary sinus ,Retrospective Studies ,Heart Valve Prosthesis Implantation ,business.industry ,Aortic Valve Stenosis ,Cardiology and Cardiovascular Medicine ,Surgery ,medicine.disease ,Survival Analysis ,Prosthesis Failure ,Treatment Outcome ,medicine.anatomical_structure ,Elective Surgical Procedures ,Orthopedic surgery ,Implant ,Emergencies ,business - Abstract
One of the most frequent causes of reoperation after heart valve replacement is periprosthetic leakage (PPL). Previous studies have failed to determine whether PPL is linked to specific anatomic details. The aim of this study was to examine the location within the aortic annulus where PPL occurs, and to evaluate the postoperative outcome after surgical correction.Between January 1985 and December 2001, 28 patients underwent reoperation because of PPL after aortic valve replacement. The aortic annulus was analyzed in a clockwise format with hour 1 corresponding to the commissure between the left coronary sinus and the right coronary sinus, hour 5 to the commissure between the right coronary sinus and the noncoronary sinus, and hour 9 to the commissure between the noncoronary sinus and the left coronary sinus.Overall operative mortality was 7.1% (2 patients). Repair of PPL was carried out in 8 patients whereas prosthetic valve replacement was necessary in 20 patients. Urgency or emergency operation (p0.0037), preoperative New York Heart Association class IV (p0.04), need for prosthetic valve replacement (p = 0.05), and implant of mechanical valve (p = 0.031) were independent determinants of dismal prognosis. Periprosthetic leakage occurred more frequently between hour 4 and hour 8 (19 patients), with the risk of leakage being two times greater than in other annular areas.Our study suggests that PPL occurs more frequently in a specific portion of the peculiar aortic annulus. In case of PPL diagnosis, a timely reoperation might decrease operative risks by avoiding emergency procedures and unfavorable preoperative clinical conditions, and preventing prosthetic valve replacement. more...
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- 2005
25. Midterm clinical results in myocardial revascularization using the radial artery
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C Reverberi, Cesare Beghi, Alessandro Maria Budillon, L Ballore, Francesco Nicolini, Bruno Borrello, and Tiziano Gherli
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Male ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Critical Care and Intensive Care Medicine ,Angina ,Cardiac surgery ,Myocardial revascularization ,Radial artery ,medicine.artery ,Internal medicine ,medicine ,Humans ,Circumflex ,Myocardial infarction ,Coronary Artery Bypass ,Ejection fraction ,business.industry ,Stroke Volume ,Canadian Cardiovascular Society ,Middle Aged ,medicine.disease ,Surgery ,Treatment Outcome ,Ventricular fibrillation ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,business ,Follow-Up Studies - Abstract
Study objectives: The aim of this study was to evaluate the immediate and midterm results of coronary artery bypass grafting with the radial artery (RA) as a conduit. Patients: Two hundred forty-one patients underwent myocardial revascularization using the RA. In 78.5% of patients, three coronary vessels were involved, and in 25% of patients, the left main coronary artery was involved. The mean ( SD) preoperative ejection fraction was 58 13%. Interventions: The RA was implanted on branches of the circumflex artery in 81% of the cases, and the left internal mammary artery was implanted on the left anterior descending artery in 94% of patients. Total arterial myocardial revascularization was performed in 58% of patients. Measurements and results: The in-hospital mortality rate was 0.8%. Two patients had acute myocardial infarction, and three patients experienced a transient low-cardiac output syndrome. We reviewed the records of all 171 patients who had undergone at least 6 months of follow-up after surgery. The late mortality rate in this group was 0.6% (one patient died 2 months after surgery because of cardiocirculatory arrest due to untreatable ventricular fibrillation). At a mean follow-up time of 545 253 days, two patients showed class 3 residual angina according to the Canadian Cardiovascular Society (CCS) guidelines. One patient required another hospital admission 6 months after undergoing surgery for PTCA/stenting on a circumflex artery that had not previously undergone bypass. The second patient, 8 months after undergoing coronary artery bypass grafting, underwent angiography and stenting on a stenosed anastomosis of a posterolateral branch of the circumflex artery that previously had been bypassed with the right internal mammary artery. Conclusions: The routine use of the RA for coronary bypass grafting is a safe surgical technique, providing excellent clinical mid-term results in terms of cardiac event-free expectancy. (CHEST 2002; 122:2075–2079) more...
