Papers by Alvise Guariento
The Journal of Thoracic and Cardiovascular Surgery
Frontiers in Cardiovascular Medicine
Anomalous aortic origin of a coronary artery (AAOCA) is reported as the second leading cause of s... more Anomalous aortic origin of a coronary artery (AAOCA) is reported as the second leading cause of sudden cardiac death in otherwise healthy young individuals. Several surgical studies have reported a shallow operative risk, describing repair as safe and effective with short or medium-term follow-up. However, surgical repair can also be associated with a high risk of complications. Numerous repair techniques have been described in the literature, but each technique's indications and limitations are often not well-understood or understated. Since explicit technical knowledge of the most appropriate surgical technique is highly desirable, we sought to thoroughly and clearly outline the safeguards and pitfalls of the most common surgical techniques used to repair AAOCA.
The Journal of Thoracic and Cardiovascular Surgery
Pediatric Cardiology
To evaluate early and long-term results of surgical treatment of aortic coarctation (CoAo) in neo... more To evaluate early and long-term results of surgical treatment of aortic coarctation (CoAo) in neonates. This is a retrospective clinical review of neonates with CoAo, who underwent surgery between 1995 and 2019. Data were retrieved from our institutional database, to identify preoperative and postoperative characteristics. Statistical analysis was performed by means of relative risk ratio and Cox and logistic multivariate analysis. 218 consecutive neonates (M/F: 129/89, median age 11 days, IQR 7–17 days) were included; 202 (92.7%) had a left thoracotomy; 178 underwent extended end-to-end anastomosis (EEEA, 81.6%). Hypoplastic aortic arch (HAA) was present in 102 patients (46.8%); complex cardiac anomalies in 85 (39%). Significant postoperative complications occurred in 20 (9.2%). Thirty-day mortality was 2.3% (most in complex types). At a median follow-up of 10.4 years (IQR 5.6–15.0 years; FU completeness 95.9%), there were 8 late deaths (3.7%), all associated to complex CoAo. Among...
The Annals of Thoracic Surgery
The Journal of Thoracic and Cardiovascular Surgery
The Annals of Thoracic Surgery
The Journal of Thoracic and Cardiovascular Surgery
European Heart Journal Supplements
Aims To investigate pulmonary valve (PV) and right ventricular function by echocardiography in pa... more Aims To investigate pulmonary valve (PV) and right ventricular function by echocardiography in paediatric patients with repaired Tetralogy of Fallot (ToF), comparing PV preservation surgical strategies to standard transannular patch (TAP) repair. Methods and results All patients undergoing transatrial-transpulmonary repair for ToF at our institution between January 2007 and May 2020 were reviewed retrospectively. Patients were divided into 2 groups, according to the different techniques used (PV preservation strategy vs TAP repair). All patients underwent standard echo-Doppler study including RV areas, fractional area change (FAC) and tricuspid annular plane systolic excursion (TAPSE); Pulmonary regurgitation (PR) was assessed by Color Doppler, continuous-wave (CW) Doppler, pressure half time (PHT) and PR index. By speckle tracking we measured also, in a subgroup of patients, right atrial strain (RAS), RV and left ventricle (LV) global longitudinal strain (RVGLS, LVGLS) and their ti...
The Journal of Thoracic and Cardiovascular Surgery
World Journal for Pediatric and Congenital Heart Surgery
Several techniques designed to improve long-term results after repair of tetralogy of Fallot are ... more Several techniques designed to improve long-term results after repair of tetralogy of Fallot are described. We have recently embarked on a program focused on preserving the native pulmonary valve. Here, combined techniques are described in detail, including intraoperative pulmonary valve balloon dilatation, pulmonary valve reconstruction by delamination and resuspension of the leaflets, and pulmonary valve annulus augmentation. As with any other complex congenital heart disease, senior surgeons should select teaching cases, starting from the less severe side of the spectrum.
The Journal of Thoracic and Cardiovascular Surgery
The Journal of Thoracic and Cardiovascular Surgery
American Journal of Physiology-Renal Physiology
Acute kidney injury is a common clinical disorder and one of the major causes of morbidity and mo... more Acute kidney injury is a common clinical disorder and one of the major causes of morbidity and mortality in the postoperative period. In this study, the safety and efficacy of autologous mitochondrial transplantation by intra-arterial injection for renal protection in a swine model of bilateral renal ischemia-reperfusion injury were investigated. Female Yorkshire pigs underwent percutaneous bilateral temporary occlusion of the renal arteries with balloon catheters. Following 60 min of ischemia, the balloon catheters were deflated and animals received either autologous mitochondria suspended in vehicle or vehicle alone, delivered as a single bolus to the renal arteries. The injected mitochondria were rapidly taken up by the kidney and were distributed throughout the tubular epithelium of the cortex and medulla. There were no safety-related issues detected with mitochondrial transplantation. Following 24 h of reperfusion, estimated glomerular filtration rate and urine output were sign...
Congenital Heart Disease
We report the case of three female patients who were scheduled for surgical correction of residua... more We report the case of three female patients who were scheduled for surgical correction of residual left-to-right shunt after initial repair of sinus venosus atrial septal defect (SV-ASD) during childhood. After excluding the possibility of an hemodynamic intervention, all three patients underwent a successful surgical closure through a right mini sub-axillary approach by using total peripheral cannulation for cardiopulmonary bypass and leaving the inferior vena cava completely un-snared allowing for an optimal visualization of the residual atrial septal communication and avoiding extensive dissection of mediastinal structures.
Journal of Visualized Experiments
Revista Española de Cardiología
Circulation
Introduction: Acute kidney injury (AKI) is a common clinical disorder and one of the major causes... more Introduction: Acute kidney injury (AKI) is a common clinical disorder and one of the major causes of morbidity and mortality during the postoperative period. In this study, we investigated the safety and efficacy of autologous mitochondrial transplantation by intra-arterial injection for renal protection in a swine model of bilateral renal ischemia-reperfusion injury (IRI). Methods: Female Yorkshire pigs (n=12) underwent percutaneous bilateral temporary occlusion of the renal arteries with balloon-catheters. Following 60 minutes of ischemia, the balloon catheters were deflated and animals received either autologous mitochondria suspended in vehicle (n=6) or vehicle alone (n=6), delivered as a single bolus to the renal arteries. Results: Injected mitochondria were rapidly taken up by the kidney and were distributed throughout the tubular epithelium of the cortex and the medulla. Evaluation of plasma electrolytes, acid-base status, complete blood count and biochemical analysis did not...
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Papers by Alvise Guariento