bluuebunny/crossref_metadata_2025 huggingface dataset:
GERAKAN SOSIAL KAUM PEREMPUAN MELAWAN EUPHORIA MEDIA MELALUI KOMUNITAS HIJABERS DI KOTA SURAKARTA
Authors: Fibrianto Alan Sigit , Bakhri Syamsul
Published: November 2018

ABSTRAKGerakan kaum muda yang dulunya dilarang oleh era orde baru, kini telah menjamur dan keberadaannya kian beragam, bahkan saat ini banyak gerakan-gerakan baru yang mengatasnamakan gerakannya dengan simbol-simbol agama. Penelitian ini menggunakan konsep teori Komunitas Sosial, Identitas Sosial, Gerakan Sosial, dan Ekofeminisme. Penelitian ini menggunakan metode penelitian kualitatif dengan pendekatan studi kasus. Hasil dari penelitian ini dibagi menjadi dua kategori pembahasan, pertama, komunitas hijabers sebagai pembentuk identitas sosial, dan kedua, komunitas hijabers sebagai ideologi gerakan sosial kaum perempuan melawan euphoria media. Kedua bagian tersebut menjawab permasalahan kaum perempuan dalam hal eksistensi hijab untuk melawan euphoria media yang akhir-akhir ini banyak menyoroti fenomena-fenomena penggunaan jilbab di Indonesia yang masih memperlihatkan lekuk tubuh perempuan. Maka dari itu, kehadiran komunitas hijabers sebagai pengawal dalam penggunaan hijab bagi kaum perempuan muslim yang sesuai dengan syariat Islam. Selain itu juga sebagai ajang silaturahim dan saling berbagi pengalaman dan pengetahuan agama Islam.
EVALUASI PERANGKAT LUNAK APLIKASI SHIPMENT TRACKING PADA TINGKAT PENERIMAAN PENGGUNA AKHIR
Authors: Pamuji Agus , Hartuti Purni Munah
Published: November 2018

Saat ini teknologi perangkat lunak mengalami perubahan dimulai dari perancangan, uji coba, implementasi sampai pada akhir yaitu evaluasi. Kondisi ini juga diikuti dengan tuntutan kualitas perangkat lunak yang di hasilkan oleh beberapa perusahaan pengembang. Khususnya dalam mengevaluasi perangkat lunak dalam faktor penggunaan yang di uji pada sisi eksternal yang dilakukan oleh pengguna. Studi kasus ini dilakukan untuk mengetahui faktor-faktor yang dapat mempengaruhi penggunaan aplikasi pelacakan barang. Evaluasi kasus ini dilakukan secara empirik dengan menggunakan model penerimaan teknologi yang dimodifikasi. Model ini melibatkan tujuh konstruk parameter sebagai metrik uji untuk mengukur tingkat penggunaan bersamaan dengan hipotesis yang diusulkan. Selain itu, perolehan data berasal dari 120 responden yang tersebar diwilayah Jabodetabek. Hasil Akhir menunjukan bahwa model yang diusulkan memberikan penjelasan hampir semua konstrak dan hipotesi memiliki nilai positif. Nilai tersebut mengindikasikan bahwa aplikasi pelacakan pengiriman barang dipengaruhi secara kuat oleh faktor kemudahan dan nilai kegunaan aplikasi yang bermula dari rasa percaya, kepuasan, serta norma subjektif.
Keterlibatan Kaum Bangsawan dalam Pemilihan Kepala Daerah (Pilkada) di Kabupaten Pinrang Provinsi Sulawesi Selatan
Authors: M. Tahir Muchlas , Razak FitrianiSari Handayani , Nahruddin. Zulfan
Published: November 2018

Pilkada became a space that presents the elite of the community, but behind the contestation of the phenomenon is quite interesting when people are faced with a dilemma where the elite who compete are the descendants of nobility.This study used a qualitative approach to explainingd main problems discussed by descriptive method. The fact is Strang Bugis society community, always have a desire to domination power and not hesitate to mutually contest between the group. The fact that Andi's group who contested in the arena of elections is inseparable from these three things: First, the building construction of the Andi's behavior in the society structure becomes the determinant to get the voters sympathy. Second, look at the capital in the Andis as a means to contest the winner, the capital's most powerful capital and also in the sense of being. Third, the habitus and capital will affect Andi's victory in which the arena of Pilkada as a container or to play the habitus and capital. These three things became the determinant of the winning process of the actor who was contesting in the arena of elections.
Sector and Country Balance of Trade Analysis Based on World Input-Output Database: Indonesian Economy
Authors: Muchdie Muchdie , Ulza Emaridial , Setiawan Edi
Published: November 2018

This paper analyses trade balance in Indonesian economy by using Indonesia input-output tables for the year 2000, 2005, 2010 and 2014. The results showed that, firstly, Indonesian export had been increased significantly during the year of study. Secondly, Indonesian import had also increased significantly during the year of study. Important sectors and countries’ trade partners of export and import had been indicated. Thirdly, trade balances in Indonesia economy were surpluses in all years of the study. Sectors and countries in which trade balances were deficits and surpluses had also been clearly indicated.
Konsep Kesatuan Iman, Iptek dan Amal Menuju Terbentuknya Insan Kamil dalam Perspektif Pendidikan Islam
Authors: Ainiyah Qurrotul , Karsiyah Karsiyah
Published: November 2018

