bluuebunny/crossref_metadata_2025_split huggingface dataset:
P77 SIEMENS ARTIS VD11 ANGIOGRAPH‘S POTENTIAL WITH THE CLEARSTENT PROTOCOL IN PERFORMING PERCUTANEOUS CORONARY ANGIOPLASTY: FIRST EXPERIENCES
Authors: Ragosa N , Aloia A , Giordano F , Grompone R , Bellarosa I , Di Santi E , De Angelis E , Benvenga R , Ferraioli D , D‘Arco G , Matturro R , Di Lascio A 
Published: May 2022

Abstract

Objectives
The use of the CLEARstent image functions allows you to highlight fine structures, for example the expansion of a stent. Composite images are created by averaging several frames of a scene and considering the alignment of the markers of a stent. If an ECG signal is available, the cardiac phase is also considered. Using the CLEARstent function allows you to create special reference images from any scene or natively acquired fluoroscopic scene. The goal of CLEARstent images is to optimize the procedural result of mechanical cardiac revascularization and to improve the outcomes of treated patients.

Methods
The use of the Siemens Artis VD11 angiograph requires specific technical and medical knowledge and skills regarding, at least, radiation protection, safety procedures and patient safety. The people who work with the system, who use it and who move it must have acquired this knowledge and skills in their working life The application training was provided to the medical–technical–nursing staff of the Hemodynamics Unit of the “San Luca” PO of Vallo della Lucania “by qualified Siemens personnel. The application training offered by Siemens is binding before any use of the system

Results
701 coronary angiography procedures and 118 urgent revascularizations were performed at our Hemodynamics Unit in the period from 11/27–2020 to 12/21–2021, period of use of the aforementioned angiograph, 701 coronary angiography procedures and 118 revascularizations in an emergency pattern ( STEMI–NSTEMI at high risk). In all mechanical myocardial revascularization procedures, the opening and optimal positioning of the coronary stents were verified with the CLEARstent system. There was no periprocedural complication.

Conclusions
The CLEARstent system allows to highlight fine structures, for example hypo–expanded stents, creating special reference images from any negatively acquired fluoroscopic scene, consequently allowing optimal positioning and opening of a coronary stent. Therefore, it is inserted together with intracoronary imaging techniques (IVUS, OCT) as a further aid to guide percutaneous interventions in order to optimize the acute procedural outcome of PCI and to improve the clinical outcomes of treated patients.
P79 FIRST GENERATION BIORESORBABLE VASCULAR SCAFFOLD VS NEXT GENERATION BIORESORBABLE VASCULAR SCAFFOLD: SINGLE CENTER, LONG–TERM FOLLOW UP EXPERIENCE
Authors: Albani S , Pisano F , Bernardi A , Amato G , Bonino C , Biava L , Contu L , Pelloni E , Scacciatella P 
Published: May 2022

Abstract

Background
Previous randomized controlled trials demonstrated a higher rate of stent thrombosis with first generation (Absorb; Abbott Vascular, USA) bioresorbable vascular scaffold (BVS) implantation as compared with second–generation drug–eluting stent. Currently, with limited indications, others next generation BVS (NGB) are available (Magmaris; Biotronik AG, Switzerland and DESolve; Elixir Medical Corporation, USA). Real world long–term outcomes of such devices are limited.

Methods and Results
In our center from 27/09/2012 to 28/08/2018 in a cohort of 277 patients, a total of 259 BVS and 191 NGB (120 Magmaris and 71 DESolve) devices were implanted. The primary efficacy endpoint was a combined end point of target–lesion revascularization (TLR) and target lesion myocardial infarction (TLMI) the primary safety endpoint was scaffold thrombosis (ScT). At a median follow–up, of 83 months (interquartile range–IQR, 61–91 months) for BVS, and 48 months (IQR, 41–53.5 months) and 64.5 months (IQR, 58.5–69 months) for Magmaris and DESolve respectively, TLR/TLMI occurred in 17 patients (10.5%) in the BVS group and 4 patients (3.5%) in the NGB group (p value= 0.03), ScT occurred in 5 patient (3.1%) and 1 patient (0.9%), p–value=0.23, respectively. Median time of ScT occurrence in the BVS group was 12.5 months (IQR 9.75–16.75), ScT in the NGB group occurred after patient’s suspension of dual antiplatelet therapy 3 months later from the implantation date.

