Papers by Cristian Monterosso
The Journal of Heart and Lung Transplantation, 2001
Turkish Journal of Thoracic and Cardiovascular Surgery, 2013
Bu çalışmada pulmoner endarterektominin erken sonuçları değerlendirildi. Ça lış ma pla nı: Mart 2... more Bu çalışmada pulmoner endarterektominin erken sonuçları değerlendirildi. Ça lış ma pla nı: Mart 2011-Temmuz 2012 tarihleri arasında pulmoner endarterektomi yapılan 64 hasta (29 erkek, 35 kadın; ort. yaş 47.4±10.4 yıl; dağılım 14-78 yıl) retrospektif olarak incelendi. Ameliyat öncesi ve ameliyat sonrası sağ ventriküler fonksiyon ve pulmoner arter hemodinamik değerleri Doppler ekokardiyografi ile değerlendirildi. Değişkenler ortalama ± standart sapma olarak ifade edildi. Karşılaştırmalar bağımsız örneklem t-testi ile yapıldı (p<0.05). P<0.05 değerleri anlamlı olarak kabul edildi. Bul gu lar: Ameliyat öncesi ölçümlerinde ortalama sistolik pulmoner arter basıncı 75.4±25.5 mmHg iken, ortalama pulmoner vasküler direnç 801.7±449.5 dynes.sec.cm-5 idi. Ameliyat sonrasında ortalama sistolik pulmoner arter basıncı 44.4±15.6 mmHg iken, ortalama pulmoner vasküler direnç 371.6±237.9 dynes.sec.cm-5 idi (p<0.001 ve p<0.001). On hastada (%15.6) erken mortalite görüldü. So nuç: Pulmoner endarterektomi, kronik tromboembolik pulmoner hipertansiyonun tedavisinde etkili ve güvenlidir. Bu yöntemin kullanımı, ülkemizde deneyimli merkezler vasıtasıyla artırılmalıdır. Anah tar söz cük ler: Endarterektomi; pulmoner arter; pulmoner emboli; pulmoner hipertansiyon; sağ ventrikül disfonksiyonu. Background:This study aims to assess the early results of pulmonary endarterectomy. Methods: Between March 2011 and July 2012, 64 patients (29 males, 35 females; mean age 47.4±10.4 years; range 14 to 78 years) who underwent pulmonary endarterectomy were retrospectively analyzed. Preoperative and postoperative Doppler echocardiographic evaluation of pulmonary arterial hemodynamics and right ventricular function were evaluated. Variables were expressed in a mean ± standard deviation. The comparisons were made using independent sample t-test (p<0.05). A p value of <0.05 was considered significant. Results:The preoperative mean systolic pulmonary artery pressure was 75.4±25.5 mmHg, while the mean pulmonary vascular resistance was 801.7±449.5 dynes.sec.cm-5. The postoperative mean systolic pulmonary artery pressure was 44.4±15.6 mmHg, whereas the mean pulmonary vascular resistance was 371.6±237.9 dynes.sec.cm-5 (p<0.001 and p<0.001). Early mortality was seen in 10 patients (15.6%). Conclusion: Pulmonary endarterectomy is effective and safe in the treatment of chronic thromboembolic pulmonary hypertension. Its usage should be extended with support of experienced centers in Turkey.
Giornale Italiano di Cardiologia, 2006
Acute pulmonary embolism is the third most common cardiovascular disease in Italy with approximat... more Acute pulmonary embolism is the third most common cardiovascular disease in Italy with approximately 65 000 new cases a year. Appropriate medical therapy does not necessarily prevent evolution of acute pulmonary embolism into chronic thromboembolic pulmonary hypertension (CTEPH), which occurs in 0.1-4.0% of cases. In our country, there are approximately up to 2600 new CTEPH patients a year. CTEPH is a progressive and potentially lethal disease. Medical therapy is palliative and only surgery can modify its natural history. Pulmonary endarterectomy (PEA) is the treatment of choice and lung transplantation should be considered only when PEA is contraindicated. Currently, nearly 4000 PEAs have been performed worldwide. Approximately ten centers are able to carry out this intervention with excellent and permanent results. Solid experience and close multidisciplinary collaboration allow appropriate patient selection, rigorous surgical technique, and adequate postoperative management. All ...
