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Minimally invasive mitral valve surgery: state-of-the-art and our experience
The minimally invasive approach is becoming the standard-of-care for surgery of the mitral valve. As any less invasive strategy, it entails an increased surgical complexity. Standard-of-care mitral repair using the totally videoscopic approach is indeed reproducible; however, few specific data on patients with complex mitral valve disease are available in the published literature. The purpose of the present paper is to provide an overview of the current state-of-the-art in minimally invasive cardiac surgery, and a summary of recent evidence on the topic, with particular regard to the surgical techniques and comparisons wit...
Source: European Journal of Heart Failure Supplements - March 10, 2015 Category: Cardiology Authors: Speziale, G., Fattouch, K., Romano, V., Del Giglio, M., Albertini, A., Comoglio, C., Gregorini, R., Coppola, R., Spirito, R., Popoff, G., Nasso, G. Tags: Articles Source Type: research

Mitral valve therapy still surgical?
Mitral regurgitation (MR) is the second most common valvular heart disease after aortic valve stenosis. With increased understanding of the heterogenic pathophysiology of MR, cardiac surgeons have developed various techniques that increase the likelihood of successful mitral valve repair (MVR). Nowadays, a rate of repair >90% may be reached in some mitral valve reference centres. In recent years, the introduction of transcatheter mitral valve intervention techniques has opened up new frontiers in mitral therapy, specifically in patients at high risk for standard surgery. Current percutaneous technologies for MVR have be...
Source: European Journal of Heart Failure Supplements - March 10, 2015 Category: Cardiology Authors: Fattouch, K., Castriota, F., Guccione, F., Dioguardi, P., Vadala, G., Squeri, A., Russo, P., Cristina Barattoni, M., Nasso, G., Speziale, G. Tags: Articles Source Type: research

Hybrid coronary artery revascularization: initial experience of a single centre
We present preliminary results of a prospective study designed to verify the selection of candidates for treatment with hybrid approach. Between September 2011 and August 2014, 42 patients [(M = 37 (88.1%); mean age 68.6 ± 10.3 years, range 53–90] were selected to receive a complete (all lesions of main vessels treated) coronary revascularization with a hybrid approach at our Institution. Age-creatinine-ejection-fraction score was high (>1.277) in 16 (38%) patients, median 1.2 (0.77; 2.89). All patients underwent off-pump single-vessel revascularization (left internal thoracic artery to the left anterior de...
Source: European Journal of Heart Failure Supplements - March 10, 2015 Category: Cardiology Authors: Mikus, E., Grattoni, C., Fiore, F., Conte, M., Coppola, R., Chierchia, S., Bosi, S., Jori, M. C., Castriota, F., Del Giglio, M. Tags: Articles Source Type: research

New cardiac bioprostheses: the case of 'sutureless' valves
Surgical aortic valve replacement (SAVR) with extracorporeal circulation (ECC) is currently the treatment of choice for patients with severe aortic stenosis, but high-risk patients may benefit from reduced ECC and cross-clamping times (CCTs) and a minimally invasive approach. A new generation of ‘sutureless’ (SU) bioprostheses has recently been introduced into clinical practice. Sutureless fixation of the valve combines the advantages of open SAVR (i.e. complete removal of pathological tissue) with reduced ECC and CCT, and facilitates small incision surgery. Between November 2012 and August 2014, we operated on...
Source: European Journal of Heart Failure Supplements - March 10, 2015 Category: Cardiology Authors: Albertini, A., Mikus, E., Sabarese, M., Caprili, L., Del Giglio, M., Lamarra, M. Tags: Articles Source Type: research