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- 2002
26. Immediate endovascular treatment of blunt aortic injury: Our therapeutic strategy
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Andrea Agostinelli, Tiziano Gherli, Pietro Larini, Bruno Borrello, Francesco Nicolini, and S Saccani
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Thorax ,Adult ,Male ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Time Factors ,medicine.medical_treatment ,Aortic Rupture ,Wounds, Nonpenetrating ,Lesion ,Blood Vessel Prosthesis Implantation ,Blunt ,Laparotomy ,medicine.artery ,Medicine ,Humans ,Minimally Invasive Surgical Procedures ,Aortic rupture ,Aged ,Aorta ,business.industry ,Accidents, Traffic ,Stent ,Middle Aged ,Surgery ,Blood Vessel Prosthesis ,Treatment Outcome ,surgical procedures, operative ,Feasibility Studies ,Accidental Falls ,Female ,Stents ,Radiology ,medicine.symptom ,business ,Complication ,Cardiology and Cardiovascular Medicine - Abstract
Background Posttraumatic aortic rupture is a potentially lethal injury. Endovascular procedure has recently proved to be a valid option. Timing of the treatment, however, is still a debated issue. We evaluated the feasibility and safety of immediate stent-graft repair of acute posttraumatic aortic injury. Methods From 1998 to 2005, 15 patients (11 men and 4 women, mean age 42.3 years) with blunt aortic injury were treated with immediate stent-graft positioning. In patients with clinical and radiologic signs of impending rupture, endovascular treatment was performed in an emergency setting (11 cases). In the 4 remaining patients the aortic lesion was treated after clinical management. When present, immediate life-threatening nonaortic lesions were treated before endovascular stenting (6 cases). In 1 case emergency laparotomy and endovascular procedure were performed simultaneously. Stent positioning was monitored by intraoperative transesophageal echocardiography in all cases. Results Endovascular procedure was successful in 100% of the patients. Two patients died perioperatively as a consequence of a multiorgan failure. Both patients were in American Society of Anesthetists class V and were in severe intractable hemorrhagic shock before the procedure. Computed tomography scan performed before discharge showed correct positioning of the stent graft and absence of endoleaks in all cases. At a mean follow-up of 29 months (range 1-79) all patients were alive but 1, who died of unrelated cause, and no intervention-related complication had occurred. Conclusions Immediate stent-graft repair of posttraumatic aortic injury is a feasible and safe procedure. It allows us to minimize the surgical risks and to treat stable and unstable lesions even when associated lesions would contraindicate traditional surgical intervention. more...
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27. Cardiac transapical approach: A new solution for the treatment of complex thoracic aortic disease
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Bruno Borrello, Andrea Agostinelli, Francesco Nicolini, and Tiziano Gherli
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Pulmonary and Respiratory Medicine ,Male ,medicine.medical_specialty ,Cardiac Catheterization ,Aortography ,medicine.medical_treatment ,Treatment outcome ,Comorbidity ,Blood Vessel Prosthesis Implantation ,medicine ,Humans ,Thoracic aortic disease ,Cardiac catheterization ,Aged, 80 and over ,medicine.diagnostic_test ,Aortic Aneurysm, Thoracic ,business.industry ,Endovascular Procedures ,medicine.disease ,Tomography x ray computed ,Treatment Outcome ,Surgery ,Radiology ,business ,Cardiology and Cardiovascular Medicine ,Tomography, X-Ray Computed ,Transapical approach ,Aneurysm, False - Full Text
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28. Giant aneurysm of Valsalva's sinus: diagnosis and preoperative planning using 64-slice computed tomography
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Chiara Martini, Erica Maffei, Alessandro Maria Budillon, Tiziano Gherli, Bruno Borrello, Claudio Reverberi, Francesco Nicolini, A. Palumbo, Cesare Beghi, Andrea Agostinelli, and Filippo Cademartiri
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Adult ,Male ,medicine.medical_specialty ,Cardiac computed tomography ,Computed tomography ,Aneurysm ,Predictive Value of Tests ,Diagnosis ,medicine ,Humans ,cardiovascular diseases ,Cardiac Surgical Procedures ,Sinus (anatomy) ,Incidental Findings ,Preoperative planning ,medicine.diagnostic_test ,Valsalva sinus aneurysm ,business.industry ,64-slice computed tomography ,Noninvasive coronary angiography ,General Medicine ,Sinus of Valsalva ,Dermatomyositis ,medicine.disease ,Echocardiography, Doppler ,Aortic Aneurysm ,Cardiac surgery ,Treatment Outcome ,medicine.anatomical_structure ,cardiovascular system ,Radiology ,Tomography, X-Ray Computed ,Cardiology and Cardiovascular Medicine ,business ,Echocardiography, Transesophageal - Abstract
We describe a giant unruptured acquired aneurysm of the noncoronary sinus of Valsalva, which was detected incidentally in a 30-year-old rugby player with clinical suspicion of dermatomyositis. Sixty-four-slice cardiac computed tomography showed a giant aneurysm (diameters: 91 x 78 x 100 mm) of noncoronary sinus of Valsalva compressing both atrial chambers. The patient underwent cardiac surgery according to the Tirone David technique based on the information provided by cardiac computed tomography. more...
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