In addition to the physical and spiritual goals, Islamic education also observe the purpose of reason. This aspect of purpose rests on the development of an intelligence within the brain. So, capable to understand and analyze the phenomena of God's creation in this universe. The formation of Insan Kamil in the Islamic Education Perspective is: If the reason works optimally, its intuition is functional, able to create culture, adorns it self with divinity, morality, and balanced spirit. While the concept of Faith, Science and charity are: Faith is the embodiment of Tawakkal, Introspective and be scientific, optimistic and consistent and keep the promise. Science and technology in Islam is as human needs in order to achieve prosperity of life in the world in order to provide ease in improving ubudiyah to Allah, then an act can be judged as a charity is if done with sincere selfless sincerity in humans and in accordance with the guidance of the Qur'an and Hadith. The concept of Faith, Science and Charity to the formation of Insan Kamil in Islamic Education Perspective is: Intellect functioning optimally and able to create culture is part of human character kamil which is manifestation (embodiment) of science applying values in human life, Himself with the nature of divinity and intuition that function is a manifestation of the value of human faith, noble and balanced spirit is a manifestation of human amaliyah during the world.
Pandangan Hidup Etnis Madura dalam Kèjhung Paparèghân
Authors: Murti Fitri Nura
Published: November 2018

Literary works comes as a reaction of the human experience to life. Through literature, we can see the spirit and way of life of a community culture. View of life is the concept of a person or a particular social group in society that intends to respond and explain all the problems facing the people of this world. Kèjhung paparèghân is one of the classic forms of oral literature that is now quite rare. Kèjhung paparèghân form like a song or poem rhyme shaped madura rhythm typical of Madura ethnic communities. Kèjhung paparèghân hereditary preserved from generation to generation orally. That's why kèjhung paparèghân including oral folklore literature. The analysis in this study used discourse analysis with data sources show ludruk in Jember. From the analysis, kèjhung paparèghân contain moral values that reflect the views of ethnic Madurese living. The conclusions of this analysis is the view of life Madurese community can not be separated from religious values of Islam. Their adherence to Islam become an important identity for the Madurese. Madurese communities have the view that life is "worship".
Analisis Konsep Kompetensi Kepribadian Guru PAI menurut Az-Zarnuji
Authors: Ma'arif Muhammad Anas
Published: November 2018

PAI teacher personality competence is one of the factors that make the success and failure of educational activities therefore educators must develop their personality competencies in order to become tauladan learners. For that personality competence that existed in the book ta`limul muta`allim work of Imam az-Zarnuji should be realized by educators today such as, seriously, keep ablution and istiqomah night prayer. Thus this study aims to analyze the personality competence of teachers PAI more depth in order to be used as a reference of teachers today.
Scientific Approach in Imparting Islamic Values In Early Childhood (A case study in Raudatul Town of Baubau Aisyiyah Athfal)
Authors: Kurniati Asma , Slamet Agus
Published: November 2018

This study aims to describe the planting of Islamic values through a scientific approach in early childhood.  This research was descriptive with qualitative research belongs to the type of case studies conducted in Raudatu Aisyiyah Athfal kelurahan, kecamatan Wale Wolio languages City Baubau, Southeast Sulawesi. Aspects that are studied are internalizing the values of islam to cultivate gratitude as a creature of God's creation and care for the environment, through the stages of scientific approaches, namely: to observe, ask yourself, menalar, try, and communicate. Researchers acted as a means of collecting the data, and using the tools in the form of guidelines for observation and interview guidelines are summarized in the form of the note field and tools documentation. The results showed that the cultivation of the values of islam through a scientific approach in early childhood can be done by providing knowledge and experience in early childhood, beginning with shows the power of the Almighty God who created living things, cultivate a sense of gratitude for existence and benefits of the creatures of his creation, as well as how to treat the creature creation.
PREVISÃO DE DEMANDA POR MEIO DO MÉTODO DE SIMULAÇÃO DE MONTE CARLO EM UMA LOJA DE CONVENIÊNCIA
Authors: Da Silva Everaldo  Francisco , Rodrigues Leandro Souza , Damasceno Luís Fernando F.
Published: November 2018

Este artigo tem por objetivo apresentar a aplicação da Simulação de Monte Carlo para prever a demanda dos quatro produtos de maior representatividade no faturamento anual em uma loja de conveniência. A Simulação por Monte Carlo pode ser definida como uma técnica que envolve a aplicação de números aleatórios e analises probabilísticas para resolver problemas. A previsão de demanda para os produtos confirmou que o método de monte Carlo é uma técnica eficiente para projeções de demandas por apresenta baixas variações entre demanda real e projetada. Pode-se perceber que os dados se mostraram confiáveis, uma vez que eles estão próximos dos valores reais. Pode-se classificar essa pesquisa como quantitativo e exploratório pela relevância apresentada à definição das variáveis, ao criar modelagens matemáticas com os dados de vendas para projetar a demanda.
OC78 THE ROLE OF CORONARY SINUS-SPARING TECHNIQUE FOR TREATMENT OF AORTIC ROOT ANEURYSM IN PATIENTS WITH BICUSPID AORTIC VALVE: PRELIMINARY LONG-TERM FOLLOW UP RESULTS
Authors: Pradegan N. , Azzolina D. , Fusca S. , Besola L. , Fabozzo A. , Rubino M. , Testolin L. , Bianco R. , Gerosa G.
Published: November 2018

Background and Aim:

to analyze late outcomes and fate of aortic root in patients with bicuspid aortic valve with antero-posterior orientation (BAV-AP) and aortic dilation undergoing ascending aorta replacement extended to the non-coronary sinus (NCS) (coronary-sinus sparing technique).

Methods:

clinical and echocardiographic data of patients with BAV-AP scheduled for ascending aorta and root aneurysm repair and undergone ascending aorta replacement with coronary sinus-sparing technique at a single Center between 2000 and 2013 were retrospectively reviewed. Patients undergone redo operations or emergent surgery were excluded.

Results:

69 patients (males n = 63, median age 66 years, IQ range 48–66) underwent coronary-sinus sparing technique: 50 (72%) required associated aortic valve replacement. There were no hospital deaths. Only 1 major postoperative bleeding requiring reintervention happened. At 15-years follow up (completeness 96%), 13 (19%) patients died, but only 4 (6%) due to cardiovascular deaths. Only 6 (9%) patients underwent cardiac reoperation (none for root dilation). No aortic dissections occurred. At follow up all patients are in good clinical status with only 7 (10%) patients with NYHA II-III. Echocardiographic analysis of available data showed significant reduction of root diameter after intervention, with slightly increase at follow up (Figure 1).

