Fabrizio Ceresa
@aopapardo.it
Cardiovascular and Thoracic Department
Azienda Ospedaliera Papardo
RESEARCH INTERESTS
cardiac surgery
Scopus Publications
Scopus Publications
Antonio Lacquaniti, Fabrizio Ceresa, Susanna Campo, Francesco Patané, and Paolo Monardo
MDPI AG
Background and Objectives: Several studies revealed a relation between abnormal cardiac remodeling and glomerular filtration rate (GFR) decline, but there are limited data regarding echocardiographic changes in chronic kidney disease (CKD). This study evaluated the abnormal cardiac structures characterizing patients with CKD, assessing the independent association between echocardiographic parameters and the risk of decline in renal function. Materials and Methods: In total, 160 patients with CKD were studied. All patients underwent an echocardiographic exam and 99mTc-DTPA renal scintigraphy to measure the GFR. After the baseline assessments, patients were followed prospectively for 12 months, or until the endpoint achievement, defined as a worsening in renal function (doubling of baseline serum creatinine, GFR decline ≥25%, the start of dialysis). Results: Patients with GFR values of 34.8 ± 15 mL/min, identifying stages III–IV of CKD, were associated with high levels of left ventricular mass index (LVMi) (101.9 ± 12.2 g/m2), which was related to proteinuria, systolic blood pressure, and pulmonary artery systolic pressure in a multiple regression model. During the observational period, 26% of patients reached the endpoint. Regression analysis revealed LVMi as a predictor of change in renal function after adjusting for kidney and cardiac risk factors. Multiple Cox regression indicated that an increase in LVMi was associated with a 12% increased risk of kidney disease progression (HR: 1.12; 95% CI: 1.04–1.16; p = 0.001). Conclusions: In patients with CKD, high LVMi represents an independent predictor of the progressive decline of the renal function, until the start of renal replacement therapy. Echocardiography can help identify patients at high risk for renal disease worsening in patients with CKD independently of clinical cardiac involvement.
Fabrizio Ceresa, Antonio Micari, Liborio Francesco Mammana, Umberto Maisano, Alessandro Di Carlo, Alfredo Luongo, and Francesco Patanè
Medknow
Abstract This case report presents a rare scenario involving a congenital anomaly of the right coronary artery’s (RCA) origin in association with an ascending aortic aneurysm. While both anomalies are individually recognized in the literature, their coexistence and potential interplay remain understudied. The aim of this report is to emphasize the challenges and implications associated with such a combination. A 78-year-old male patient with an enlarged ascending aortic aneurysm necessitating surgical intervention was found to have an anomalous origin of the RCA during preoperative coronary angiography, confirmed by computed tomography scan. Transesophageal echocardiography further elucidated the coronary abnormality. Intraoperatively, successful aortic replacement was performed, and careful repositioning of the anomalous right coronary ostium was achieved. This case raises important considerations regarding the potential complications arising from coronary anomalies and their impact on the surgical management of ascending aortic aneurysms. The rarity of this combination limits our understanding of their association, making a multidisciplinary approach crucial for optimal patient care. Further research and comprehensive evaluation of similar cases are necessary to better understand the relationship between coronary anomalies and ascending aortic aneurysms. Such investigations will help in improving treatment strategies and outcomes for patients with these complex conditions.
Antonio Lacquaniti, Fabrizio Ceresa, Susanna Campo, Giovanna Barbera, Daniele Caruso, Elenia Palazzo, Francesco Patanè, and Paolo Monardo
MDPI AG
Background: Identifying a panel of markers detecting kidney injury before the glomerular filtration rate reduction is a challenge to improving the diagnosis and management of acute kidney injury (AKI) in septic patients. This study evaluated the roles of tissue inhibitor metal proteinase-2, insulin growth factor binding protein-7 (TIMP2*IGFBP7), and mid-regional pro-adrenomedullin (MR-proADM) in patients with AKI. Patients and Methods: This study was prospectively conducted in an intensive care unit (ICU) enrolling 230 patients who underwent cardiac surgery. Biomarkers were evaluated before and after 4 h of the cardiac surgery. Results: Whereas urine and creatinine alterations appeared at 23.2 (12.7–36.5) hours after cardiac surgery, urinary TIMP2*IGBP7 levels were higher at 4 h in AKI patients (1.1 ± 0.4 mg/L vs. 0.08 ± 0.02 mg/L; p < 0.001). Its concentration > 2 mg/L increases AKI risk within the following 24 h, clearly identifying the population at high risk of renal replacement therapy (RRT). In patients with sepsis, MR-proADM levels were 2.3 nmol/L (0.7–7.8 nmol/L), with the highest values observed in septic shock patients (5.6 nmol/L (3.2–18 nmol/L)) and a better diagnostic profile than procalcitonin and C-reactive protein to identify septic patients. MR-proADM values > 5.1 nmol/L and urine TIMP2*IGBP7 levels > 2 mg/L showed a significantly faster progression to RRT, with a mean follow-up time of 1.1 days. Conclusions: TIMP2*IGBP7 and MR-proADM precociously diagnose AKI in septic patients after cardiac surgery, giving prognostic information for RRT requirement.
