luca franchin
@sanita.fvg.it
Cardiology
Azienda Sanitaria Universitaria Friuli Centrale
Scopus Publications
Scopus Publications
Mario Iannaccone and Luca Franchin
Elsevier BV
Mario Iannaccone, Umberto Barbero, Luca Franchin, Andrea Montabone, Ovidio De Filippo, Fabrizio D'ascenzo, Giacomo Boccuzzi, Vasileios Panoulas, Jonathan Hill, Emmanouil S. Brilakis,et al.
Elsevier BV
Filippo ANGELINI, Luca FRANCHIN, Pier P. BOCCHINO, Nuccia MORICI, Wojciech WAŃHA, Stefano SAVONITTO, Daniela TRABATTONI, Enrico CERRATO, Lucia BARBIERI, Federico FORTUNI,et al.
Edizioni Minerva Medica
Mario Iannaccone, Luca Franchin, Filippo Russo, Giulia Botti, Davide Castellano, Matteo Montorfano, Giacomo Boccuzzi, Mamas A. Mamas, and Alaide Chieffo
Elsevier BV
Massimo Imazio, Vartan Mardigyan, Alessandro Andreis, Luca Franchin, Marzia De Biasio, and Valentino Collini
Elsevier BV
Alessandro Vairo, Rossella Manai, Lorenzo Gaiero, Paolo Desalvo, Matteo Bellettini, Lorenzo Zaccaro, Andrea Rinaudo, Luca Franchin, Francesco Piroli, Francesco Bruno,et al.
SAGE Publications
Objective: Transventricular beating-heart mitral valve repair (TBMVR) with artificial chordae implantation is a technique to treat mitral valve prolapse. Two-dimensional (2D) echocardiography completed with simultaneous biplane view during surgeon finger pushing on the left ventricular (LV) wall (finger test [FT]) is currently used to localize the desired LV access, on the inferior-lateral wall, between the papillary muscles (PMs). We aimed to compare a new three-dimensional (3D) method with conventional FT in terms of safety and better localization of LV access. Methods: During TBMVR, conventional FT was completed using 3D transesophageal echocardiography by placing the sample box in the bicommissural view of the LV, including the PMs and the apex. The 3D volume was subsequently edited to visualize the LV from above (surgical view) to localize the bulge of the operator’s finger pushing on the LV. We asked the first operator, the second operator, and the cardiac surgery fellow, separately, to evaluate the location of their finger pushing, both with the 2D method and the 3D method, to estimate the interoperator concordance. Results: From 2019 to 2021, 42 TBMVRs were performed without complications related to access using FT completed with the 3D method. Regarding the choice of the right and safe entry site, the operator’s agreement was higher using 3D rendering compared with conventional FT (mean agreement 0.59 ± 0.29 for 2D vs 0.83 ± 0.20 for 3D), while full operator agreement was 10 of 42 for 2D and 23 of 42 for 3D ( P = 0.004). Conclusions: Three-dimensional FT is easy to perform and facilitates surgeons choosing the best access for TBMVR in term of anatomical localization and safety.
Ovidio De Filippo, Antonino Di Franco, Paolo Boretto, Francesco Bruno, Vincenzo Cusenza, Paolo Desalvo, Michelle Demetres, Andrea Saglietto, Luca Franchin, Francesco Piroli,et al.
Elsevier BV
Mario Iannaccone, Luca Franchin, Francesco Burzotta, Giulia Botti, Vittorio Pazzanese, Carlo Briguori, Carlo Trani, Tommaso Piva, Federico De Marco, Giulia Masiero,et al.