Conclusions:

coronary sinus-sparing technique with ascending aorta replacement extended to NCS in patients scheduled for aortic aneurysm repair with BAV-AP and asymmetrical root enlargement is a safe and low risk procedure, with good results in terms of late survival and freedom from root reintervention. This procedure reduces preoperative root diameter, granting nearly stable results at long-term follow up.
OC29 FROZEN ELEPHANT TRUNK TECHNIQUE IN AORTIC SURGERY: A SINGLE-CENTER EXPERIENCE
Authors: Leone A. , Coppola G. , Di Marco L. , Amodio C. , Murana G. , Mariani C. , Barberio G. , Pacini D. , Di Bartolomeo R.
Published: November 2018

Background and aim:

The Frozen Elephant Trunk (FET) is a well-known technique for the treatment of complex pathologies of the thoracic aorta. In the following years, the indications have been expanded also for chronic and acute aortic dissections. We report our experience with this technique.

Methods:

Between 2007 and 2018, a total of 273 consecutive patients underwent FET procedure. Main indications were: 58.2% chronic aortic dissections (A,B and residual A), 27.1% degenerative aneurysms and 14.7% acute aortic dissections (A and B) and 52.7% were redo. Mean age of the patients was 61.34 ± 11.1 years. Baseline cardiovascular risk factors and comorbidities were analysed along with intraoperative variables, to evaluate postoperative outcome.

Results:

The overall in-hospital mortality was 16.8%, the rate of paraplegia and stroke were 3.7% and 9.2% respectively. CPB time was 229 ± 70 min and visceral ischemia time was 55 ± 20 min. ASCP time was 93.40 ± 35 min. The CPB time is a risk factor for in-hospital mortality (p-value 0.010, OR:1.011, CI: 1. 003–1.019). Follow-up was complete at 98% of the patients. Mean follow-up time was 41.6 ± 36 months and the mortality was 16.1% with a rate of reoperation of 22.4% including 43 endoprosthesis implants (19%).

Conclusions:

The frozen elephant trunk showed satisfactory results and demonstrated to be a feasible solution for all complex pathology of thoracic aorta, in expert hands and in high volume centers. In selected cases, it allows to treat the entire thoracic aortic pathology in a single-surgical step.
OC40 MIDTERM RESULTS OF RANDOMIZED TRIAL OF TRICUSPID ANNULOPLASTY FOR LESS THAN SEVERE FUNCTIONAL TRICUSPID REGURGITATION AT THE TIME OF MITRAL VALVE SURGERY
Authors: Pettinari M. , Lazam S. , De Kerchove L. , Pasquet A. , Gerber B. , Vanoverschelde J. , El-Khoury G.
Published: November 2018

Objectives:

The optimal management of functional tricuspid regurgitation (FTR) in the setting of mitral valve operations remains controversial. A prospective randomized trial was performed to evaluate the worth of repairing moderate FTR during mitral valve operations.

Methods:

A single center randomized study was design to allocate patients with less than severe FTR undergoing mitral valve surgery to be prophylactically treated with (TVP+) or without (TVP-) tricuspid valve annuloplasty. Primary outcome was the recurrence of more than mild tricuspid regurgitation (TR)(Vena contracta >4 mm) and secondary outcome was VO2 max, right ventricle (RV) dimension and function measured by cardiac magnetic resonance (CMR).

Results:

Of the 103 consecutive patients enrolled, 51 (49.5%) were allocated in the TVP- group and 52 (50.5%) in the TVP+ group. At a median follow up was 3.1 years, TR > mild was observed in 13.7% (7/51) of patients in the TVP- and in 1.9% (1/52) of patients in the TVP- group (p = 0.05). VO2max (TVP- = 20.1 ± 7.6 vs TVP+ = 19 ± 7.8 ml/kg/min, p = 0.09) was similar. CMR confirms no difference in RV end-diastolic (TVP- = 157.05 ± 33.40 vs TVP+ = 149.5 ± 33.6 ml, p = 0.58), end-systolic volume (TVP- = 76.3 ± 23.2 vs TVP+ = 70.9 ± 21.7 ml, p = 0.55) and RV Ejection Fraction (TVP- = 51.97 ± 8.33 vs TVP+ = 53.26 ± 4.56%, p = 0.5).

Conclusion:

This single-center prospective randomized trial demonstrated that tricuspid annuloplasty at the time of mitral surgery reduce the incidence of moderate or severe FTR. Nevertheless, the functional capacity, the right ventricle function/dimension remain similar. The influence of the tricuspid annulus dimension has still to be validated and this sub-analysis is still in progress.
OC42 MINIMALLY INVASIVE MITRAL VALVE SURGERY IN HIGH-RISK PATIENTS: 12-YEAR SINGLE CENTRE EXPERIENCE
Authors: Stura E. Cura , Ricci D. , Marchetto G. , Barbero C. , Qarra S. El , Boffini M. , Rinaldi M.
Published: November 2018

Objective:

This study analyzed the results of 12-year experience with mini-invasive MV operations in high-risk patients.

Methods:

From 1/2006 to 2/2018, 153 patients with EuroSCORE ≥ 10 underwent minimally invasive MV surgery (13.0% of 1175): mean EuroSCORE was 12.0 ± 3.1 and Logistic was 30.7 ± 15.8, mean age was 73.6 ± 8.6, male were 32.7%. Comorbidities included: diabetes (23.5%), COPD (24.2%), chronic renal failure (28.1%), peripheral vasculopathy (16.3%), previous AMI (10.5%), neurological deficit (13.7%), active endocarditis (9.2%) and AF (63.4%). The mean EF was 50.7 ± 13.8 and 34.0% had pulmonary hypertension. In 71.2% had undergone previous cardiac surgery, in 11.1% were urgiences.