Conclusion
In a single center real world setting, the use of NGB appear safer compared to BVS at long–term follow–up.
P84 RENAL DENERVATION IN RESISTANT ARTERIAL HYPERTENSION: OUR CENTER‘S EXPERIENCE
Authors: De Vita E , Laurenzano E , Asparago S , Petruziello B , Quirino C , Ranauro A , Villari B 
Published: May 2022

Abstract

Introduction
The renal denervation procedure (RDN) represents an innovative alternative in patients with resistant arterial hypertension, in addition to medical therapy and lifestyle changes. This document presents our experience at the Cardiology department of the “Fatebenefratelli di Benevento” hospital where 19 effective RDN procedures were performed.

Methods
19 RDNs were performed at the “Fatebenefratelli di Benevento” Hospital in patients with resistant arterial hypertension (defined as failure to control blood pressure values using three or more drugs, including a diuretic). The long–term efficacy of the technique was evaluated by comparing blood pressure measurements using ECG–holter before and after the RDN (follow–up visit – 12 months). In addition, patients underwent a clinical–instrumental evaluation before the procedure and at the follow–up visit.

Results
The analysis of the collected data revealed a significant reduction in systolic, mean (p–value &lt;0.001) and diastolic (p–value = 0.001) blood pressure. The mean variation was –13 ± 8 for systolic blood pressure, –7 ± 7 for diastolic blood pressure, and –11 ± 9 for mean pressure. The procedure was completed in all patients without peri–procedural and post–procedural complications. During the 12 months of observation, no fatal or non–fatal cardiovascular events, hospitalization or death from any cause were reported.

Conclusions
In our experience, renal denervation has been a safe and efficacy procedure in reducing blood pressure and the amount of drugs taken in high–risk cardiovascular patients with resistant arterial hypertension. It will be necessary to confirm the results benefits through a longer follow up.
P88 LEFT ATRIAL APPENDAGE CLOSURE DEVICE COMPLICATED BY LATE ONSET PERICARDIAL EFFUSION AND TAMPONADE: A CASE REPORT
Authors: Albani S , Pisano F , Berlier N , Pelloni E , Caterina B , Biava L , Contu L , Scacciatella P 
Published: May 2022

Abstract

Background
Late onset complications of left atrial appendage occlusion (LAAO) device procedure are anecdotal and there are no such complications reported in literature using Cardia Ultraseal (Cardia, USA).

Case Summary
We report the case of a 74–year–old Caucasian man affected by paroxysmal atrial fibrillation with significant bleeding risk (familiar thrombocytopenia, macroscopic hematuria episodes during therapy with direct oral anticoagulants, HAS–BLED risk score: 4) and ischemic risk as well (CHADSVASC score: 3). The patient was treated with LAAO device implantation for high bleeding risk. Subsequently, after 26 days from LAAO procedure, he was admitted to the emergency department for hematic cardiac tamponade. The patient was successfully treated with subxyphoidal pericardiocentesis in the acute phase, unfortunately cardiac arrest occurred during the transfer to the referral hospital for urgent cardiac surgery. Permanent neurological damage was reported and the patient died on day 28.

Discussion
There are several clinical and radiological aspects that may suggest a cause–effect relationship with the occurrence of hematic pericardial effusion and LAA occlusion device implantation: firstly the pericardial effusion was hematic and its occurrence was preceded by acute interscapular pain suggesting an acute pericardial irritation caused by the hematic effusion and secondly, the CT scan played an “indirect key role” excluding several causes of hematic pericardial effusion (such as aortic dissection and solid tumors that could infiltrate the pericardial membrane), thirdly there are no other anamnestic events that may be associated with this clinical manifestation (such as trauma). The low flexibility of the Cardia Ultraseal (Cardia, Inc., Eagan, MN, USA) nitinol mesh structure, as previously reported in others settings, may be associated to increased torque of the device by the beating heart. A bench test showed that the Ultrasept, a large–mashed device for interatrial defect closure, very similar to Ultraseal, needs a high compression force during implantation as a result of its low radial strength. In addition, compared to other devices, the bulb part is much larger. Consequently, when the device is deeply inserted in LAA, a higher surface area within the appendage wall is directly overlapped, having more chance of causing friction.All these aspects could be responsible of wall erosion.
P89 THE HEART TEAM SUCCESS: TAVI IN–VALVE IN A COMPLEX PATIENT
Authors: Vecchio C , Calderone D , Oreglia J , Nassiacos D 
Published: May 2022

