Edwards Intuity Elite In a Patient With Bicuspid Aortic Stenosis and Ventricular Septal Defect

This study reports on 65-year-old male with a bicuspid Aortic Stenosis (AS) low flow, low gradient and a congenital Ventricular Septal Defect (VSD) of pars membranosa. A ministernotomy and Cardiopulmonary Bypass (CPB) by aorto-femoral cannulation was performed. The VSD was below the commissure between right and non coronary sinus. It was decided to correct it by a stitch with a pericardial patch and a further safer coverage by the stent of an Intuity Elite aortic valve. To the best of our knowledge this was the first time that a VSD could be covered with a suturless valve for two reasons: International Journal of e and conformable configuration of the valve

Treatment of Common Femoral Artery Lesions Involving the Superficial and Profunda Femoral Artery Bifurcation: Is the Snow Too Melted to Plow With New Endovascular Devices?

Surgical endarterectomy for common femoral artery bifurcation obstructive atherosclerotic disease repre- sents the "gold standard" therapy, with excellent long-term results and minimal complications. On the other hand, recent advances in endovascular therapy have led to a safer and similar effective results, with a potential reduction in hospital stays, quicker recovery to normal functional status, good short- and long-term clinical outcomes, and consequent lower morbidity and mortality. Percutaneous directional atherectomy and intravascular lithotripsy are game-changer medical devices for the treatment of peripheral arterial disease related to complex and severely calcific atherosclerotic plaque encroaching the common femoral artery bifurcation segment. The application of these devices, technical execution, and clinical experience is reported in two exemplary cases

Endovascular repair in atypical traumatic rupture of thoracic aorta

Introduction. The traumatic rupture of thoracic aorta is a surgical emergency with high risk of morbidity and mortality. Case report. We describe the case of an atypical rupture of retrocardiac thoracic aorta with dissection of brachiocephalic trunk and spleen trauma occurred after a road accident. TC scan and perioperative angiography showed an atypical rupture of thoracic aorta. Conclusion. A combined treatment, endovascular for retrocardiac thoracic aorta and surgical for brachiocephalic artery, has been useful to diminish the hemodinamic and organ ischemic problems associated with open surgery

AN UNUSUAL CASE OF CHRONIC AIRFLOW OBSTRUCTION IN A HEAVY SMOKER

We report here the case of a 49-year-old perimenopausal woman, current smoker of 30 pack-years, that was referred to our attention in our outpatient pulmonology clinic for the presence of progressive exertional dyspnea and persistent cough. In the last five years the patient has been seen in many different pulmonology outpatient clinics for the presence of chronic airflow obstruction and performed four computed tomography of the chest that showed the presence of a diffuse and bilateral cystic pattern in the lung parenchyma. After a careful differential diagnostic approach including medical history, lung function tests, laboratory exams and chest imaging reanalysis a diagnosis of pulmonary Langerhans Cell Histiocytosis was made with therapeutic recommendation of cigarette smoking cessation. Chronic airflow obstruction and diffuse and bilateral cystic lung disease have many different causes. A complex differential diagnosis must be applied to every patient to understand the etiology and to provide the specific treatment

Sutureless and rapid deployment versus sutured aortic valve replacement: a propensity-matched comparison from the Sutureless and Rapid Deployment International Registry

OBJECTIVES: To compare procedural and in-hospital outcomes of patients undergoing sutureless (Perceval, Livanova PLC, London, UK) and rapid deployment (Intuity Elite, Edwards Lifesciences, Irvine, CA, USA) aortic valve replacement (group 1) versus sutured aortic valve replacement (group 2).METHODS: Patients receiving isolated aortic valve replacement between 2014 and 2020 were analysed using data from the Sutureless and Rapid Deployment International Registry. Patients in group 1 and group 2 were propensity-score matched in a 1:1 ratio.RESULTS: A total of 7708 patients were included in the study. After matching, 2 groups of 2643 each were created. Patients in group 1 were more likely to undergo minimally invasive approaches and were associated with shorter operative times when compared with group 2. Overall in-hospital mortality was similar between groups. While an increased risk of stroke was observed in group 1 in the first study period (2014-2016; relative risk 3.76, P < 0.001), no difference was found in more recent year period (relative risk 1.66, P = 0.08; P for heterogeneity 0.003). Group 1 was associated with reduced rates of postoperative low cardiac output syndrome, atrial fibrillation and mild aortic regurgitation. New pacemaker implant was three-fold higher in group 1.CONCLUSIONS: Our findings showed significant differences in procedural and clinical outcomes between the study groups. These results suggest that sutureless and rapid deployment aortic valve replacement should be considered as part of a comprehensive valve programme. The knowledge of the respective post-aortic valve replacement benefits for different valve technologies may result in patient-tailored valve selection with improved clinical outcomes