Results:

In 24.8% were mitral repair, associated procedures were TV procedures (20.3%) and AF-crioablation (5.3%). Mean cardiopulmonary and cross clamp time were respectively 133.8 ± 54.1 and 83.8 ± 28.5 minutes. The most utilized aortic clamp technique was endoreturn (58.8%). Conversions to sternotomy were 4.6%. Reoperation for bleeding occured in 11.8%. Postoperatively, in 2.6% were reported major neurologic complications, in 14% was necessary CVVH, in 5.2% PM implantation and in 6.5% tracheostomy. Mean, median intubation time, ICU and hospital stay were respectively 135.3 ± 833.9 (12)h, 9.7 ± 36.0 (2)days and 20.1 ± 39.1 (10)days. The 30-day mortality rate was 9.2%.

Conclusions:

mini-invasive approach allows acceptable morbidity and mortality in high-risk patients.
OC84 TRANSTHORACIC CLAMP AND ENDOAORTIC OCCLUSION FOR MINIMALLY INVASIVE CARDIAC SURGERY
Authors: Malvindi P.G. , Margari V. , Kounakis G. , Visicchio G. , Favale A. , Labriola C. , Carbone C. , Paparella D.
Published: November 2018

Background and Aim:

Two techniques of aortic occlusion have been used in small thoracotomy cardiac surgery: transthoracic clamp (TTC) and endoaortic balloon occlusion (EAO). Both techniques present peculiar advantages and limitations whose current evidences are based on observational studies. We report our experience comparing early outcomes of these two techniques.

Methods:

235 consecutive patients underwent minimally invasive cardiac surgery through right mini-thoracotomy from January 2013 to March 2018.One-hundred forty-two patients were operated on with TTC, in 93 cases EAO was used. Mean age was 60.1 ± 13.6, patients with TTC were significantly older (62.4 ± 12.4 TTC vs. 56.1 ± 14.5 EAO, p = 0.0002); reoperations were carried out mostly with EAO (2% TTC vs. 12% EAO, p = 0.005). No differences were detected between the two techniques in terms of types of operation, CPB and cardioplegic arrest times.

Results:

Similar values of postoperative Troponin I and CK-Mb were recorded. New neurologic deficit occurred in 6 patients, 2 temporary deficit in the TTC patients and 4 strokes in the EAO group (p = 0.048). There was no case of aortic dissection, no patient suffered peripheral ischaemia. Overall hospital mortality was 2.1%, 1.4% in TTC and 3.2% in EAO (p = 0.62); hospital mortality, excluding redo-operations was 1.4%, 1.4% in TTC and 1.2% in EAO (p = 0.98).

Conclusions:

Both TTC and EAO provided to be safe.A higher rate of cerebral stroke was observed in the EAO group. However, the use of endo-aortic balloon inflation system showed technical advantages in avoiding tissue dissection and aortic manipulations. It remains our choice in redo operations.
OC19 DETERMINANTS OF FUNCTIONAL CAPACITY AFTER RESTRICTIVE ANNULOPLASTY FOR ISCHEMIC MITRAL REGURGITATION
Authors: Tamagnini G. , Pettinari M. , Amoroso F. , Van Kerrebroeck C. , Dion R.A. , Gutermann H.
Published: November 2018

OBJECTIVE(S):

This study was designed to evaluate prevalence and determinants of reduced functional capacity, in patients who underwent restrictive mitral valve annuloplasty (RMA) for severe ischemic mitral regurgitation (IMR).

METHODS:

Between January 2008 and December 2015, 90 patients with severe ischemic mitral regurgitation underwent coronary artery bypass grafting and restrictive mitral valve annuloplasty. After a mean period of 3.5 +/- 2.4years, cardiopulmonary exercise testing (CPET) was performed to assess peak oxygen consumption (VO2 max).

RESULTS:

At five years, survival was 68.8+/-5.3%. The mean VO2 max was 17.4+/-4 ml/kg/min (76.3+/-2% of the age predicted) but varied widely (32% to 121% of predicted) and was markedly reduced (<80% of predicted) in 37 patients (63%). Linear regression identifiedkidney function (Creatinine clearance, p < 0.01), preoperative functional capacity (NYHA > 4, p = 0.01), triple vessel disease (p = 0.03), BMI (p < 0.01), preoperative left ventricular end-diastolic volume (p = 0.04) and left ventricular systolic diameter (p = 0.04) as independent determinants of reduced VO2 max. No patients needed a mitral valve reoperation, freedom from more than moderate mitral regurgitation was 83.5+/-6.7 % at 5 years.

CONCLUSIONS:

Even with a relative low rate of IMR recurrence, functional capacity quantitatively assessed by CPET is markedly reduced in nearly two out of three patients after restrictive mitral valve annuloplasty. Reduced peak VO2 is independently determined by patient comorbidity, extensive coronary disease, left ventricle dimensions and preoperative functional status, but not by recurrence of IMR.
OC44 VENTRICULAR TACHYCARDIA SURGICAL ABLATION IN REPAIRED TETRALOGY OF FALLOT PATIENTS
Authors: Caldaroni F. , Rito M. Lo , Varrica A. , Chessa M. , Micheletti A. , Pappone C. , Giamberti A.
Published: November 2018

Background and Aim:

Arrhythmias are the main causes of mortality in repaired TOF patients and ventricular tachycardia, due to abnormal electrical conduction near patches and surgical incisions, is refractory to medical therapy.

The aim of the study is to evaluate the effectiveness of surgical ventricular RF ablation during pulmonary valve replacement.

Methods:

20 patients (median age 37,5 y) in 2004–2013 underwent re-operation for symptomatic pulmonary valve regurgitation with RF ablation, 28 (16–39) years after first repair. Inducible VT was demonstrated during preoperative electrophysiological study in all. Median QRS was 178 (100–268) ms. Right ventricular dilation and dysfunction were present in all, with moderate-to-severe tricuspid regurgitation in 20%. Eleven patients showed spontaneous ventricular arrhythmia, 5 had preoperative ICD, and one presented out-of-hospital cardiac arrest.