Abstract
CG was a 80–years–old man with normal BMI, arterial hypertension and CAD family history.He suffered OSAS needs nocturnal cPAP, MGUS, colon diverticulosis and CKD in dialysis treatment since 2006 after right nephrectomy for adenocarcinoma and wrinkle left kidney for focal glomerulosclerosis since 1982.Note valvular heart disease with mitro–aortic insufficiency: in 6/2010 he performed aortic valve replacement with Carpentier Perimount 23 bioprosthesis, mitral annuloplasty with St Jude 28 ring and surgical revascularization with single graft on PDA coronary.During post–surgical period transients III degree AVB and AF were observed with subsequent restoration and stabilization in sinus rhythm.In 5/2011, thanks to Holter registration of stable sinus rhythm, VKA anticoagulation was stopped and only ASA continued.In 1/2013 well tolerated AF was found then VKA resumed.In 6/2016 during the follow up the echocardiogram showed hypertrophic and hypokinetic left ventricle, EF 45%, moderate biatrial dilatation, normofunctioning aortic bioprosthesis with mild aortic root and first ascending tract dilatation and successful mitral annuloplasty.In 3/2018 worsening exertional dyspnea with initial heart failure were documented and echocardiography showed aortic bioprosthesis degeneration with severe stenosis and mild intraprosthetic insufficiency, preserved EF, mild mitral steno–insufficiency, normal right sections with mild–moderate tricuspid insufficiency and mild pulmonary hypertension.In 6/2018 the subsequent coronary angiography evidenced venous graft occlusion and critical RCA stenosis treated by PTCA+DES Biofreedom in the middle segment: triple therapy with ASA, clopidogrel and VKA indicated for one month.One month later, in 7/2018 TAVI was performed on aortic bioprosthesis with Portico n.23 prosthesis: in the post–procedural phase mild anemia and positive FOB were found. The patient presented high both thrombotic and bleeding risk because of persistent AF, recently coronary reperfusion with DES and dialysis treatment so we decided to close left atrial appendage by Watchman system and keep on single antiplatelet therapy with ASA. Pre and post procedures dialysis treatments were performed without complications.Subsequent clinical and echocardiographic follow up without complications.The diagnostic–therapeutic iter sharing in Heart and multi–specialists team has favored the best timing of treatment and the success of procedures in a very high cardiovascular risk patient.
P93 THE POWER OF GROUP WORK IS THE STRENGTH OF A SUCCESS: TAVI!
Authors: Campolo G , Iacopino F 
Published: May 2022

Abstract
TAVI (Transcatheter Aortic Valve Implantation) is a procedure performed by a multidisciplinary team, preferably in a hybrid room where both interventional and cardiac surgery procedures are performed. This procedure is a splendid example of team work, where all the figures involved (hemodynamist, cardiac surgeon, anesthetist, sonographer and nurses) collaborate, each with a specific role, in the safe execution of the implantation of the transcatheter aortic valve in patients with high operative risk. Specifically, during the TAVI there are 4 nurses with very specific roles: CIRCULATING NURSE: • He/she welcomes the patient in pre–operating room (identification, checklist) • He/she transfers the patient to the hybrid room (positioning, etc.) • He/she supports the scrub nurse (materials, Pacemaker management) • He/she performs TIME–OUT and SIGN–OUTANESTHESIA NURSE: • He/she takes care of positioning all the monitoring instruments (ECG plates, defibrillator, etc. ..), finds all the venous accesses and supports the anesthetist (ventilation, intubation if necessary, EGA, ACT, etc …)SCRUB NURSE: • He/she collaborates with the hemodynamist in the execution of the procedure and in the management of sterile materials.CRIMPER NURSE: • He/she is responsible for the correct preparation of the valve and the material required for its assembly. This “new” competence of the nurse sees him engaged in the following activities: 1. preparation of the overbed table 2. preparation of catheters, introducers and any catheters for pre–dilatation (valvuloplasty) 3. preparation of valve delivery and positioning systems 4. valve washing 5. assembly and “crimping” of the valve
At the end of the procedure, the nurses carry out the compressive dressing of the arterial and venous accesses, monitor and verify the correct arterial haemostasis by promptly intervening on any vascular complications (haemorrhages, pseudoaneurysms). Since October 2017, our Center has carried out numerous procedures with intra–operative and post–operative results comparable to national data, thanks to the efforts and commitment of our Heart Team. TAVI turns out to be an excellent example of teamwork, where success is given by the synergy between the various professional figures that are essential to each other.
P96 ACUTE CORONARY SYNDROME AND CORONARY ARTERY KINK
Authors: Viele A , Trivisonno A , Porchetta N , Cuzzola B , Giannotti G , Colavita A 
Published: May 2022