Francesca Lofrumento, Maurizio Cusmà Piccione, Francesco Costa, Silvia Perfetti, Gianluca Di Bella, Concetta Zito, Scipione Carerj, Fabrizio Ceresa, Francesco Patanè, and Antonio Micari
Elsevier BV
Fabrizio Ceresa, Liborio Francesco Mammana, Aurora Leonardi, Augusto Palermo, and Francesco Patanè
MDPI AG
Background and Objectives: Minimally invasive cardiac surgery (MICS) has been developing since 1996. Peripheral cannulation is required to perform MICS, and good venous drainage and a bloodless field are crucial for the success of this procedure. We assessed the benefits of using a virtually wall-less cannula in comparison with the standard thin-wall cannula in clinical practice. Materials and Methods: Between January 2021 and December 2022, we evaluated 65 elective patients, who underwent isolated minimally invasive mitral valve surgery. Both the virtually wall-less and the thin-wall cannulas were placed through a surgical cut-down. Patients’ characteristics at baseline were similar in the two groups, except for the body surface area (BSA), which was greater in the virtually wall-less group compared to the thin-wall one. In the standard group, the size of the cannula was chosen depending on the patient’s BSA, and the choice of the Smartcannula was based on their height. Results: There were no significant differences between the two groups in terms of negative pressure applied, target flow achieved, hemolysis, the need for blood transfusion, and the post-operative increases in liver and renal enzymes. However, in all the patients, the estimated target flow was achieved, thereby showing the better hemodynamic performance of the virtually wall-less cannula, since, in this group, the patients’ BSA was significantly greater compared to the thin-wall group. Ultimately, the mean cross-clamp time, as an indirect index of the effectiveness of the venous drainage, is shorter in the virtually wall-less group compared with the thin-wall group. Conclusions: The virtually wall-less cannula should be preferred in minimally invasive mitral valve surgery due to its superior performance in terms of venous drainage compared with the standard thin-wall cannula.
Marco Franzino, Francesco Costa, Tommaso De Ferrari, Giampiero Vizzari, Fabrizio Ceresa, Francesco Patanè, Gianluca Di Bella, and Antonio Micari
Elsevier BV
Fabrizio Ceresa, Aurora Leonardi, FilomenaBruna De Donno, Auguto Palermo, LiborioFrancesco Mammana, and Francesco Patanè
Medknow
A 76-year-old man with history of previous coronary artery bypass grafting, permanent atrial fibrillation in novel oral anticoagulation therapy, and gastrointestinal bleedings underwent percutaneous left atrial appendage closure. The procedure was complicated by intraoperative device embolization, which caused a dynamic obstruction of the left ventricular outflow tract leading to severe hemodynamic instability. Transesophageal echocardiography showed a device in the ventricle site of the mitral anterior leaflet. The coronary angiography showed also patency of both arterial grafts in stable coronary artery disease. After failing the percutaneous retrieval with a snare, emergent surgery was planned. A moderate calcified aortic valve stenosis was also found, but in consideration of the unstable clinical conditions of the patient, we thought of performing a transcatheter aortic valve replacement (TAVR) in a second time. We have carefully planned the surgical retrieval of the device embolized paying attention of his several comorbidities. The strategy to remove the device with cardiopulmonary bypass without cross-clamping the aorta through a right mini-thoracotomy has been preferred.