Carotid artery stenting: current role of proximal neuroprotection and technical advancements in stroke prevention
For more than 50 years, carotid endarterectomy has been considered the gold standard therapy to prevent stroke in patients with carotid artery disease. Carotid artery stenting (CAS) has emerged in the last 15 years as minimally invasive alternative to surgery, especially in patients at high surgical risk. Recent randomized trials have challenged this concept reporting a relatively high incidence rate (4–6%) of post-CAS neurological adverse events. The aim of this study is to evaluate the current role of CAS in all-comers with advanced carotid disease, managed with mandatory proximal neuroprotection in a high-volume c...
Source: European Journal of Heart Failure Supplements - March 10, 2015 Category: Cardiology Authors: Cremonesi, A., Mussardo, M., Sbarzaglia, P., Spagnolo, B., Cavazza, C., Castriota, F. Tags: Articles Source Type: research

Early and late clinical outcomes of endovascular, surgical, and hybrid revascularization strategies of combined carotid and coronary artery diseases: the FRIENDS study group (Finalized Research In ENDovascular Strategies)
The best therapeutic strategy for patients with concomitant carotid obstructive disease (COD) and coronary artery disease (CAD) remains controversial. The aim of the study is to observe post-procedural and 1-year clinical outcomes of patients with COD and CAD after an endovascular, surgical, or a combined (hybrid) revascularization approach, selected by consensus of a multidisciplinary team. Between January 2006 and December 2012, 1043 consecutive patients with COD and concomitant CAD were treated. According to treatment strategies, patients were divided into three groups: surgical: 391 patients (37.1%), endovascular: 502 ...
Source: European Journal of Heart Failure Supplements - March 10, 2015 Category: Cardiology Authors: Castriota, F., Tomai, F., Gabrio Secco, G., Reimers, B., Piccoli, A., De Persio, G., Pesarini, G., Schiavina, G., Borioni, R., Pacchioni, A., Cremonesi, A., Vassanelli, C., Ribichini, F. Tags: Articles Source Type: research

New imaging modalities in peripheral interventions
The aim of this article is to evaluate the feasibility and results of our peripheral revascularization where we used non-conventional intra-procedural imaging techniques. Between January 2014 and September 2014, 45 patients were imaged with CO2 angiography and/or optical coherence tomography (OCT) or 2D perfusion imaging. The scope was to minimize the use of contrast and obtain additional information to improve the outcome. CO2 angiography was used in all patients with impaired renal function. Two-dimensional perfusion was used in all patients with critical limb ischaemia before and after revascularization to quantify angi...
Source: European Journal of Heart Failure Supplements - March 10, 2015 Category: Cardiology Authors: Micari, A., Sbarzaglia, P., Meeks, M. D. M. E., Liso, A., Riina, M., Lunetto, M. L., Roscitano, G., Vadala, G. Tags: Articles Source Type: research

Multipoint left ventricular pacing provides additional echocardiographic benefit to responders and non-responders to conventional cardiac resynchronization therapy
Cardiac resynchronization therapy (CRT) with multipoint left ventricular (LV) pacing [MultiPoint™ Pacing (MPP), St. Jude Medical, Sylmar, CA, USA] improves LV function and clinical response relative to conventional CRT in patients receiving a de novo device implant. We hypothesized that patients with a previously implanted conventional CRT device would receive additional benefit by switching to MPP. Patients receiving a CRT implant (Unify Quadra MP™ or Quadra Assura MP™ CRT-D and Quartet™ LV lead, St. Jude Medical) were programmed to conventional CRT (i.e. biventricular pacing with right ventricular...
Source: European Journal of Heart Failure Supplements - March 10, 2015 Category: Cardiology Authors: Pappone, C., Ćalović, Žarko, Cuko, A., McSpadden, L. C., Ryu, K., Jordan, C. D., Saviano, M., Baldi, M., Pappone, A., Dozza, L., Giannelli, L., Fragakis, N., Vicedomini, G., Santinelli, V. Tags: Articles Source Type: research

