0000000000054894

AUTHOR

Sebastiano Castrovinci

showing 12 related works from this author

Surgical management of moderate ischemic mitral valve regurgitation: Where do we stand?

2014

Ischemic mitral regurgitation (IMR) represents a common complication after myocardial infarction. The valve is anatomically normal and the incompetence is the result of papillary muscles displacement and annular dilatation, causing leaflets tethering. Functionally the leaflets present a restricted systolic motion due to tethering forces that displaces the coaptation surface toward the left ventricle apex. The patients present poor left ventricular function at the time of surgery and the severity of the mitral regurgitation increases the risk of mortality. Currently there is general agreement to treat surgically severe IMR nevertheless strong evidences for patient with moderate insufficiency…

medicine.medical_specialtyCardiologyValveMitralInternal medicinemedicineRisk of mortalitycardiovascular diseasesMyocardial infarctionPapillary muscleMitral regurgitationbusiness.industryMinireviewsmedicine.diseaseSurgerymedicine.anatomical_structureVentricleEchocardiographyCardiologySurgeryAnatomyCardiology and Cardiovascular MedicinebusinessMitral valve regurgitationComplicationArtery
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Papillary muscle relocation and mitral annuloplasty in ischemic mitral valve regurgitation: midterm results.

2014

Objectives The surgical approach for ischemic mitral regurgitation remains unclear. Many studies are in favor of adding the subvalvular procedure to mitral annuloplasty to reduce recurrent mitral regurgitation. This study reports the clinical and echocardiographic outcomes of papillary muscle relocation combined with mitral annuloplasty.Methods From 2003, 115 patients with severe ischemic mitral regurgitation who underwent papillary muscle relocation plus nonrestrictive mitral annuloplasty and coronary artery bypass grafting were retrospective analyzed. Patients' mean age was 52 ± 12.8 years, New York Heart Association class III or IV was 71%, and preoperative left ventricular ejection frac…

Pulmonary and Respiratory MedicineAdultMalemedicine.medical_specialtyMitral Valve AnnuloplastyTime FactorsTime FactorMyocardial IschemiaPapillary MuscleSeverity of Illness IndexDisease-Free SurvivalVentricular Function LeftPostoperative ComplicationsRecurrenceRisk FactorsMitral valve annuloplastyInternal medicineMitral valveMedicineHumanscardiovascular diseasesVentricular remodelingPapillary muscleMitral regurgitationEjection fractionVentricular Remodelingbusiness.industryRisk FactorMedicine (all)Mitral Valve InsufficiencyMiddle AgedPapillary Musclesmedicine.diseaseSurgerymedicine.anatomical_structureTreatment OutcomeCardiologycardiovascular systemMitral ValveSurgeryFemalePostoperative ComplicationCardiology and Cardiovascular MedicinebusinessMitral valve regurgitationHumanArteryThe Journal of thoracic and cardiovascular surgery
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Outcomes of aortic valve repair according to valve morphology and surgical techniques

2012

OBJECTIVES: The aim of this study was to assess the impact of aortic valve morphology and different surgical aortic valve repair techni- ques on long-term clinical outcomes. METHODS: Between February 2003 and May 2010, 216 patients with aortic insufficiency underwent aortic valve repair in our institu- tion. Ages ranged between 26 and 82 years (mean 53 ± 15 years). Aortic valve dysfunctions, according to functional classification, were: type I in 55 patients (25.5%), type II in 126 (58.3%) and type III in 35 (16.2%). Sixty-six patients (27.7%) had a bicuspid valve. Aortic valve repair techniques included sub-commissural plasty in 138 patients, plication in 84, free-edge reinforcement in 80,…