MDPI AG
(1) Background: Percutaneous left ventricle assist devices (pLVADs) demonstrated an improvement in mid-term clinical outcomes in selected patients with severely depressed left ventricular ejection fraction (LVEF) undergoing percutaneous coronary interventions. However, the prognostic impact of in-hospital LVEF recovery is unclear. Accordingly, the present sub-analysis aims to evaluate the impact of LVEF recovery in both cardiogenic shock (CS) and high-risk percutaneous coronary intervention (HR PCI) supported with pLVADs in the IMP-IT registry. (2) Methods: A total of 279 patients (116 patients in CS and 163 patients in HR PCI) treated with Impella 2.5 or CP in the IMP-IT registry were included in this analysis, after excluding those who died while in the hospital or with missing data on LVEF recovery. The primary study objective was a composite of all-cause death, rehospitalisation for heart failure, left ventricle assist device (LVAD) implantation, or heart transplantation (HT), overall referred to as the major adverse cardiac events (MACE) at 1 year. The study aimed to evaluate the impact of in-hospital LVEF recovery on the primary study objective in patients treated with Impella for HR PCI and CS, respectively. (3) Results: The mean in-hospital change in LVEF was 10 ± 1% (p < 0.001) in the CS cohort and 3 ± 7% (p < 0.001) in the HR PCI group, achieved by 44% and 40% of patients, respectively. In the CS group, patients with less than 10% in-hospital LVEF recovery experienced higher rates of MACE at 1 year of follow-up (FU) (51% vs. 21%, HR 3.8, CI 1.7–8.4, p < 0.01). After multivariate analysis, LVEF recovery was the main independent protective factor for MACE at FU (HR 0.23, CI 0.08–0.64, p = 0.02). In the HR PCI group, LVEF recovery (>3%) was not associated with lower MACE at multivariable analysis (HR 0.73, CI 0.31–1.72, p = 0.17). Conversely, the completeness of revascularisation was found to be a protective factor for MACE (HR 0.11, CI 0.02–0.62, p = 0.02) (4) Conclusions: Significant LVEF recovery was associated with improved outcomes in CS patients treated with PCI during mechanical circulatory support with Impella, whereas complete revascularisation showed a significant clinical relevance in HR PCI.
Federico Angriman, Luca Franchin, Francesco Piroli, and Massimo Imazio
Elsevier BV
Andrea Sardone, Luca Franchin, Diego Moniaci, Salvatore Colangelo, Francesco Colombo, Giacomo Boccuzzi, and Mario Iannaccone
MDPI AG
The use of percutaneous mechanical circulatory support (pMCS), such as intra-aortic balloon pump, Impella, TandemHeart and VA-ECMO, in the setting of cardiogenic shock or in protect percutaneous coronary intervention (protect-PCI) is rapidly increasing in clinical practice. The major problem related to the use of pMCS is the management of all the device-related complications and of any vascular injury. MCS often requires large-bore access, if compared with common PCI, and for this reason the correct management of vascular access is a crucial point. The correct use of these devices in catheterization laboratories requires specific knowledge such as the correct evaluation of the vascular access performed, when possible, with advance imaging techniques in order to choose a percutaneous or a surgical approach. In addition to conventional transfemoral access, other types of access, such as transaxillary/subclavial access and the transcaval approach, have emerged over the years. These other approaches require advanced skills of the operators and a multidisciplinary team with dedicated physicians. Another important part of the management of vascular access is the closure systems used for hemostasis. Currently, two types of devices are typically used in the lab: suture-based or plug-based ones. In this review we want to describe all these aspects related to the management of vascular access in pMCS and describe, finally, a case report from our center’s experience.
Luca Franchin, Francesco Piroli, Pierluigi Demola, Francesca Mantovani, Mario Iannaccone, Roberto Manfredi, Fabrizio D’Ascenzo, Federico Fortuni, Fabrizio Ugo, Francesco Meucci,et al.
Frontiers Media SA
BackgroundsTwo recent randomized controlled trials (RCTs), the PROTECT-AF and the PREVAIL, showed that in atrial fibrillation (AF) patients, left atrial appendage closure (LAAC) is comparable to oral anticoagulants (OAC) in the prevention of stroke and could also possibly reduce mortality. Nevertheless, this net clinical benefit was not confirmed in the most recent RCT comparing LAAC vs. OAC, the PRAGUE-17 trial.Aimaim of the present study was to evaluate the efficacy and safety of LAAC compared with OAC among available high-quality studies.MethodsA systematic search of electronic databases (Medline, Scopus, Embase and the Cochrane Library) was performed to identify eligible RCTs and observational studies with propensity score matching (PSM) analysis. PRISMA guidelines were used for abstracting data and assessing data quality and validity. Outcomes of interest were the occurrence of cardiovascular death (CVD), all-cause death, all-type stroke, and major bleedings.ResultsA total of 3 RCTs and 7 PMS studies involving 25,700 patients were identified. 12,961 patients received LAAC while 12,739 received OAC therapy. After a median follow-up of 2.6 years (IQR 2–4.4), patients who received LAAC had lower risk of CVD (RR = 0.62; 95%CI, 0.51–0.74, I2 = 0%), all-cause death (RR = 0.67; 95% CI, 0.57–0.78, I2 68%) and major bleedings (RR = 0.68; 95%CI, 0.48–0.95 I2 = 87%) compared with patients on OAC. No difference was found between the two groups regarding strokes incidence (RR = 0.94; 95% CI, 0.77–1.15, I2 = 0%).ConclusionsAccording to this meta-analysis, LAAC has comparable efficacy in the prevention of stroke compared with OAC and a reduced risk of major bleedings, all-cause death and CVD that may be even larger with longer follow-up.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?RecordID=269768, identifier CRD42021269768.