Annals of Cardiothoracic Surgery, 2021
Journal of Cardiovascular Medicine, 2020
AIMS Aim of the study was to verify the feasibility, safety and efficacy of pulmonary endarterect... more AIMS Aim of the study was to verify the feasibility, safety and efficacy of pulmonary endarterectomy (PEA) in octogenarian patients with chronic thromboembolic pulmonary hypertension. METHODS We retrospectively analyzed 635 chronic thromboembolic pulmonary hypertension patients who underwent PEA at our center and were followed-up for at least 1 year. The end-points of the study were in-hospital mortality, hemodynamic results at 1 year and long-term survival. RESULTS In-hospital mortality was 4, 10 and 17%, respectively, for 259 patients under the age of 60 years, 352 aged between 60 and 79 years and 24 octogenarians (P = 0.006 octogenarians vs. <60 years). At multivariable analysis, age and pulmonary vascular resistances were independent risk factors for mortality (P = 0.021 and P < 0.001, respectively). At 1 year, the improvement in cardiac index was lower and the distance walked in 6 min was poorer for octogenarians than for the other two groups (both P = 0.001). Survival after hospital discharge was similar over a median follow-up period of 59 months (P = 0.113). Although in-hospital mortality and long-term survival are similar in octogenarians as compared with patients aged between 60 and 79, the improvement in cardiac index and in functional capacity at 1 year are lower in this very elderly population. CONCLUSION Age over 80 years should not be a contraindication to PEA surgery in selected patients operated on in referral centers.
European Radiology, 2021
Objectives The aim of this study was to describe the radiological features of chronic thromboembo... more Objectives The aim of this study was to describe the radiological features of chronic thromboembolic pulmonary disease (CTEPD), not yet systematically described in the literature. Furthermore, we compared vascular scores between CTEPD and chronic thromboembolic pulmonary hypertension (CTEPH) patients, trying to explain why pulmonary hypertension does not develop at rest in CTEPD patients. Methods Eighty-five patients (40 CTEPD, 45 CTEPH) referred to our centre for pulmonary endarterectomy underwent dual-energy computed tomography pulmonary angiography (DE-CTPA) with iodine perfusion maps; other 6 CTEPD patients underwent single-source CTPA. CT scans were reviewed independently by an experienced cardiothoracic radiologist and a radiology resident to evaluate scores of vascular obstruction, hypoperfusion and mosaic attenuation, signs of pulmonary hypertension and other CT features typical of CTEPH. Results Vascular obstruction burden was similar in the two groups (p = 0.073), but CTEP...
Giornale italiano di cardiologia, 2006
Acute pulmonary embolism is the third most common cardiovascular disease in Italy with approximat... more Acute pulmonary embolism is the third most common cardiovascular disease in Italy with approximately 65 000 new cases a year. Appropriate medical therapy does not necessarily prevent evolution of acute pulmonary embolism into chronic thromboembolic pulmonary hypertension (CTEPH), which occurs in 0.1-4.0% of cases. In our country, there are approximately up to 2600 new CTEPH patients a year. CTEPH is a progressive and potentially lethal disease. Medical therapy is palliative and only surgery can modify its natural history. Pulmonary endarterectomy (PEA) is the treatment of choice and lung transplantation should be considered only when PEA is contraindicated. Currently, nearly 4000 PEAs have been performed worldwide. Approximately ten centers are able to carry out this intervention with excellent and permanent results. Solid experience and close multidisciplinary collaboration allow appropriate patient selection, rigorous surgical technique, and adequate postoperative management. All ...
Classic Hodgkin lymphoma (HL) involving the endometrium is extremely rare as lymphoma involving t... more Classic Hodgkin lymphoma (HL) involving the endometrium is extremely rare as lymphoma involving the female genital tract is uncommon in general and those that do are most commonly non-Hodgkin lymphomas. Here, we present a patient with refractory classic HL where PET scan imaging results led to an endometrial biopsy that confirmed uterine involvement of her disease.