Abstract
Coronary artery kink is a variant of anomalous coronary artery, not related to vessel disease. Often it is associated with coronary artery tortuosity (CAT) and fibromuscular dysplasia. The pathogenesis and clinical implications are not fully understood. Kinks are hypothesized to cause coronary blood flow alterations that can results in ischemia and even in acute coronary syndrome. It is speculated that coronary artery kinks are most often caused by guide wire straightening and seen after wiring the artery, but that is not always the case. We describe the case of a 55 years old woman, with familiar history of CAD. In 2019 she had percutaneous Patent Foramen Ovale closure intervention. She presented to the Emergency Department complaining chest pain radiating into the neck. The ECG was normal, but Troponin I levels were mildly elevated (2,1 ng/ml) and ipokinesia of basal and mid segment of the anterior intraventricular spetum was found at the ecoscopy. The patient was admitted to Cardiology department with diagnosis of unstable angina and urgent coronary angiography was performed. At a first glance the coronary arteries did not exhibit significant arteriosclerotic or thrombotic changes. However, upon a closer review, a focal kink of the mid left descending coronary artery was found. This coronary kink folded the LAD during systole causing a transient stenosis that resolved during diastole. Management of coronary kinks is controversial. In the past, literature suggested treatment with coronary stenting as one of the management options. However there are reported cases of adverse outcomes, such as shifting of kink proximally, requiring an additional stenting. We decided to treat patient with medical approach: beta–blockers at the tolerated doses was initiated, in addition to ACE–Inibithor, Aspirin and statin. Stenting of the coronary artery was not a choice, due to the possibility of shifting (as described in literature) and stent fracture. At a one month follow up the patient presented asymptomatic for angina, palpitation or dyspnea. Even if rarely coronary artery kink is a potential cause of myocardial ischemia and its treatment is often challenging to improve patient quality of life and to prevent adverse cardiac event.
P111 CLINICAL PROFILE AND CORONARY ANGIOGRAPHIC FINDINGS IN A PATIENT POPULATION WITH NORMAL STRESS ECHOCARDIOGRAPHY AND ANGINAL SYMPTOMS AND/OR ELECTROCARDIOGRAM ABNORMALITIES INDUCED BY THE STRESS TEST
Authors: Spinelli A , Cianfrocca C , Di Fusco S , Di Michele S , Speciale G , Auriti A , Imperoli G , Colivicchi F 
Published: May 2022

Abstract

Patients with normal pharmacologic stress echocardiography (SE) imaging but anginal symptoms and/or electrocardiographic (ECG) abnormalities induced by the stress test are commonly encountered in clinical practice.

The aim of this study
was to report the clinical profile of these patients and the coronary angiographic findings observed in this setting.

Methods
We analysed pharmacologic SE results of all patients who underwent this examination at our centre between 2015 and 2020. 34 (74%) patients performed pharmacological SE with dipyridamole and 11 (24%) with dobutamine. All patients with normal SE imaging and anginal symptoms and/or ECG abnormalities triggered by this examination who required further diagnostics using coronary angiography were enrolled in this study. Patient data were retrospectively collected from hospital records.

Results
1553 SEs were performed from 2015 to 2020. Forty–five patients met the inclusion criteria of our study (62% female, mean age 67 years). The majority of included patients 37 (82%) had hypertension, 22 (49%) dyslipidemia, 13 (29%) diabetes and 7 (16%) were smokers. Thirteen patients (29%) had anginal symptoms induced by SE and positive coronary angiography. Six patients (13%) had ECG abnormalities and positive coronary angiography. Only two patients (4%) had both ECG abnormalities, anginal symptoms, and positive coronary angiography. Overall, 47% of patients had positive coronary angiography, half of whom had a history of ischemic heart disease. Seventeen patients (38%) had anginal symptoms and negative CVG. Two patients (4%) had ECG abnormalities and negative CVG. Five patients (11%) had both ECG abnormalities and anginal symptoms (Table 1). Overall, 53% of patients had negative CVG.