Aortic valveMaleTime Factorsmedicine.medical_treatmentKaplan-Meier EstimateAortic valve repairRecurrenceRisk FactorsMitral valve80 and overHospital MortalityCoronary Artery BypassAortaUltrasonographyAged 80 and overTricuspid valveCalcinosisCardiac Valve AnnuloplastyMiddle AgedAortic valve repair • Bicuspid aortic valve • Tricuspid aortic valve • Aortic annulus stabilization medicine.anatomical_structureTreatment OutcomeAortic ValveReplantationcardiovascular systemCardiologyChordae TendineaeMitral ValveFemaleChordae tendineaeCardiology and Cardiovascular MedicineAdult; Aged; Aged 80 and over; Aorta; Aortic Valve; Aortic Valve Insufficiency; Blood Vessel Prosthesis Implantation; Calcinosis; Chordae Tendineae; Coronary Artery Bypass; Disease-Free Survival; Female; Hospital Mortality; Humans; Kaplan-Meier Estimate; Male; Middle Aged; Mitral Valve; Proportional Hazards Models; Recurrence; Replantation; Risk Assessment; Risk Factors; Time Factors; Treatment Outcome; Ultrasonography; Cardiac Valve Annuloplasty; Suture TechniquesPulmonary and Respiratory MedicineAdultmedicine.medical_specialtyAortic Valve InsufficiencyRisk AssessmentCardiac Valve AnnuloplastyDisease-Free SurvivalBlood Vessel Prosthesis ImplantationBicuspid valveInternal medicinemedicineHumansAgedProportional Hazards ModelsMitral valve repairbusiness.industrySuture TechniquesSettore MED/23 - Chirurgia CardiacaOriginal ArticlesSurgerySurgerybusiness
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Papillary muscle relocation in conjunction with valve annuloplasty improve repair results in severe ischemic mitral regurgitation

2012

OBJECTIVE: The incidence of recurrent mitral regurgitation (MR) after restrictive annuloplasty (RA) was 5% to 20% in several reports. There are many opinions in favor of adding subvalvular procedures to RA to reduce the tenting forces and improve the repair results. METHODS: From March 2003 to May 2010, 55 patients with severe ischemic MR who had undergone papillary muscle (PPM) relocation in conjunction with mitral annuloplasty in our institutions were enrolled. The patients were matched 1:1 with those who underwent isolated RA using the propensity score. The mean left ventricular ejection fraction was 42% ± 6%. The mean tenting area and coaptation depth was 3.2 ± 0.6 cm(2) and 1.3 ± 0.2 c…

MaleTime FactorsMitral Valve AnnuloplastyLeftMyocardial IschemiaKaplan-Meier EstimateSeverity of Illness IndexVentricular Function LeftPapillary muscle annuloplasty mitral regurgitationPostoperative ComplicationsRisk FactorsMitral valve annuloplastyAged; Chi-Square Distribution; Disease-Free Survival; Female; Hospital Mortality; Humans; Italy; Kaplan-Meier Estimate; Logistic Models; Male; Matched-Pair Analysis; Middle Aged; Mitral Valve Insufficiency; Myocardial Ischemia; Papillary Muscles; Postoperative Complications; Propensity Score; Proportional Hazards Models; Risk Assessment; Risk Factors; Secondary Prevention; Severity of Illness Index; Stroke Volume; Time Factors; Treatment Outcome; Ventricular Function Left; Mitral Valve AnnuloplastySecondary PreventionClinical endpointVentricular FunctionHospital MortalityMyocardial infarctionEjection fractionIncidence (epidemiology)Mitral Valve InsufficiencyMiddle AgedPapillary MusclesTreatment Outcomemedicine.anatomical_structureItalyCardiologyFemaleCardiology and Cardiovascular MedicinePulmonary and Respiratory Medicinemedicine.medical_specialtyMatched-Pair AnalysisRisk AssessmentDisease-Free SurvivalInternal medicinemedicineHumansPropensity ScorePapillary muscleAgedProportional Hazards ModelsMitral regurgitationChi-Square Distributionbusiness.industryStroke VolumeSettore MED/23 - Chirurgia Cardiacamedicine.diseaseSurgeryLogistic ModelsPropensity score matchingSurgerybusiness
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Mid-term results of bicuspid aortic valve repair guided by morphology and function assessment.