Fabrizio Ceresa, Antonio Micari, Antonino Salvatore Rubino, Liborio Mammana, Vito Pipitone, Giampiero Vizzari, Francesco Costa, and Francesco Patanè
Springer Science and Business Media LLC
Abstract Introduction The treatment of moderate functionalmitral regurgitation (FMR) during coronary artery bypass grafting (CABG) is still debated. Our primary end point was to assess the improvement of “mitral valve reserve” (MVR) after CABG alone as a clinical demonstration of left ventricular (LV) recovery. Materials and methods Between June 2019 and June 2021, we prospectively enrolled 104 consecutive patients undergoing CABG with moderate FMR. Inclusion criteria were inferior-posterior-lateral wall hypokinesia and revascularization of the circumflex or right coronary artery. MVR was calculated as the ratio between anterior and posterior leaflets’ straight length. All patients were followed for 1 year. The improvement of MVR has been considered as a reduction of the ratio between anterior and posterior leaflets straight length. Results Compared to baseline, mean MVR was significantly reduced both at 6 (2.24 ± 0.95 vs. 1,91 ± 0.6; p = 0,047) and 12 months follow-up (2.24 ± 0.95 vs. 1,69 ± 0.49; p = 0,006). Left ventricular (LV) reverse remodeling, meant as improvement of LV ejection fraction and reduction of LV end-systolic volume index and mitral anulus diameter were evaluated at 6 months and 1 year. Mitral regurgitation grade were also significantly reduced at 6 months (p < .001). Conclusion The benefits of myocardial revascularization in term of improvement of mitral regurgitation’s degree can be explained by the changes of MVR. The patients with FMR, who could have more advantages from CABG alone, should be the ones who have LVESVi just moderately increased.
Giuseppe Vadalà, Fabrizio Ceresa, Francesco Costa, Antonio Bottari, Giuseppe Roscitano, Francesco Patanè, and Antonio Micari
Oxford University Press (OUP)
ABSTRACT In-stent restenosis (ISR) is a common superficial femoral artery (SFA) stenting complication, occurring in more than one third of patients within 2–3 years after the index procedure. Moreover, there is no standard treatment for ISR, and although many options are available, there is still limited data regarding its optimal management. We report a paradigmatic case report of a patient complaining of symptomatic peripheral arterial disease, underwent multiple endovascular revascularizations for recurrent femoro-popliteal ISR. A step-by-step approach was followed. At the time of the first presentation, the ISR was treated by drug-eluting balloon (DEB) angioplasty. The repeated ISR was treated by laser debulking, achieving a good angiographic result. Finally, after the third repeated restenosis, a combined approach with laser debulking and DEB angioplasty guaranteed a good acute angiographic result. Long-term duplex-scan follow-up demonstrated the good patency of the femoro-popliteal target lesion.
F. Ceresa, A. Micari, Maria Paola Trifirò, F. Costa, G. Vizzari, Alessio Giuseppe and F. Patanè
A 72-year-old woman, recently COVID-19 vaccinated with a third dose, was referred to our center for acute chest pain and dyspnea. On admission, the electrocardiography showed a STEMI on inferior derivations and the dyskinesia of the inferior wall was found at the first transthoracic echocardiogram. The coronary angiography did not show coronary artery disease. After 1 week, a huge posterolateral left ventricular (LV) aneurysm with initial signs of rupture was found and the patient underwent a Dor's procedure to exclude the LV aneurysm. As far as we know, this is the first reported case of Takotsubo following the COVID-19 vaccination requiring cardiac surgery.
Alessandro Caracciolo, Renato Francesco Maria Scalise, Fabrizio Ceresa, Gianluca Bagnato, Antonio Giovanni Versace, Roberto Licordari, Silvia Perfetti, Francesca Lofrumento, Natasha Irrera, Domenico Santoro,et al.
MDPI AG
Percutaneous coronary intervention (PCI) is one of the most common procedures performed in medicine. However, its net benefit among patients with chronic kidney disease (CKD) is less well established than in the general population. The prevalence of patients suffering from both CAD and CKD is high, and is likely to increase in the coming years. Planning the adequate management of this group of patients is crucial to improve their outcome after PCI. This starts with proper preparation before the procedure, the use of all available means to reduce contrast during the procedure, and the implementation of modern strategies such as radial access and drug-eluting stents. At the end of the procedure, personalized antithrombotic therapy for the patient’s specific characteristics is advisable to account for the elevated ischemic and bleeding risk of these patients.