Surgical ablation of the slow-conducting isthmus between the VSD patch and the pulmonary annulus was performed with linear RF lesions. All patients underwent clinical evaluation, echocardiography and Holter-ECG at 1-3-6 months together with electrophysiological study after 6 months.

Results:

16 patients underwent RVOT reduction and 4 TV repair. Median follow-up of 6.5 years was complete. 1 patient with pulmonary artery occlusion died on V-V ECMO for respiratory failure. No late mortality was observed. Residual inducible VT was present in 3/19 patients, whom received ICD as primary prevention. Freedom from ventricular arrhythmia was respectively 94% and 89.5% at 1 and 5 years of follow-up.

Conclusion:

Pulmonary regurgitation and ventricular dysfunction are correlated with SCD. Ablation of slow-conducting isthmus between the pulmonary valve and VSD patch prevents ventricular arrhythmias.
OC74 THE FATE OF TRICUSPID VALVE AFTER TRANSATRIAL CLOSURE OF VENTRICULAR SEPTAL DEFETC
Authors: Giordano R. , Palumbo S. , Cioffi S. , Russolillo V. , Mucerino M. , Comentale G. , Cantinotti M. , Iannelli G. , Palma G.
Published: November 2018

Background:

The transatrial repair of the ventricular septal defect (VSD) requires an adequate exposure of its rim. We retrospectively evaluated the impact of adopting the tricuspid valve incision (TVI) technique, either with detachment or radial incision, on the postoperative outcome of children undergoing surgical VSD repair.

Methods:

From January 2008 to September 2017 we retrospectively enrolled 141 patients, divided into two groups: 97 patients were subjected to TVI (68.8%) and 44 patients (31.2%) were not subjected to TVI. All patients received an echocardiogram upon discharge from the hospital and after 1 month, 3 months, 6 months and a year from the treatment.

Results:

No perioperative or late deaths resulted in our dataset. TVI was associated with a slightly longer cardio-pulmonary bypass and cross-clamp time but there were no differences in the surgical outcome between the two groups. Moreover, no differences occurred concerning residual VSD, atrioventricular block or tricuspid regurgitation at discharge. Echocardiograms at follow-up were available for 134 patients (95%) with a median of 5.3 years (range 0.5–9.3) and the degree of tricuspid regurgitation did not differ between groups. No patient required reoperation for tricuspid regurgitation or residual interventricular shunt. Finally, no difference was found even when comparing the two TVI subgroups.

Conclusions:

TVI should be used whenever intraoperative exposure of VSD is compromised in order to avoid a residual shunt and atrioventricular block. Here we show that this procedure does not significantly compromise the tricuspid function although a large, multicenter, randomized controlled trial is advised to validate this hypothesis.
OC06 BUILDING UP A MULTIDISCIPLINARY 360° MINIMALLY INVASIVE PROGRAM FOR AVR: OUR EXPERIENCE
Authors: Berretta P. , Wessella V. , Pierri M. , Fazzi D. , Cefarelli M. , Zingaro C. , Capestro F. , D’alfonso A. , Di Eusanio M.
Published: November 2018

Aim:

The aim of this study was to report the first results of our multidisciplinary minimally invasive program to treat patients who require aortic valve replacement (AVR), which involves: 1) reduced chest incision (through upper ministernotomy or right anterior minithoracotomy), 2) sutureless or rapid deployment AVR, 3) minimally invasive extracorporeal circulation (MiECC) system and 4) ultra fast-track (UFT) anaesthesia.

Methods:

Data from 167 consecutive patients undergoing primary isolated aortic valve replacement through minimally invasive approaches (MIAVR) between October 2016 and April 2018 were prospectively collected. The mean age of the study population was 74 ± 9 years, and the average EuroSCORE II was 2.1 ± 1.2.

Results:

MIAVR was performed using sutureless or rapid deployment valves in 76 (45.5%) patients, MiECC system in 63 (37.7%), and UFT management in 67 (40.1%). Overall in-hospital mortality was 0.6% (n = 1). The rate of postoperative stroke and atrioventricular block requiring pacemaker implantation was 1.2% (n = 2) and 3.6% (n = 6), respectively. MiECC system was associated with reduced postoperative bleeding (requiring chest re-opening) compared with conventional cardio-pulmonary bypass circuits (0% vs. 5.8%, p = 0.05). The mean intensive care unit stay was 25 hours in UFT patients and 52.2 hours in no-UFT patients (p = 0.04). Hospital stay was similar between groups (UFT 6.9 days, no-UFT 13.9 days, p = 0.2).

Conclusions:

Our UFT mini AVR program is a multidisciplinary minimally approach that involves the latest best technologies and techniques for AVR. We believe it may considerably increase patient's comfort being associated with faster recovery and excellent hospital outcomes.
OC41 MID-TERM RESULTS OF TRANSCATHETER AORTIC VALVE IMPLANTATION BY TRANS-CAROTID APPROACH UNDER LOCO-REGIONAL ANAESTHESIA. SINGLE CENTER EXPERIENCE
Authors: Olivier M. , Aludaat C. , Di Cesare A. , Droandi G. , Amr G. , Torossian F. , Caplan B. , Poncet A. , Tassan S. , Metz D. , Ruggieri V.G.
Published: November 2018

Background and Aim:

Trans-carotid access with loco-regional anesthesia has been developped as peripheral approach for transcatheter aortic valve implantation (TAVI) in alternative to transthoracic more invasive accesses for patients with transfemoral contraindications, high vascular risk and severe comorbidities. In this study, we report our experience and mid-term results in trans-carotid TAVI under loco-regional anesthesia by cervical block.

Methods:

Thirty patients were selected by the Heart Team of our institution for trans-carotid TAVI between September 2014 and December 2017. Mean age was 83.6 ± 6, 9 years old. the Logistic EuroSCORE was 21,7 ± 12,2, EuroSCORE 2 was 7.7 ± 5,2 and STS Score was 21,1 ± 8,8. The carotid approach was performed through a small low longitudinal cervicotomy with loco-regional anaesthesia by cervical block.