Conclusion
In our centre, more than half of patients with normal SE imaging associated with ECG abnormalities and anginal symptoms induced by the stress test had negative coronary angiography. Hypertension was the most common risk factor in this patient population.
P112 REPRODUCIBILITY AND AGREEMENT OF 2D VS M–MODE ECHOCARDIOGRAPHIC LINEAR MEASUREMENTS IN ESTIMATION OF LEFT VENTRICLE MASS IN NORMAL ADULT SUBJECTS
Authors: Rossi D , Alessi F , Campanile C , Pinna G , Forni G 
Published: May 2022

Abstract

Background:
Left ventricle (LV) mass is one of the echocardiographic parameters, essentials to define the LV remodeling
P123 PERCUTANEOUS CLOSURE OF PATENT FORAME OVALE IN PATIENT WITH FORME FRUSTE COR TRIATRIATUM DEXTER: A CASE REPORT
Authors: Barca L , Gil Ad V , Masoero G , Bezante G , Porto I , Crimi G 
Published: May 2022

Abstract

Cortriatriatum Dexter (CTD) is an uncommon congenital cardiac anomaly defined by the presence of abnormal septation within the right atrium due to incomplete reabsorption of the right venous valve. While Cor triatriatum with obstructive membranous is often found in early infancy, the non–obstructive forme (“forme fruste”, ff–CTD) usually remain asymptomatic until late adulthood. Non–obstructive forms, in fact, generally have a modest clinical impact, but in some clinical situations, they may represent a significant obstacle. CTD and ff–CTD are commonly associated with other congenital heart anomalies, e.g. atrial septal defects (ASDs), and a few cases of extreme difficulties in percutaneous procedures like ASD or patent foramen ovale (PFO) closure have been described.
We present a case of a 51–year–old male patient with a recent diagnosis of paradoxical cardioembolic stoke that during the procedure of percutaneous PFO closure, ff–CTD was detected. Multifenestrated Amplatzer septal occluder 18 mm device was successfully deployed under TEE monitoring, confirming optimal positioning and no distortion of the device, particularly of the right disk.

Conclusion
cc–CTD is generally a benign condition but may represent a challenge and should be searched prior to percutaneous heart procedures.
P133 UTILITÀ DEL MYOCARDIAL WORK NELLA VALUTAZIONE ECOCARDIOGRAFICA MULTIPARAMETRICA DI PAZIENTI CON CARCINOMA MAMMARIO
Authors: Di Lisi D , Madaudo C , Rossetto L , Di Palermo A , Gambino G , Buccheri G , Damerino G , Di Leo G , Galassi A , Novo G 
Published: May 2022

Abstract

Background
The aim of our study was to assess subclinical cardiac effects of anthracyclines (ANTs) in women treated for breast cancer (BC).

Methods
We enrolled 46 female patients with BC undergoing adjuvant treatment with anthracycline–containing chemotherapy (CT) followed by taxane (paclitaxel/docetaxel). Patients underwent physical examination, electrocardiogram (ECG) and standard transthoracic echocardiography (TTE) including evaluation of diastolic and systolic function, measured as left ventricular ejection fraction (LVEF), left ventricular global longitudinal strain (GLS) and myocardial work (MW) expressed as global work index (GWI), global constructive work (GCW), global work waste (GWW), and global work efficiency (GWE). The parameters were measured at baseline (T0) and at 3 months (T1) and 6 months (T2) follow up.

Results
All patients completed the chemotherapy cycles. No significant cardiovascular adverse events were observed during treatment. Neither 2D left ventricular ejection fraction (LVEF) nor E/e’ ratio evaluation at TDI were significantly changed after treatment. Conversely, GLS was significantly reduced at T1 and T2 since baseline (GLS – 19,99 % IQR –20,6 –19,3 % at T0 vs –17,88 % IQR –18,8 –16,9 % at T1, p &lt; 0,00 1 and –16,71 % IQR 17,6 –15,7 % at T2, p &lt; 0,001). Consensually, a significant reduction in myocardial work was also measured (GWI 2115 mmHg% IQR 1888 – 2342 mmHg% at T0 vs 1714 mmHg% IQR 1557 – 1870 mmHg% at T1, p &lt; 0,0001 and 1694 mmHg% IQR 1482 – 1907 mmHg% at T2, p &lt; 0,0001).

Conclusion
Our study demonstrates that evaluation of myocardial work allows very early detection of subclinical cardiac damage induced by chemotherapy, consensually to the reduction of the GLS. A multiparametric assessment of the myocardial function, including myocardial work and GLS, could improve the accuracy of risk stratification of cardiotoxicity in patients undergoing ANTs treatment.