Antonino Salvatore Rubino, Fabrizio Ceresa, Liborio Mammana, Giuseppe Vite, Gianluca Cullurà, Augusto Palermo, Aurora Leonardi, Bruna Filomena De Donno, and Francesco Patanè
MDPI AG
Intraoperative assessment of graft patency is pivotal for successful coronary revascularization. In the present study we aimed to propose a new, easy to perform tool to assess anastomotic quality intraoperatively, and to investigate its potential reliability in predicting early graft failure. Intraoperative graft flowmetry of 63 consecutive patients undergoing CABG were prospectively collected. Transit time flowmetry and its derivatives were recorded. Coronary resistances were calculated according to Hagen–Poiseuille equation both during cardioplegic arrest and after withdrawal from cardiopulmonary bypass. Angiographic evidence of graft occlusion at follow-up was cross-checked with intraoperative recordings. After a mean follow-up of 10.4 ± 6.0 months, 22 grafts were studied, and occlusion was documented in five (22.7%). Occluded grafts showed lower flows and higher resistances recorded during aortic cross-clamping. Coronary resistances, recorded during aortic cross-clamping, greater than 2.0 mmHg/mL/min, showed a sensitivity of 80% and a specificity of 100% to predict graft failure. We propose the routine recording of coronary resistances during aortic cross-clamping as an additional tool to overcome the acknowledged limitation of TTF to predict graft occlusion at 1 year.
Cesare Gregorio, Giuseppe Ferrazzo, Fabrizio Ceresa, Bruna Filomena De Donno, and Francesco Patanè
Wiley
We report the case of massive hydatic heart disease in a 50‐year‐old male patient referred to hospital for recent‐onset dyspnea, atypical chest, and hypotension. Right ventricular outflow tract obstruction was demonstrated to be caused by hypoechogenic formations at Doppler‐echocardiography and confirmed to be hydatic cysts at cardiac magnetic resonance. These cysts developed within the right ventricular wall and the septum, and caused hemodynamic instability.
Cesare Gregorio, Fabrizio Ceresa, Giuseppe Ferrazzo, and Francesco Patanè
Wiley
Anomalous origin of the right coronary artery (RCA) from the left sinus of Valsalva is a rare but clinically relevant congenital anomaly, since the RCA may be subjected to cyclical compression due to its interarterial course. At least in the past, most patients experienced bad outcomes before being diagnosed with a malignant variant. Chronic (often subclinical) myocardial ischemia and possible arrhythmias are common complications. Once symptoms or electrocardiographic signs of myocardial ischemia become apparent, a quick diagnosis is mandatory. We report the case of a late symptomatic woman in whom RCA originated from the opposite sinus of Valsalva. The malignant variant was confirmed at transesophageal echocardiography directly in the catheterization laboratory, soon after angiographic diagnosis of aberrant origin.
Francesco Patanè, Fabrizio Ceresa, Giuseppe Ferrazzo, and Cesare de Gregorio
Ovid Technologies (Wolters Kluwer Health)
: The authors describe the case of adulthood inherited heart and vessel disease. A young pregnant woman presenting with initial symptoms of heart failure was diagnosed with pentacuspid aortic valve and bilateral renal artery malformation.
Emmanuel Lansac, Pouya Youssefi, Frederiek de Heer, Joseph Bavaria, Laurent De Kerchove, Ismail El-Hamamsy, Gebrine Elkhoury, Maurice Enriquez-Sarano, Laurent de Guillaume Jondeau, Jolanda Kluin,et al.
Elsevier BV
We are currently in an era of change in management and shared decision-making for heart valve disease. Aortic valve surgery in non-elderly patients represents a very challenging patient population. Their high level of physical activity places haemodynamic demands on the valve. Their post-operative quality of life is extremely important, and must be compatible with their professional and personal lifestyle. More importantly, the younger the patient is at the point of aortic valve intervention, the longer their anticipated life expectancy will be. This fact alone poses the biggest challenge to any aortic valve procedure - i.e. longer anticipated life expectancy means longer exposure to valve-related complications such as degeneration, need for re-operation, bleeding and thromboembolism. Unlike what is found in older patients, aortic insufficiency (AI) is very common in the younger aortic valve patients. More than 50% of AI cases are in patients under the age of 50 years, and these patients with AI have an impaired survival compared to those with aortic stenosis.1.