Results:

The transcatheter Edwards SAPIEN 3 valves (Edwards Lifesciences, Irvine, California) (n = 27; 90%) and the Medtronic Corvalve Evolut R (Medtronic, Inc., Mineapolis, Minnesota) (n = 3;10%) were used. All patients were successfully implanted. Two procedural not-access related deaths were registered, no vascular access complications occurred. There was one in-hospital minor stroke. Two patients required a pacemaker implantation for atrioventricular block. Post-operative echocardiogram showed satisfactory transvalvular gradients without significant paravalvular leak. At late follow-up (mean 12,3 ± 9,2 months) two non-cardiac deaths and one major stroke were registered and functional NYHA class improved.

Conclusions:

Carotid artery access for TAVI is a safe and feasible access compared to trans-apical and trans-aortic approaches. It can be realized under loco-regional anaesthesia with continuous clinical monitoring of neurological status. This approach should be considered a valid alternative for TAVI in patients with unfavourable vascular access.
OC07 CAN WE USE THE NEW INFANT JARVIK 2015 IN PATIENTS LESS THAN 8KG? A SIMULATION STUDY
Authors: Di Molfetta A. , Zielinski K. , Ferrari G. , Iacobelli R. , Perri G. , Filippelli S. , Darowski M. , Massetti M. , Amodeo A.
Published: November 2018

Objective:

to study test the feasibility of implanting the Infant Jarvik 2015 in patients lower than 8 kg.

Methods:

The LVAD was tested in a hybrid simulator of the cardiovascular system reproducing specific haemodynamic for different patients weight (2–8 kg). For each weight, we tested the LVAD sensitivity to circulatory parameters (pheripheral resistance, left and right ventricular elastances, heart rate and heart filling) repeating for each experiment a pump ramp (10000–18000 rpm).

Results:

The increment of the pump speed causes a decrement (increment) of the left (right) atrial pressure, an increment (decrement) of the arterial systemic (pulmonary) pressure, an increment of the right ventricular pressure, a decrement (increment) of the left (right) ventricular volume, a decrement of the left ventricular cardiac output, an increment of the LVAD output and an increment of the right ventricular cardiac output (total cardiac output). Suction was observed for lower weight patients and for higher pump speed in the case of vasodilation, left ventricular recovery, bradycardia, right ventricular failure and left ventricular hypertrophy, while backflow was observed only in the case of left ventricular recovery at lower pump speed.

Conclusions:

the use of a hybrid circulatory permits to test innovative VAD and the sensitivity of the pump to different circulatory parameters. In this specific application, the Infant Jarvik 2015 was suitable for the implantation in lower weight patients because of the stability respect to the cardiocirculatory changes (low frequency of suction and backflow) and because of the capability of the device in maintaining an adequate patients haemodynamics.
OC22 ECLS IN PRIMARY REFRACTORY CARDIOGENIC SHOCK: IMPACT OF SHORT-TERM EXTRACORPOREAL MECHANICAL CIRCULATORY SUPPORT ON SURVIVAL
Authors: Tarzia V. , Bagozzi L. , Bellanti E. , Folino G. , Bortolussi G. , Tessari C. , Bianco R. , Guglielmi C. , Testolin L. , Rubino M. , Bottio T. , Gerosa G.
Published: November 2018

Background/Aim:

Previous studies have demonstrated dubious results of ECMO for the treatment of refractory cardiogenic shock (RCS) after 9 days of support. The use of short-term extracorporeal mechanical circulatory support (ST-MCS) has emerged in the last years. We therefore evaluate the outcome of patients that needed prolonged support and underwent ST-MCS implantation compared to conventional ECMO implantation.

Methods:

Between January 2009 and October 2017, 183 patients were treated with extracorporeal life support (ECLS) in our centre for primary RCS; we selected the 101 patients that exceed the 9 days of ECLS. 44 cases (44%) were treated exclusively with ECMO implantation (Group 1), while 57 cases (56%) underwent left ventricular or biventricular extracorporeal ST-MCS implantation (Group 2). Among these last patients, in 42 cases the ST-MCS was intended as upgrade of ECMO support.

Results:

Average duration of the support was 17 ± 9 days in the Group 1 and 13 ± 9 days in the Group 2 (p = 0.08), while mean rates support of the maximal theoretic flow were 62 ± 15% and 79 ± 20% (p < 0.01), respectively. 12 patients of first group and 9 patients of second one died during ECLS support (p = 0.12); 30-days survivals were 61% and 70% (p = 0.24) and rates of hospital discharge were 43% and 61% (p = 0.04), respectively. Kaplan-Meier analysis (Fig.1) demonstrates a better survival in Group 2 rather than in Group 1 (p = 0.04) at median follow-up of 16 ± 24 months.

Conclusions:

ST-MCS has proved to increase the survival respect single-stage ECMO in patients with primary RCS who need prolonged ECLS and full hemodynamic support.
OC39 META-ANALYSIS OF PERIPHERAL OR CENTRAL ECMO IN POSTCARDIOTOMY AND NON-POSTCARDIOTOMY SHOCK
Authors: Raffa G. , Kowalewski M. , Meani P. , Pilato M. , Lorusso R.
Published: November 2018

Background:

Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) application in post-cardiotomy shock (PCS) and non-PCS is increasing. VA-ECMO plays a critical role in the management of these patients, yet may be associated with serious complications.

Methods:

A systematic review of all available reports in the literature of patients receiving VA-ECMO, either directly or indirectly comparing central cannulation (right atrial to ascending aorta) versus peripheral cannulation (femoral vein to femoral artery or axillary artery) were analyzed. The primary endpoint was survival. Cerebrovascular events, limb complications, bleeding requiring reoperation, sepsis, continuous veno-venous hemofiltration, and transfusions, were also assessed in both groups.

