Browsing by Author "Boccuzzo, G"
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- Anomalous Aortic Origin of Coronary Arteries: Early Results on Clinical Management from an International Multicenter StudyPublication . Padalino, M; Franchetti, N; Sarris, GE; Hazekamp, M; Carrel, T; Frigiola, A; Horer, J; Roussin, R; Cleuziou, J; Meyns, B; Fragata, J; Telles, H; Polimenakos, A; Francois, K; Veshti, A; Salminen, J; Rocafort, A; Nosal, M; Vedovelli, L; Protopapas, E; Tumbarello, R; Merola, A; Pegoraro, C; Motta, R; Boccuzzo, G; Sojak, V; Rito, M; Caldaroni, F; Corrado, D; Basso, C; Stellin, GBACKGROUND: Anomalous aortic origin of coronary arteries (AAOCA) is a rare abnormality, whose optimal management is still undefined. We describe early outcomes in patients treated with different management strategies. METHODS: This is a retrospective clinical multicenter study including patients with AAOCA, undergoing or not surgical treatment. Patients with isolated high coronary take off and associated major congenital heart disease were excluded. Preoperative, intraoperative, anatomical and postoperative data were retrieved from a common database. RESULTS: Among 217 patients, 156 underwent Surgical repair (median age 39 years, IQR: 15-53), while 61 were Medical (median age 15 years, IQR: 8-52), in whom AAOCA was incidentally diagnosed during screening or clinical evaluations. Surgical patients were more often symptomatic when compared to medical ones (87.2% vs 44.3%, p < 0.001). Coronary unroofing was the most frequent procedure (56.4%). Operative mortality was 1.3% (2 patients with preoperative severe heart failure). At a median follow up of 18 months (range 0.1-23 years), 89.9% of survivors are in NYHA ≤ II, while only 3 elderly surgical patients died late. Return to sport activity was significantly higher in Surgical patients (48.1% vs 18.2%, p < 0.001). CONCLUSIONS: Surgery for AAOCA is safe and with low morbidity. When compared to Medical patients, who remain on exercise restriction and medical therapy, surgical patients have a benefit in terms of symptoms and return to normal life. Since the long term-risk of sudden cardiac death is still unknown, we currently recommend accurate long term surveillance in all patients with AAOCA.
- Scimitar Syndrome: a European Congenital Heart Surgeons Association (ECHSA) Multicentric StudyPublication . Vida, V; Padalino, M; Boccuzzo, G; Tarja, E; Berggren, H; Carrel, T; Çiçek, S; Crupi, G; Carlo, D; Donato, R; Fragata, J; Hazekamp, M; Hraska, V; Maruszewski, B; Metras, D; Pozzi, M; Pretre, R; Rubay, J; Sairanen, H; Sarris, G; Schreiber, C; Meyns, B; Tlaskal, T; Urban, A; Thiene, G; Stellin, GBackground: Scimitar syndrome is a rare congenital heart disease. To evaluate the surgical results, we embarked on the European Congenital Heart Surgeons Association (ECHSA) multicentric study. Methods and results: From January 1997 to December 2007, we collected data on 68 patients who underwent surgery for scimitar syndrome. Primary outcomes included hospital mortality and the efficacy of repair at follow-up. Median age at surgery was 1.4 years (interquartile range, 0.46 to 7.92 years). Forty-four patients (64%) presented with symptoms. Surgical repair included intraatrial baffle in 38 patients (56%; group 1) and reimplantation of the scimitar vein onto the left atrium in 21 patients (31%; group 2). Eight patients underwent right pneumectomy, and 1 had a right lower lobe lobectomy (group 3). Four patients died in hospital (5.9%; 1 patient in group 1, 2.6%; 3 patients in group 3, 33%). Median follow-up time was 4.5 years. There were 2 late deaths (3.1%) resulting from severe pulmonary arterial hypertension. Freedom from scimitar drainage stenosis at 13 years was 83.8% in group 1 and 85.8% in group 2. Four patients in group 1 were reoperated, and 3 patients (2 in group 1 [6%] and 1 in group 2 [4.8%]) required balloon dilation/stenting for scimitar drainage stenosis. Conclusions: The surgical treatment of this rare syndrome is safe and effective. The majority of patients were asymptomatic at the follow-up control. There were a relatively high incidence of residual scimitar drainage stenosis that is similar between the 2 reported corrective surgical techniques used.