Frederiek de Heer, Jolanda Kluin, Gebrine Elkhoury, Guillaume Jondeau, Maurice Enriquez-Sarano, Hans-Joachim Schäfers, Johanna J.M. Takkenberg, Emmanuel Lansac, Christian Dinges, Johannes Steindl,et al.
Elsevier BV
OBJECTIVES
Current national registries are lacking detailed pathology-driven analysis and long-term patients outcomes. The Heart Valve Society (HVS) aortic valve (AV) repair research network started the Aortic Valve Insufficiency and ascending aorta Aneurysm InternATiOnal Registry (AVIATOR) to evaluate long-term patient outcomes of AV repair and replacement. The purpose of the current report is to describe the AVIATOR initiative and report in a descriptive manner the patients included.
METHODS
The AV repair research network includes surgeons, cardiologists, and scientists and established an online database compliant with the guidelines for reporting valve-related events. Prospective inclusion started from January 2013. Adult patients (18 years or older) who were operated on between 1995 and 2017 with complete procedural specification of the type of repair/replacement were selected for descriptive analysis.
RESULTS
Currently 58 centers from 17 countries include 4896 patients with 89% AV repair (n = 4379) versus 11% AV replacement (n = 517). AV repair was either isolated (28%), or associated with tubular/partial root replacement (22%) or valve-sparing root replacement (49%) with an in-hospital mortality of 0.5%, 1.7%, and 1.2%, respectively. AV replacement was either isolated (24%), associated with tubular/partial root replacement (17%) or root replacement (59%) with an in-hospital mortality of 1%, 2.6%, and 2.0%, respectively.
CONCLUSIONS
The multicenter surgical AVIATOR registry, by applying uniform definitions, should provide a solid evidence base to evaluate the place of repair versus replacement on the basis of long-term patient outcomes. Obtaining data completeness and adequate representation of all surgery types remain challenging. Toward the near future AVIATOR-medical will start to study natural history, as will AVIATOR-kids, with a focus on pediatric disease.
Frederiek de Heer, , Emmanuel Lansac, Ismail El-Hamamsy, Philippe Pibarot, Laurent De Kerchove, Gebrine El Khoury, Hans-Joachim Schäfers, Johanna J. M. Takkenberg, and Jolanda Kluin
AME Publishing Company
Alberto Clerici, Augusto Pellegrini, Fabrizio Sansone, Fabrizio Ceresa, and Francesco Patanè
Elsevier BV
Fabrizio Sansone, Fabrizio Ceresa, and Francesco Patanè
Elsevier BV
Giuseppe Mario Calvagna, Ludovico Vasquez, Francesco Patanè, Fabrizio Sansone, Fabrizio Ceresa, Laura Tassone, and Salvatore Patanè
Elsevier BV
a Cardiologia Ospedale San Vincenzo, Taormina (Me) Azienda Sanitaria Provinciale di Messina, 98039, Taormina, (Messina), Italy b Cardiologia Ospedale San Vincenzo, Taormina (Me) and Cardiologia Presidio Ospedaliero “G. Fogliani”, Milazzo (ME) Azienda Sanitaria Provinciale di Messina, Italy c Cardiochirurgia Ospedale Papardo Messina, Azienda Ospedaliera Ospedali Riuniti Papardo Piemonte, 98158 Messina, Italy
Giuseppe Mario Calvagna, Salvatore Patanè, Fabrizio Ceresa, Alessandro Fontana, Giovanni Sicuso, Eugenio Vinci, Gianfranco Muscio, Ludovico Vasquez, and Francesco Patanè
Elsevier BV
a Cardiologia Ospedale San Vincenzo— Taormina (Me) Azienda Sanitaria Provinciale di Messina, 98039, Taormina (Messina), Italy b Cardiochirurgia Ospedale Papardo Messina, Azienda Ospedaliera Ospedali Riuniti Papardo Piemonte, 98158 Messina, Italy c UOC Cardiologia Ospedale Umberto I° ASP Siracusa, Italy d Cardiologia Ospedale San Vincenzo— Taormina (Me) and Cardiologia Presidio Ospedaliero “G. Fogliani” — Milazzo (ME) Azienda Sanitaria Provinciale di Messina, Italy
Giancarlo Agnelli, , Anselm K. Gitt, Rupert Bauersachs, Eva-Maria Fronk, Petra Laeis, Patrick Mismetti, Manuel Monreal, Stefan N. Willich, Wolf-Peter Wolf,et al.