Previous studies have showed the associations between various BRCA1-interacting protein 1 (BRIP1)... more Previous studies have showed the associations between various BRCA1-interacting protein 1 (BRIP1) polymorphisms and cancer risk. But, these results were inconsistent. This meta-analysis based on 18 studies involving 13,716 cancer patients and 15,590 cancer-free controls is aimed at to evaluate the relationship between the four common SNPs of BRIP1 (rs2048718, rs4988344, rs4986764, and rs6504074) and cancer risk. The results showed a decreased risk of rs2048718 or rs4986764 for cervical cancer rather than breast cancer in the overall population (P < 0.05). However, rs6504074 was associated with gynecologic cancer risk among overall population (P < 0.05). Further stratification analyses by ethnicity indicated that all 4 polymorphisms (rs2048718, rs4988344, rs4986764, and rs6504074) were strongly related to cancer susceptibility in Chinese people (P < 0.05). This meta-analysis showed that rs6504074 may play a decreased risk of gynecologic cancer in the overall population. Rs4988344, rs4986764, and rs6504074 were significantly related to decreasing cancer risk in Chinese population.
International Journal of Cardiology, 2021
BACKGROUND Few studies addressed the issue of risk stratification in patients with residual pulmo... more BACKGROUND Few studies addressed the issue of risk stratification in patients with residual pulmonary hypertension (pH) after pulmonary endarterectomy (PEA). This study tested the potential added value of parameters that have not been included in existing risk models. METHODS We evaluated 546 consecutive patients with chronic thromboembolic pulmonary hypertension who underwent PEA and were followed-up for a median period of 58 months. RESULTS Among the 242 with residual PH, 27 died and had 127 a clinical worsening event. At univariable analysis, the parameters associated with poor survival were pulmonary vascular resistance (PVR) ≥425 dyn·s·cm-5 (p ≤0.001), mean pulmonary artery pressure (mPAP) ≥38 mmHg (p = 0.003) and pulmonary artery compliance (CPA) ≤1.8 ml/mmHg (p = 0.014). In the bivariable models including either PVR or mPAP as first parameter, the addition of CPA was not statistically significant. The parameters associated with poor clinical worsening were CPA ≤1.8 ml/mmHg (p < 0.001), PVR ≥425 dyn·s·cm-5 (p = 0.002), arterial oxygen tension (PaO2) ≤ 75 mmHg (p = 0.003), mPAP ≥38 mmHg (p = 0.008). In a multivariable analysis which included PVR ≥425 as the first parameter, the addition of both CPA ≤1.8 ml/mmHg and of PaO2 ≤ 75 mmHg significantly improved prognostic stratification (Harrel's C of the model = 0.64, p < 0.001). Noticeably, the lower tertile of the model's predictor index identified a subgroup of 91 patients who had an event rate numerically similar to that of patients without residual PH. CONCLUSIONS Risk stratification in residual PH can be refined if CPA and PaO2 are considered in association with standard hemodynamic parameters.
The Journal of Heart and Lung Transplantation, 2018
In this paper we will consider new bounds on the smallest primitive root modulo a prime. we will ... more In this paper we will consider new bounds on the smallest primitive root modulo a prime. we will make more judicious use of the Pólya-Vinogradov and Burgess inequalities, and use them to prove that the smallest primitive root is smaller than p 0.68 for all primes p.
The Journal of Heart and Lung Transplantation, 2019
Purpose The aim of our study was to investigate hemodynamic and functional outcome after pulmonar... more Purpose The aim of our study was to investigate hemodynamic and functional outcome after pulmonary endarterectomy (PEA) in patients with symptomatic chronic thromboembolic pulmonary disease (CTED). Methods The study included 48 consecutive CTED patients who underwent PEA from February 2001 to April 2018. In all patients a clinic, functional and hemodynamic evaluation was performed before PEA. Hemodynamic changes and functional capacity were recorded at 3 months and one year after PEA. Results At every time-points after PEA patients had significantly lower values of mean pulmonary artery pressure (mPAP) (p=0.001) and pulmonary vascular resistance (PVR) (p Conclusion In our opinion, the PEA is the gold standard treatment in symptomatic CTED patients. The improvement of hemodynamic and functional outcome at every time-points after surgery and the low mortality shows the efficacy and the safety of this treatment.
Uploads
Papers by Cristian Monterosso