Ju Hyeon Kim, Luca Franchin, Soon Jun Hong, Jung-Joon Cha, Subin Lim, Hyung Joon Joo, Jae Hyoung Park, Cheol Woong Yu, Do-Sun Lim, Ovidio De Filippo,et al.
Frontiers Media SA
BackgroundOlder patients who treated by percutaneous coronary intervention (PCI) are at a higher risk of adverse cardiac outcomes. We sought to investigate the clinical impact of bifurcation PCI in older patients from Korea and Italy.MethodsWe selected 5,537 patients who underwent bifurcation PCI from the BIFURCAT (comBined Insights from the Unified RAIN and COBIS bifurcAtion regisTries) database. The primary outcome was a composite of target vessel myocardial infarction, clinically driven target lesion revascularization, and stent thrombosis at two years.ResultsIn patients aged ≥75 years, the mean age was 80.1 ± 4.0 years, 65.2% were men, and 33.7% had diabetes. Older patients more frequently presented with chronic kidney disease (CKD), severe coronary calcification, and left main coronary artery disease (LMCA). During a median follow-up of 2.1 years, older patients showed similar adverse clinical outcomes compared to younger patients (the primary outcome, 5.7% vs. 4.5%; p = 0.21). Advanced age was not an independent predictor of the primary outcome (p = 0.93) in overall patients. Both CKD and LMCA were independent predictors regardless of age group.ConclusionsOlder patients (≥75 years) showed similar clinical outcomes to those of younger patients after bifurcation PCI. Advanced age alone should not deter physicians from performing complex PCIs for bifurcation disease.
Mario Iannaccone, Luca Franchin, Ivan D. Hanson, Giacomo Boccuzzi, Mir B. Basir, Alexander G. Truesdell, and William O'Neill
Elsevier BV
Luca Franchin, Giacomo Boccuzzi, Diego Moniaci, and Mario Iannaccone
MDPI AG
The complexity of coronary artery disease is currently on the rise [...]
Andrea Sardone, M. Iannaccone, D. Savio, Francesco Colombo, L. Di Maggio, S. Colangelo, L. Franchin and G. Boccuzzi
Pulmonary embolism is the third most common cause of cardiovascular emergency. Risk stratification is crucial in the clinical and therapeutic management of these patients. The latest European guidelines introduced a new classification based on short-term mortality risk stratification, dividing patients into four categories (high, intermediate-high, intermediate-low and low risk). Despite the limited evidence in this field, the percutaneous treatment of pulmonary embolism represents an option of interest; however, correct patient selection and device choice should be better investigated. In this article, we present two case reports of patients with intermediate-high-risk and high-risk pulmonary embolism treated with the EkoSonic Endovascular System (EKOS Corp., Bothell, WA, USA) and the FlowTriever System (Inari Medical, Irvine, CA, USA), respectively.
Guglielmo Gallone, Edoardo Elia, Francesco Bruno, Filippo Angelini, Luca Franchin, Pier Paolo Bocchino, Francesco Piroli, Umberto Annone, Andrea Montabone, Giorgio Marengo,et al.
Elsevier BV
Pier Paolo Bocchino, Luca Franchin, Filippo Angelini, Fabrizio D'Ascenzo, Gaetano Maria De Ferrari, and Fernando Alfonso
Wiley
We aimed to compare the incidence and timing of major adverse cardiovascular events (MACE) within the first year after spontaneous coronary artery dissection (SCAD) according to the management strategy: conservative versus invasive.
Fabrizio D’Ascenzo, Ovidio De Filippo, Edoardo Elia, Mattia Paolo Doronzo, Pierluigi Omedè, Antonio Montefusco, Mauro Pennone, Stefano Salizzoni, Federico Conrotto, Guglielmo Gallone,et al.