Springer Science and Business Media LLC
BackgroundVenous thromboembolism (VTE) is a major health problem, with over one million events every year in Europe. However, there is a paucity of data on the current management in real life, including factors influencing treatment pathways, patient satisfaction, quality of life (QoL), and utilization of health care resources and the corresponding costs. The PREFER in VTE registry has been designed to address this and to understand medical care and needs as well as potential gaps for improvement.Methods/designThe PREFER in VTE registry was a prospective, observational, multicenter study conducted in seven European countries including Austria, France Germany, Italy, Spain, Switzerland, and the UK to assess the characteristics and the management of patients with VTE, the use of health care resources, and to provide data to estimate the costs for 12 months treatment following a first-time and/or recurrent VTE diagnosed in hospitals or specialized or primary care centers. In addition, existing anticoagulant treatment patterns, patient pathways, clinical outcomes, treatment satisfaction, and health related QoL were documented. The centers were chosen to reflect the care environment in which patients with VTE are managed in each of the participating countries. Patients were eligible to be enrolled into the registry if they were at least 18 years old, had a symptomatic, objectively confirmed first time or recurrent acute VTE defined as either distal or proximal deep vein thrombosis, pulmonary embolism or both. After the baseline visit at the time of the acute VTE event, further follow-up documentations occurred at 1, 3, 6 and 12 months. Follow-up data was collected by either routinely scheduled visits or by telephone calls.ResultsOverall, 381 centers participated, which enrolled 3,545 patients during an observational period of 1 year.ConclusionThe PREFER in VTE registry will provide valuable insights into the characteristics of patients with VTE and their acute and mid-term management, as well as into drug utilization and the use of health care resources in acute first-time and/or recurrent VTE across Europe in clinical practice.Trial registrationRegistered in DRKS register, ID number: DRKS00004795
Fabrizio Sansone, Alessandro Morgante, Fabrizio Ceresa, Giovanni Salamone, and Francesco Patanè
Georg Thieme Verlag KG
Background: “Type A” acute aortic dissection (AAAD) is the most challenging among the emergency operations in cardiac surgery. The aim of this study was the evaluation of the role of acute renal failure (ARF) in postoperative survival of patients operated for AAAD. Methods: From February 2010 to April 2012, 37 consecutive patients were operated at our department for AAAD. We studied our population by subdividing the patients within groups according to the presence of ARF requiring continuous veno-venous hemofiltration (CVVH) and according to hypothermic circulatory arrest (HCA) times and degrees. Results: The overall 30-day mortality was 27% (50% group A with ARF, 13% group B no ARF). Acute renal failure requiring CVVH was 37.8%. Multivariate analysis revealed a significant association with 30-day mortality (odds ratio 6.6 and p = 0.020). Preoperative oliguria [urine output less than 30 ml/h (odds ratio 4.7 p = 0.039)], CPB greater than 180 minutes (odds ratio 6.5 p = 0.023) and postoperative bleeding requiring a surgical reopening (odds ratio 12.2 and p = 0.021) were the variables significantly associated with acute kidney injury. Conclusions: The data obtained from our analysis bring out the high incidence of renal injuries after surgery for AAAD, and indicate a negative impact on renal injuries of a preoperative oliguria, longer Cardiopulmonary bypass (CBP)/HCA times, and postoperative bleeding requiring a surgical revision. Our data also suggest a better 30-day survival and better renal outcomes in case of shorter HCA and lesser degree of hypothermia. The option of lesser and shorter hypothermia may be very useful, especially for the elderly patients and octogenarians.
Giuseppe Mario Calvagna, Fabrizio Ceresa, Alessandro Morgante, and Salvatore Patanè
Elsevier BV