Aortic valve disease is a prevalent disorder that affects approximately 2% of the general adult population. Surgical aortic valve replacement is the gold standard treatment for symptomatic patients. This treatment has...Aortic valve disease is a prevalent disorder that affects approximately 2% of the general adult population. Surgical aortic valve replacement is the gold standard treatment for symptomatic patients. This treatment has demonstrably proven to be both safe and effective. Over the last few decades, in an attempt to reduce surgical trauma, different minimally invasive approaches for aortic valve replacement have been developed and are now being increasingly utilized. A narrative review of the literature was carried out to describe the surgical techniques for minimally invasive aortic valve surgery and report the results from different experienced centers. Minimally invasive aortic valve replace- ment is associated with low perioperative morbidity, mortality and a low conversion rate to full sternotomy. Long-term survival appears to be at least comparable to that reported for conventional full sternotomy. Minimally invasive aortic valve surgery, either with a partial upper stemotomy or a right anterior minithoracotomy provides early- and long-term benefits. Given these benefits, it may be considered the standard of care for isolated aortic valve disease.展开更多
Background and Aim: The Button technique was the operative technique generally used for the reimplantation of coro- nary arteries in the aortic root replacement because of reduced anastomotic complications respect to ...Background and Aim: The Button technique was the operative technique generally used for the reimplantation of coro- nary arteries in the aortic root replacement because of reduced anastomotic complications respect to the original wrapped operation described by Bentall and De Bono. The “Button Inside” technique is a modified Button technique recently performed in all consecutive series of patients operated on aortic root replacement at our Institution. In this study we report early postoperative angiographic results of patients operated on aortic root replacement using the “But- ton Inside” technique. Methods: Magnetic Resonance Imaging angiography was achieved in all patients operated on aortic root replacement. Morphological characteristics of the site of coronary buttons reattachment were accurately evaluated. Results: No postoperative anastomotic leakages were detected at the site of coronary buttons anastomosis. Moreover, in this first series of postoperative control aneurisms of coronary buttons were not detected. Conclusions: Early postoperative non-invasive angiographic results of the “Button Inside” technique are encouraging. This surgical approach for the reattachment of coronary arteries is suggested in aortic root replacement when is possible to mobilize coronary arteries in order to reduce coronary artery anastomotic complications.展开更多
Aims: Secondary cardiac tumours are rare conditions, often difficult to suspect. We aim to describe the diagnostic potential of transthoracic and transesophageal echocardiography in this field, and to discuss their re...Aims: Secondary cardiac tumours are rare conditions, often difficult to suspect. We aim to describe the diagnostic potential of transthoracic and transesophageal echocardiography in this field, and to discuss their reliability as modalities of choice for preoperative diagnosis. Methods and Results: We used several complementary diagnostic approaches: Color-Doppler transthoracic echocardiography, transesophageal echocardiography, regional myocardial perfusion test and three-dimensional transthoracic echocardiography. The latter was employed to confirm the previously performed tests. All tests revealed the presence of an echogenic, oval-shaped and well-delimited mass in the basal part of intervenetricular septum. Conclusion: Even though it was initially asymptomatic and characterized by scarce clinical manifestations, the intra-cardiac mass was reliably identified in this patient by means of the cited diagnostic modalities, which also allowed adequate surgical planning. The immunohistochemical examination revealed the secondary nature of this tumour. Basic and advanced echocardiography examinations were crucial in the decision-making process.展开更多
The Tako-Tsubo syndrome is a rare yet recognized condition characterized by acute but rapidly reversible left ventricular dysfunction in absence of obstructive coronary artery stenosis. Although several factors have b...The Tako-Tsubo syndrome is a rare yet recognized condition characterized by acute but rapidly reversible left ventricular dysfunction in absence of obstructive coronary artery stenosis. Although several factors have been associated with the development of this syndrome, still its etiology remains undefined. We report the case of a 51-years-old woman presenting with dyspnea in whom the diagnosis of Tako-Tsubo syndrome was posed. We describe the diagnostic modalities and the clinical outcome of the patient. Secondly, the present paper is aimed at providing a review of the current evidence over this topic and at proposing future research directions.展开更多
文摘Aortic valve disease is a prevalent disorder that affects approximately 2% of the general adult population. Surgical aortic valve replacement is the gold standard treatment for symptomatic patients. This treatment has demonstrably proven to be both safe and effective. Over the last few decades, in an attempt to reduce surgical trauma, different minimally invasive approaches for aortic valve replacement have been developed and are now being increasingly utilized. A narrative review of the literature was carried out to describe the surgical techniques for minimally invasive aortic valve surgery and report the results from different experienced centers. Minimally invasive aortic valve replace- ment is associated with low perioperative morbidity, mortality and a low conversion rate to full sternotomy. Long-term survival appears to be at least comparable to that reported for conventional full sternotomy. Minimally invasive aortic valve surgery, either with a partial upper stemotomy or a right anterior minithoracotomy provides early- and long-term benefits. Given these benefits, it may be considered the standard of care for isolated aortic valve disease.
文摘Background and Aim: The Button technique was the operative technique generally used for the reimplantation of coro- nary arteries in the aortic root replacement because of reduced anastomotic complications respect to the original wrapped operation described by Bentall and De Bono. The “Button Inside” technique is a modified Button technique recently performed in all consecutive series of patients operated on aortic root replacement at our Institution. In this study we report early postoperative angiographic results of patients operated on aortic root replacement using the “But- ton Inside” technique. Methods: Magnetic Resonance Imaging angiography was achieved in all patients operated on aortic root replacement. Morphological characteristics of the site of coronary buttons reattachment were accurately evaluated. Results: No postoperative anastomotic leakages were detected at the site of coronary buttons anastomosis. Moreover, in this first series of postoperative control aneurisms of coronary buttons were not detected. Conclusions: Early postoperative non-invasive angiographic results of the “Button Inside” technique are encouraging. This surgical approach for the reattachment of coronary arteries is suggested in aortic root replacement when is possible to mobilize coronary arteries in order to reduce coronary artery anastomotic complications.
文摘Aims: Secondary cardiac tumours are rare conditions, often difficult to suspect. We aim to describe the diagnostic potential of transthoracic and transesophageal echocardiography in this field, and to discuss their reliability as modalities of choice for preoperative diagnosis. Methods and Results: We used several complementary diagnostic approaches: Color-Doppler transthoracic echocardiography, transesophageal echocardiography, regional myocardial perfusion test and three-dimensional transthoracic echocardiography. The latter was employed to confirm the previously performed tests. All tests revealed the presence of an echogenic, oval-shaped and well-delimited mass in the basal part of intervenetricular septum. Conclusion: Even though it was initially asymptomatic and characterized by scarce clinical manifestations, the intra-cardiac mass was reliably identified in this patient by means of the cited diagnostic modalities, which also allowed adequate surgical planning. The immunohistochemical examination revealed the secondary nature of this tumour. Basic and advanced echocardiography examinations were crucial in the decision-making process.
文摘The Tako-Tsubo syndrome is a rare yet recognized condition characterized by acute but rapidly reversible left ventricular dysfunction in absence of obstructive coronary artery stenosis. Although several factors have been associated with the development of this syndrome, still its etiology remains undefined. We report the case of a 51-years-old woman presenting with dyspnea in whom the diagnosis of Tako-Tsubo syndrome was posed. We describe the diagnostic modalities and the clinical outcome of the patient. Secondly, the present paper is aimed at providing a review of the current evidence over this topic and at proposing future research directions.