Results:

Seventeen retrospective case series clearly describing the VA-ECMO access and including 1,691 patients with PC- and non-PCS were found. The peripheral approach was more commonly used (980 patients, 57.9%) than the central one. There was no difference in the analysis between the two techniques regarding all-cause mortality RR (Risk Ratio) 95 CIs (Confidence Intervals): 1.00 (0.94–1.08) I2 = 0%, P = 0.92. No statistical differences were found between peripheral and central VA-ECMO with regards to cerebrovascular events, limb complications, or sepsis rates. Peripheral cannulation, was associated with a significant reduction in the risk of bleeding (p = 0.02), continuous veno-venous hemofiltration (p = 0.03), transfusion of red blood cells units (p < 0.00001), fresh frozen plasma units (p = 0.0002) and platelets units (p < 0.00001).

Conclusions:

Peripheral and central VA-ECMO configurations showed comparable in-hospital survival in PCS and non-PCS. The risk of bleeding, continuous veno-venous hemofiltration and blood product transfusion was significantly lower with the peripheral cannulation strategy.
OC34 IMPACT OF CONTINUOUS FLOW LEFT VENTRICULAR ASSIST DEVICES AS BRIDGE TO TRANSPLANT ON GRAFT REJECTION AND DEVELOPMENT OF DONOR-SPECIFIC ANTIBODIES
Authors: Carrozzini M. , Bejko J. , Gambino A. , Tarzia V. , Cozzi E. , Gregori D. , Bottio T. , Gerosa G.
Published: November 2018

Background and Aim:

We analysed patients transplanted with and without previous continuous-flow left ventricular assist devices (CF-LVADs) to compare survival and rates of acute rejection, development of donor-specific antibodies (DSA) and chronic allograft vasculopathy (CAV).

Methods:

All consecutive patients aged>18 years, who underwent HTx at our Institution from Jan-2012 to Dec-2017 were included. Patients assisted with pulsatile LVADs or total artificial heart were excluded. Cellular rejection score – CRS and antibody rejection score – ARS (total number of rejections divided by the number of endo-myocardial biopsies performed) were calculated at 3, 6 and 12 months after HTx.

Results:

We included 149 patients with a mean age of 54 ± 12 years. Among these, 47 (32%) were implanted with a CF-LVAD (25 HeartWare, 20 Jarvik 2000 and 2 HeartMate III) before HTx (LVAD group) and 102 (68%) were not (No-LVAD group). Pre-HTx allo-sensitization records were comparable among groups. Mean time of follow up was 25 ± 18 months in LVAD group and 24 ± 22 months in No-LVAD (p = 0.58). Overall mortality was comparable among groups (19% LVAD vs 18% No-LVAD, p = 0.83; Kaplan-Meier log-rank p = 0.98). Cellular and antibody-mediated rejection occurred similarly among groups. Incidence of CAV was comparable (p = 0.77), as well. De-novo DSA developed in a significantly higher number of bridged cases (29% vs 9%, p = 0.03).

Conclusions:

Patients supported with a CF-LVAD showed similar rates of cellular and antibody-mediated rejection and CAV after heart transplant, compared with non-bridged patients. Despite development of de-novo DSA was more frequent in assisted patients, this did not translate in worsened clinical outcomes.
OC88 COMPARATIVE ANALYSIS OF PROTHROMBIN COMPLEX CONCENTRATE AND FRESH FROZEN PLASMA IN THE MANAGEMENT OF PERIOPERATIVE BLEEDING AFTER CORONARY ARTERY BYPASS GRAFTING
Authors: Salsano A. , Mariscalco G. , Santini F. , Ruggieri V.G. , Perrotti A. , Chocron S. , Gherli R. , Reichart D. , Demal T. , Faggian G. , Franzese I. , Dalén M. , Santarpino G. , Fischlein T. , Rubino A.S. , Maselli D. , Nardella S. , Nicolini F. , Saccocci M. , Gatti G. , Bounader K. , Rosato S. , Kinnunen E. , De Feo M. , Tauriainen T. , Onorati F. , Biancari F.
Published: November 2018

Background and Aim:

Recent studies suggested that prothrombin complex concentrate (PCC) might be more effective than fresh frozen plasma (FFP) to reduce red blood cell (RBC) transfusion requirement after cardiac surgery. The benefits and risks associated with the use of PCC over FFP have been investigated in this study including patients undergoing isolated coronary artery bypass grafting(CABG) from a prospective, multicenter registry.

Methods:

This is a comparative analysis of 416 patients who received postoperatively FFP and 119 patients who received PCC with or without FFP after isolated CABG.

Results:

Mixed-effects regression analyses adjusted for multiple covariates and participating centers showed that PCC significantly decreased RBC transfusion (67.2% vs. 87.5%, adjusted OR 0.319, 95%CI 0.136–0.752) and platelet transfusion requirements (11.8% vs. 45.2%, adjusted OR 0.238, 95%CI 0.097–0.566) compared with FFP. The PCC cohort received a mean of 2.7 ± 3.7 (median, 2.0, IQR 4) units of RBC and the FFP cohort received a mean of 4.9 ± 6.3 (median, 3.0, IQR 4) units of RBC (adjusted coefficient, -1.926, 95%CI -3.357–0.494). The use of PCC increased the risk of KDIGO acute kidney injury (41.4% vs. 28.2%, adjusted OR 2.300, 1.203–4.400), but not of KDIGO acute kidney injury stage 3 (6.0% vs. 8.0%, OR 0.850, 95%CI 0.258–2.796) when compared with the FFP cohort.