2016

Bicuspid aortic valve (BAV) is frequently associated with aortic insufficiency (AI) due to cusp disease and/or aortic root dilatation. Based on functional classification and morphology, a systematic surgical approach was used for aortic valve repair (AVr).From 2004 to 2014, 152 consecutive patients (mean age 55 ± 7 years) with BAV underwent AVr with or without concomitant aortic root surgery. Cusp pathology was treated with central plication in 60 (39.5%) patients, free edge reinforcement in 45 (29.6%), triangular resection in 28 (18.4%) and pericardial patch in 19 (12.5%). Aortic root dilatation was corrected with valve sparing reimplantation in 65 patients. Mean follow-up was 68 ± 36 mont…

Pulmonary and Respiratory MedicineAortic valveMalemedicine.medical_specialtyTime FactorsHeart VentriclesMid term resultsHeart Valve DiseasesAortic root dilatation030204 cardiovascular system & hematologyPreoperative careVentricular Function Left03 medical and health sciences0302 clinical medicineAortic valve repairBicuspid aortic valvePostoperative ComplicationsBicuspid Aortic Valve DiseaseRecurrenceInternal medicineMedicineHumansHospital MortalityRetrospective StudiesPericardial patchbusiness.industryIncidenceMiddle Agedmedicine.diseaseSurvival Ratemedicine.anatomical_structureTreatment Outcome030228 respiratory systemItalyEchocardiographyConcomitantAortic Valvecardiovascular systemCardiologySurgeryFemaleCardiology and Cardiovascular MedicinebusinessFollow-Up StudiesInteractive cardiovascular and thoracic surgery
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A Comparison of 2 Mitral Annuloplasty Rings for Severe Ischemic Mitral Regurgitation: Clinical and Echocardiographic Outcomes.

2016

Controversies regarding the choice of annuloplasty rings for treatment of ischemic mitral regurgitation still exist. Aim of the study is to compare early performance of 2 different rings in terms of rest and exercise echocardiographic parameters (transmitral gradient, systolic pulmonary artery pressure, and mitral valve area), clinical outcomes, and recurrence of mitral regurgitation. From January 2008 till December 2013, prospectively collected data of patients who underwent coronary artery bypass grafting and undersizing mitral valve annuloplasty for severe chronic ischemic mitral regurgitation at our Institution were reviewed. A total of 93 patients were identified; among them 44 had sem…

MaleMitral Valve AnnuloplastyTime FactorsMyocardial IschemiaHemodynamics030204 cardiovascular system & hematologySeverity of Illness IndexVentricular Function Left0302 clinical medicinePostoperative ComplicationsRecurrenceMitral valve annuloplastyMitral valve030212 general & internal medicineHospital MortalityHeart Valve Prosthesis ImplantationExercise ToleranceIschemic mitral regurgitationMitral Valve InsufficiencyGeneral MedicineMiddle Agedmedicine.anatomical_structureTreatment OutcomeItalyHeart Valve ProsthesisCardiologyMitral ValveFemaleCardiology and Cardiovascular MedicineArteryEchocardiography StressPulmonary and Respiratory Medicinemedicine.medical_specialtyProsthesis Design03 medical and health sciencesInternal medicinemedicine.arterymedicineHumansMitral AnnuloplastyAgedRetrospective StudiesMitral regurgitationbusiness.industryRecovery of FunctionSurgeryPulmonary arteryChronic DiseaseExercise TestSurgerybusinessSeminars in thoracic and cardiovascular surgery
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Functional annulus remodelling using a prosthetic ring in tricuspid aortic valve repair: mid-term results