Oxford University Press (OUP)
Abstract Aims A 5-year survival of patients with unprotected left main (ULM) stenosis according to the choice of revascularization (percutaneous vs. surgical) remains to be defined. Methods and results Randomized controlled trials (RCTs) comparing percutaneous coronary intervention (PCI) vs. coronary artery bypass graft (CABG) with a follow-up of at least 5 years were included. All-cause death was the primary endpoint. MACCE [a composite endpoint of all-cause mortality, myocardial infarction (MI), stroke, and repeat revascularization] along with its single components and cardiovascular (CV) death were the secondary ones. Analyses were stratified according to the use of first- vs. last-generation coronary stents. Subgroup comparisons were performed according to SYNTAX score (below or above 33) and to age (using cut-offs of each trial’s subgroup analysis). Four RCTs with 4394 patients were identified: 2197 were treated with CABG, 657 with first generation, and 1540 with last-generation stents. At 5-year rates of all-cause death did not differ [odds ratio (OR) 0.93, 95% confidence interval (CI) 0.71–1.21], as those of CV death and stroke. Coronary artery bypass graft reduced rates of MACCE (OR 0.69, 95% CI 0.60–0.79), mainly driven by MI (OR 0.48, 95% CI 0.36–0.65) and revascularization (OR 0.53, 95% CI 0.45–0.64). Benefit of CABG for MACCE was consistent, although with different extent, across values of SYNTAX score (OR 0.76, 95% CI 0.59–0.97 for values &lt; 32 and OR 0.63, 95% CI 0.47–0.84 for values ≥ 33) while was not evident for ‘younger’ patients (OR 0.83, 95% CI 0.65–1.07 vs. OR 0.65, 95% CI 0.51–0.84 for ‘older’ patients). Conclusion For patients with ULM disease followed-up for 5 years, no significant difference was observed in all-cause and cardiovascular death between PCI and CABG. Coronary artery bypass graft reduced risk of MI, revascularization, and MACCE especially in older patients and in those with complex coronary disease and a high SYNTAX score.
Pier Paolo Bocchino, Filippo Angelini, Alessandro Vairo, Alessandro Andreis, Federico Fortuni, Luca Franchin, Simone Frea, Claudia Raineri, Stefano Pidello, Federico Conrotto,et al.
Elsevier BV
Alessandro Vairo, Federico Conrotto, Luca Franchin, Federico Fortuni, Francesco Bruno, Antonio Montefusco, Fabrizio D'Ascenzo, Alberto Milan, MicheleLa Torre, Gianluca Alunni,et al.
Medknow
A 55-year-old male with a history of severe organic mitral regurgitation treated with surgical mitral valve (MV) repair was referred for a transcatheter MV replacement due to recurrent regurgitation. After the release of the first transcatheter MV, a severe paravalvular leak coming from the lateral side was observed. To promptly tackle this issue, a second valve with further postdilation was successfully implanted and the paravalvular leak disappeared. This case highlights the feasibility of implanting a second valve in case of severe paravalvular leaks after MV-in-ring procedures due to device malapposition.
Saveria Femminò, Fabrizio D’Ascenzo, Francesco Ravera, Stefano Comità, Filippo Angelini, Andrea Caccioppo, Luca Franchin, Alberto Grosso, Cecilia Thairi, Emilio Venturelli,et al.
MDPI AG
Extracellular vesicles (EVs) are promising therapeutic tools in the treatment of cardiovascular disorders. We have recently shown that EVs from patients with Acute Coronary Syndrome (ACS) undergoing sham pre-conditioning, before percutaneous coronary intervention (PCI) were cardio-protective, while EVs from patients experiencing remote ischemic pre-conditioning (RIPC) failed to induce protection against ischemia/reperfusion Injury (IRI). No data on EVs from ACS patients recovered after PCI are currently available. Therefore, we herein investigated the cardio-protective properties of EVs, collected after PCI from the same patients. EVs recovered from 30 patients randomly assigned (1:1) to RIPC (EV-RIPC) or sham procedures (EV-naive) (NCT02195726) were characterized by TEM, FACS and Western blot analysis and evaluated for their mRNA content. The impact of EVs on hypoxia/reoxygenation damage and IRI, as well as the cardio-protective signaling pathways, were investigated in vitro (HMEC-1 + H9c2 co-culture) and ex vivo (isolated rat heart). Both EV-naive and EV-RIPC failed to drive cardio-protection both in vitro and ex vivo. Consistently, EV treatment failed to activate the canonical cardio-protective pathways. Specifically, PCI reduced the EV-naive Dusp6 mRNA content, found to be crucial for their cardio-protective action, and upregulated some stress- and cell-cycle-related genes in EV-RIPC. We provide the first evidence that in ACS patients, PCI reprograms the EV cargo, impairing EV-naive cardio-protective properties without improving EV-RIPC functional capability.
Luca Franchin, Jeehoon Kang, Ovidio De Filippo, Hyeon-Cheol Gwon, Francesco Piroli, Hyo-Soo Kim, Wojciech Wańha, Young Bin Song, Giuseppe Patti, Soon-Jun Hong,et al.
Elsevier BV
Filippo Angelini, Federico Fortuni, Georgios Tsivgoulis, Giancarlo Agnelli, Pier Paolo Bocchino, Luca Franchin, Ovidio De Filippo, Matteo Bellettini, Fabrizio D’Ascenzo, Gabriele Crimi,et al.
Springer Science and Business Media LLC