Conclusions:

These results suggest that the use of PCC compared with FFP may reduce the need of blood transfusion after CABG. In view of the observational nature of this study, these results should be considered hypothesis generating and need to be confirmed in randomized trials.
VD19 TRANS-FEMORAL IMPLANT OF A BALLOON EXPANDABLE AORTIC VALVE IN A LEAKING SUTURELESS SELF-EXPANDABLE VALVE
Authors: Loforte A. , Coppola G. , Amodio C. , Folesani G. , Saia F. , Taglieri N. , Marozzini C. , Savini C. , Pacini D. , Di Bartolomeo R.
Published: November 2018

We report the case of a 83-year-old woman affected by aortic valve stenosis who underwent a minimally invasive Perceval S (size M) implantation. Intraoperative monitorings ruled out any any valvular leakage or valve dislocation. On postoperative day 3, a trans-thoracic echocardiography revealed a severe aortic valvular regurgitation with an isolated partial collapse of the basal ring at the right coronary sinus, as confimed by additional imagings.

Transfemoral percutaneous Edwards Sapien XT 23 mm was successfully deployed as aortic valve in-valve (A-ViV) interventionwith excellent result.

Despite the suspicious of a sutureless prosthesis mismatch or an uncorrect placement of the Perceval S, we consistently suppose that the preoperative severe septal hypertrophy exacerbated by postoperative edema might have played a significant role in the eventual dynamic sutureless valve infolding.

This report confirms the rare but possible sutureless vave related adverse events which may be corrected by the current transcatheter A-ViV procedures.
VD16 SUTURELESS MINIAVR WITH RIGHT ANTERIOR THORACOTOMY AND ULTRA FAST TRACK ANAESTHESIA: OUR MULTIDISCIPLINARY APPROACH IN ANCONA
Authors: Berretta P. , Cefarelli M. , Zingaro C. , Pierri M. , Capestro F. , Di Eusanio M.
Published: November 2018

While anatomical and clinical indications to transcatheter aortic valve interventions are expanding, surgical aortic valve replacement continues to progress as demonstrated by improving clinical outcomes in contemporary patients’ cohorts. However, mainly due to the availability of significantly less invasive trans-catheter cardiac interventions, patients’ expectations have dramatically changed in the last decade with reduced trauma and fast recovery being now strongly valued. An increasing employment of minimally invasive multidisciplinary approaches that call surgeons, anaesthesiologists, perfusionists, nurses and physiotherapists to more efficacious collaborative efforts becomes so crucial to minimize surgical invasiveness as well as to decrease the psychological impact of surgery and fasten patient's return to pre-operative lifestyle. With this video we would like to share our multidisciplinary approach to aortic valve replacement. This involves a right anterior mini-thoracotomy, the implantation of a sutureless Livanova Perceval S valve and ultra fast track anaesthetic protocols.
EP20 INTRACARDIAC MASSES: PROTOCOL EVOLUTION OVER 15 YEARS IN A HIGH VOLUME REFERRAL CENTER
Authors: Saccocci M. , Ricciardi G. , Corona S. , Previtali I. , Zanobini M. , Pepi M. , Alamanni F.
Published: November 2018

Background:

Intracardiac masses are not such uncommon findings in daily clinical routine. They can be essentially subdivided into tumors, thrombi, anatomical variation and infective vegetations. The 75 % of Primary cardiac tumors are benign and are mainly represented by myxomas; while the 25% remnants are subdivided between sarcomas (95%) and lymphomas (5%). Clinical presentation is often non-specific leading to delay in diagnosis. This study aims to analyze outcomes and evolution of the protocol management of tertiary high volume referral center over the last 15yrs.

Methods:

We retrospectively analyzed 83 consecutive patients who underwent surgical removal of intracardiac mass from January 2004 to January 2018. All the patients underwent preoperative transthoracic echocardiography. Cardiac CTscan, endomyocardial biopsy, and MRI were performed in selected cases. Symptoms presentation, Implantation site, macroscopic description and histological classification was collected. Preoperative Multidisciplinary team discussion was carried out for all elective cases. Different surgical techniques have been used according to type and localization of the lesions. Follow-up was performed by phone calls +/- TT-Echo and clinical visits.

Results:

Perioperative mortality was 0%. The percentage of the different type of masses, origins, and aspect are reported in the figure.

Conclusion:

TTE remains the first-line diagnosis method. In the modern era, intracardiac masses can benefit from multi-imaging preoperative assessment to maximize diagnosis accuracy and to choose the most appropriate surgical technique and approach. Optimal surgical excision technique is crucial. To achieve excellent outcomes dedicated referrals centers are needed. An interdisciplinary approach is essential: oncologists, echocardiographists, and surgeons must cooperate closely.
EP13 EVOLUTIONARY AND CYCLICAL CHANGES IN CARDIAC SURGERY
Authors: Picichè M. , Dato G. Actis , Lorusso R. , Salvador L.
Published: November 2018

Background and aim:

The analysis of modern models and criteria discloses that current cardiac surgery often recalls the past. The aim of this study is to investigate whether historical knowledge is an important tool for research in aortic valve surgery and myocardial revascularization.

Methods:

PubMed, Scopus and Sciencedirect analysis of past and current literature were adopted to compare previous and current ideas.

Results:

In 1922, Graham and Allen introduced a cardioscope and a knife through the subclavian artery, or the left ventricular apex, to divide calcified aortic valve leaflets. This technique is a precursor of TAVI. The concept of sutureless prosthesis existed in the fifties and sixties. Hufnagel routinely implanted sutureless prostheses in the descending thoracic aorta to treat aortic insufficiency. The sutureless Magovern-Cromie valve has been implanted in orthotropic position from 1964 onward.

The Sen's technique of trans-ventricular tunnels is a precursor of laser trans-myocardial revascularization. The Italian technique of internal mammary arteries ligature to treat angina pectoris, dating back to 1939 (Fieschi), and to the 50’ (Battezzati) was rediscovered, following 50 years of silence, in 2010. Endovascular occlusion of the mammary arteries by embolization has been suggested to treat patients suffering from angina not amenable to conventional revascularization techniques.

Conclusions:

Knowledge of old ideas and experiments, released from the technological constraints of their time, can be useful in current research. Ingenious theories that have fallen by the wayside can be brought back and explored again. History is a cycle. Heart valve surgery and myocardial revascularization are no exception.