2013

OBJECTIVES: The functional aortic valve annulus (FAVA) is a complex unit with proximal (aorto-ventricular junction) and distal (sinotubular junction) components. The aim of our study was to evaluate the impact of the total FAVA remodelling, using a prosthetic ring, on mid-term clinical and echocardiographic-RESULTS:-after aortic valve repair. METHODS: Since February 2003, 250 patients with tricuspid aortic valve insufficiency (AI) underwent aortic valve repair. FAVA dilatation was treated by prosthetic ring in 52 patients, by isolated subcommissural plasty in 62, by subcommissural plasty plus ascending aortic replacement in 57 and by David's reimplantation procedure in 79. Survival rate and…

MaleAortic valveTime Factorsmedicine.medical_treatmentKaplan-Meier EstimateAortic valve repairRisk FactorsRecurrenceAortic Valve AnnulusAortic valveHospital MortalityUltrasonographyAged 80 and overHeart Valve Prosthesis ImplantationAnnulus (mycology)Sinotubular JunctionMiddle AgedCardiac Valve AnnuloplastyTreatment Outcomemedicine.anatomical_structureEchocardiographyHeart Valve ProsthesisReplantationReplantationcardiovascular systemCardiologyFemaleCardiology and Cardiovascular MedicineHumanAdultHeart Defects CongenitalPulmonary and Respiratory Medicinemedicine.medical_specialtyTime FactorAortic Valve InsufficiencyProsthesis DesignCardiac Valve AnnuloplastyDisease-Free SurvivalRisk analysiInternal medicinemedicineHumansSurvival rateStatisticAgedbusiness.industryPatient SelectionRisk FactorSettore MED/23 - Chirurgia CardiacaOriginal ArticlesSurgeryHeart Valve ProsthesiSurgerybusinessRepairInteractive CardioVascular and Thoracic Surgery
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Relocation of Papillary Muscles for Ischemic Mitral Valve Regurgitation

2014

Objective The assessment of the mitral valve apparatus (MVA) and its modifications during ischemic mitral regurgitation (IMR) is better performed by three-dimensional (3D) transesophageal echocardiography (TEE). The aim of our study was to carry out nonrestrictive mitral annuloplasty in addition to relocation of papillary muscles (PPMs) oriented by preoperative real-time 3D TEE through the mitral valve quantification dedicated software. Methods Since January 2008, a total of 70 patients with severe IMR were examined both before and after mitral valve repair. The mean (SD) coaptation depth and the mean (SD) tenting area were 1.4 (0.4) cm and 3.2 (0.5) cm2, respectively. Intraoperative 3D TEE…

MalePulmonary and Respiratory Medicinemedicine.medical_specialtyMitral Valve AnnuloplastyMyocardial ischemiamedicine.medical_treatmentTreatment outcomeMyocardial IschemiaEchocardiography Three-DimensionalThree-dimensional echocardiographyPapillary MuscleIschemic mitral valve regurgitationIntraoperative PeriodRetrospective StudieInternal medicineMitral valveMitral valve annuloplastymedicineHumansRetrospective StudiesAgedMitral valve repairIschemic mitral regurgitationbusiness.industryMitral Valve InsufficiencyGeneral MedicinePapillary Musclesmedicine.diseaseFeasibility StudieTreatment Outcomemedicine.anatomical_structureCardiologyFeasibility StudiesFemaleSurgeryIntraoperative PeriodbusinessMitral valve regurgitationCardiology and Cardiovascular MedicineMitral valve repairEchocardiography TransesophagealHumanInnovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
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Multiplane Two-Dimensional versus Real Time Three-Dimensional Transesophageal Echocardiography in Ischemic Mitral Regurgitation