The natural history of WPW syndrome
We report our experience on untreated WPW patients purely looking at the natural history of the disease. In a 15-year period (1995–2010), among 11 237 WPW patients referred to our Arrhythmology Department, a total of 1847 selected patients (820 symptomatic) underwent electrophysiological testing without ablation and were followed for a median (25th–75th) follow-up of 8 (5–8) years. During follow-up, malignant arrhythmias (MA) occurred in 16 patients (0.9%) of whom 14 (1.4%) were initially asymptomatic and two (0.2%) symptomatic (P = 0.01). Potentially MA developed in 143 patients (7.7%) without difference...
Source: European Journal of Heart Failure Supplements - March 10, 2015 Category: Cardiology Authors: Pappone, C., Vicedomini, G., Manguso, F., Baldi, M., Petretta, A., Giannelli, L., Saviano, M., Pappone, A., Ionescu, B., Ciaccio, C., Vitale, R., Cuko, A., Calovic, Z., Fundaliotis, A., Moscatiello, M., Catalano, C., Santinelli, V. Tags: Articles Source Type: research

Strategic management of a healthcare organization: engagement, behavioural indicators, and clinical performance
(Source: European Journal of Heart Failure Supplements)
Source: European Journal of Heart Failure Supplements - March 10, 2015 Category: Cardiology Authors: Speziale, G. Tags: Articles Source Type: research

Strategic role of a flag hospital in a large healthcare network
(Source: European Journal of Heart Failure Supplements)
Source: European Journal of Heart Failure Supplements - March 10, 2015 Category: Cardiology Authors: Biagi, B. Tags: Articles Source Type: research

Introduction
(Source: European Journal of Heart Failure Supplements)
Source: European Journal of Heart Failure Supplements - March 10, 2015 Category: Cardiology Authors: Sansavini, E. Tags: Introduction Source Type: research

ANMCO/SICI-GISE paper on antiplatelet therapy in acute coronary syndrome
Antiplatelet therapy is the cornerstone of the pharmacologic management of patients with acute coronary syndrome (ACS). Over the last years, several studies have evaluated old and new oral or intravenous antiplatelet agents in ACS patients. In particular, research was focused on assessing superiority of two novel platelet adenosine diphosphate (ADP) P2Y12 receptor antagonists (i.e. prasugrel and ticagrelor) over clopidogrel. Several large randomized controlled trials have been undertaken in this setting and a wide variety of pre-specified and post hoc analyses are available that evaluated the potential benefits of novel an...
Source: European Journal of Heart Failure Supplements - November 28, 2014 Category: Cardiology Authors: De Luca, L., Bolognese, L., Valgimigli, M., Ceravolo, R., Danzi, G. B., Piccaluga, E., Rakar, S., Cremonesi, A., Bovenzi, F. M., for the Associazione Nazionale Medici Cardiologi Ospedalieri (ANMCO, Italian Association of Hospital Cardiologists) and the So Tags: Articles Source Type: research

Antiplatelet therapy in acute coronary syndrome: current status and future directions
(Source: European Journal of Heart Failure Supplements)
Source: European Journal of Heart Failure Supplements - November 28, 2014 Category: Cardiology Authors: Jukema, J. W. Tags: Articles Source Type: research

Characteristics, treatment, and outcome of patients with acute coronary syndrome presenting at King Abdulaziz Cardiac Center compared with the European patients
The aim of this study was to examine the management of acute coronary syndrome (ACS) at King Abdul Aziz Cardiac Center (KACC) and to compare our practice with that of the European population of Euro Heart Survey—2009 (EHS 2009). This is a study of 3233 consecutive ACS patients who presented to KACC from January 2010 to December 2013. The data describing baseline characteristics, treatment, and outcome were collected and compared with that of EHS-2009 population. The diagnosis of ST elevation myocardial infarction (STEMI) and non-STEMI at KACC compared with EHS 2009 was 30 vs. 70% and 60.5 vs. 39.5%, respectively. Our...
Source: European Journal of Heart Failure Supplements - November 10, 2014 Category: Cardiology Authors: Khan, W., Elsherif, Z., Daoud, Y., Mukhtar, A., Omer, H., Saeed, B., Halim, M. Tags: Articles Source Type: research