2011

Objectives: Intraoperative three-dimensional (3D) transesophageal echocardiography (TEE) has been suggested to be a valuable technique for the evaluation of the mechanisms of ischemic mitral regurgitation (IMR). Studies comparing multiplane two-dimensional (2D) with 3D TEE reconstruction of the mitral valve using the new mitral valve quantification (MVQ) software are lacking. We undertook a prospective comparison between multiplane 2D and 3D TEE for the assessment of IMR. Methods: We evaluated echocardiographically 45 patients with IMR who underwent mitral valve surgery in our institution. 2D and 3D TEE examinations followed by a 3D offline assessment of the mitral valve apparatus were perf…

medicine.medical_specialtyIschemic mitral regurgitationbusiness.industryReal time 3d echocardiographymedicine.anatomical_structureMitral valveInternal medicinecardiovascular systemmedicineCardiologyOffline analysisRadiology Nuclear Medicine and imagingcardiovascular diseasesMitral annulusRadiologyCardiology and Cardiovascular Medicinebusinesshuman activitiesPapillary muscleMitral valve surgeryEchocardiography
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Mitral valve annuloplasty and papillary muscle relocation oriented by 3-dimensional transesophageal echocardiography for severe functional mitral reg…

2012

Objective The study of the mitral valve apparatus and its modifications during functional mitral regurgitation (FMR) is better revealed by 3-dimensional (3D) transesophageal echocardiography (TOE). To plan mitral valve repair by annuloplasty and papillary muscle (PPM) relocation, we proposed a valve repair procedure oriented by the new main features obtained by real-time 3D TOE reconstruction of the mitral valve apparatus. Methods Since January 2008, 25 patients with severe FMR before mitral valve repair were examined. Mean coaptation depth and mean tenting area were 1.3 ± 0.2 cm and 3.2 ± 0.5 cm 2 , respectively. Intraoperative 2D and 3D TOE were performed, followed by a 3D offline reconst…

Pulmonary and Respiratory Medicinemedicine.medical_specialtyMitral Valve Annuloplastymedicine.medical_treatmentEchocardiography Three-DimensionalSeverity of Illness Index3 dimensional transesophageal echocardiographyBlood Vessel Prosthesis ImplantationPredictive Value of TestsMitral valve annuloplastyInternal medicineMitral valveImage Interpretation Computer-AssistedMedicineHumansFunctional mitral regurgitationPapillary muscleAgedMitral valve repairMitral regurgitationbusiness.industryRing annuloplastyMitral Valve InsufficiencySettore MED/23 - Chirurgia CardiacaMiddle AgedPapillary Musclesmedicine.anatomical_structureTreatment OutcomeMitral valve annuloplastyItalycardiovascular systemCardiologyMitral ValveSurgeryCardiology and Cardiovascular MedicinebusinessEchocardiography TransesophagealThe Journal of thoracic and cardiovascular surgery
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Aortic stenosis: insights on pathogenesis and clinical implications

2016

Aortic stenosis (AS) is a common valvular heart disease in the Western populations, with an estimated overall prevalence of 3% in adults over 75 years. To understand its patho-biological processes represents a priority. In elderly patients, AS usually involves trileaflet valves and is referred to as degenerative calcific processes. Scientific evidence suggests the involvement of an active "atherosclerosis-like" pathogenesis in the initiation phase of degenerative AS. To the contrary, the progression could be driven by different forces (such as mechanical stress, genetic factors and interaction between inflammation and calcification). The improved understanding presents potentially new thera…

Degenerative aortic stenosisThe elderlyPathogenesiSymposium: Transcatheter aortic valve implantationAtherosclerosiClinical implicationsPathogenesisDegenerative aortic stenosiAtherosclerosisClinical implication
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Aortic valve stenosis: Treatments options in elderly high-risk patients

2016

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Elderly patientsTranscatheter aortic valve implantationMinimaly invasive surgerySymposium: Transcatheter aortic valve implantationAortic valve stenosiAortic valve stenosis; Elderly patients; Minimaly invasive surgery; Risck stratification; Transcatheter aortic valve implantation; Cardiology and Cardiovascular Medicine; Geriatrics and GerontologyAortic valve stenosisGeriatrics and GerontologyRisck stratificationCardiology and Cardiovascular MedicineElderly patient
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