Papers by Roberto Violini
Social Science Research Network, 2021
Catheterization and Cardiovascular Interventions, May 12, 2021
To determine the prognostic impact of anemia in patients randomized to bivalirudin or unfractiona... more To determine the prognostic impact of anemia in patients randomized to bivalirudin or unfractionated heparin (UFH) during transcatheter aortic valve replacement (TAVR).
Journal of Cardiovascular Medicine, Aug 1, 2010
Coronary artery fistulas (CAFs) are rare congenital or acquired anomalies characterized by an abn... more Coronary artery fistulas (CAFs) are rare congenital or acquired anomalies characterized by an abnormal communication between the coronary arteries and the cardiac chambers or great vessels. Most patients are asymptomatic during childhood but symptoms and complications have been reported with advancing age. Until recently, surgery was the routine mode of treatment for CAFs but, today transcatheter closure is recommended using a variety of devices, such as occlusion coils, vascular plugs, umbrella devices and covered stents. The case described here is of a 47-year-old woman with a large bilateral CAF draining into the pulmonary artery, successfully treated by implantation of two Amplatzer vascular plugs using a telescoping catheter technique.
![Research paper thumbnail of [Pulmonary stenosis with intact interventricular septum: qualitative and quantitative analysis of the vectorcardiogram (author's transl)]](https://a.academia-assets.com/images/blank-paper.jpg)
PubMed, 1981
Eighty-one patients suffering from pulmonary stenosis with intact interventricular septum were di... more Eighty-one patients suffering from pulmonary stenosis with intact interventricular septum were divided into two groups according to their age: Group I (greater than 2 years), Group II (less than 2 years). In Group I, patients with RVSP up to 50 mmHg have been included in subgroup A; patients with RVSP from 50 to 90 mmHg in subgroup B, patients with RVSP greater than 90 mmHg in subgroup C. In Group II forms with RVSP less than or equal to 60 mmHg have been considered moderate and forms with RVSP greater than 60 mmHg severe. The rotation and duration of the QRS loop on the various planes, presence of a terminal slowing, the ratios 0,01"/LMSV and 0,02"/LMSV, the LMSV and the RMSV in order to assess the most significant vcgraphic parameters to predict severity of the stenosis have been analysed. A fair correlation has been found between RMSV and RVSP (r = 0,55 in Group I; r = 0,54 in Group II). The AA. conclude that a counterclockwiseloop on the H plane and the presence of a terminal slowing are the most reliable parameters for recognizing the light forms, while the clockwise loop on the H plane and a markedly increased voltage of RMSV indicate more severe stenosis.
We describe a 63 year old Romanian female patient admitted to our institution with complaints of ... more We describe a 63 year old Romanian female patient admitted to our institution with complaints of typical angina and a diagnosis of non ST-elevation myocardial infarction. Coronary arteriography unveiled anomalous origin of a left circumflex coronary artery from the right coronary sinus of Valsalva near the right coronary ostium and a hyperdominant left anterior descending coronary artery giving off a posterior descending coronary artery with small distal-posterolateral left ventricular branch. The co-existence of a left circumflex coronary artery originating ectopically from the right sinus of Valsalva together with a posterior descending coronary artery originating from the distal end of the anterior descending artery is important to keep in mind especially by those doing coronary angiography in the cardiac catheterization laboratory.
PubMed, Feb 1, 1984
We have evaluated the diagnostic accuracy of subxyphoid 2-dimensional (2-D) echocardiography in F... more We have evaluated the diagnostic accuracy of subxyphoid 2-dimensional (2-D) echocardiography in Fallot's tetralogy by employing two planes defined as left anterior oblique (LAO) and right anterior oblique (RAO), similar to the respective angiographic axial projections. Echocardiographic and angiographic findings were compared in 39 patients. The pulmonary branches, the trunk, the infundibulum, the septal defect and the aorta were identified in all cases, the pulmonary valve in 97% and associated defects in 71%. The LAO view was best suited for an overall diagnosis and for the visualization of the left pulmonary branch, of the pulmonary anulus, and of the overriding of the aorta. The RAO proved optimal for the evaluation of the right pulmonary branch, of the infundibulum and of the relationship between ventricular septal defect and adjacent structures. It is concluded that the subxiphoid approach is a valuable technique for the 2-D echocardiographic evaluation of Tetralogy of Fallot.
PubMed, 2017
We describe a 63 year old Romanian female patient admitted to our institution with complaints of ... more We describe a 63 year old Romanian female patient admitted to our institution with complaints of typical angina and a diagnosis of non ST-elevation myocardial infarction. Coronary arteriography unveiled anomalous origin of a left circumflex coronary artery from the right coronary sinus of Valsalva near the right coronary ostium and a hyperdominant left anterior descending coronary artery giving off a posterior descending coronary artery with small distal-posterolateral left ventricular branch. The co-existence of a left circumflex coronary artery originating ectopically from the right sinus of Valsalva together with a posterior descending coronary artery originating from the distal end of the anterior descending artery is important to keep in mind especially by those doing coronary angiography in the cardiac catheterization laboratory.
PubMed, 1980
In this study multivariate analysis was adopted to establish how simultaneous changes in heart ra... more In this study multivariate analysis was adopted to establish how simultaneous changes in heart rate (HR), blood pressure (BP) and work load (W) can affect systolic time intervals (STI). Thus, 13 normal volunteers underwent two consecutive exercise stress tests in the supine and upright position on a bicycle ergometer. By multivariate analysis it was shown that, while in the supine position left ventricular ejection time (LVET) is influenced by HR and W (LVET) = 330.6 - 0.76 HR - 0.41 W, F = 224, P is less than 0.001), in the upright position LVET changes are due only to HR variations (LVET = 309 - 0.88 HR, P is less than 0.001). Pre-ejection period (PEP) in both positions is related to HR and W, but this latter has a non-linear influence (supine: PEP = 110.9 - 0.15 HR -0.34 W + 0.0012 W(2), F = 56.4, P is less than 0.001; upright: PEP = 119 - 0.16 HR - 0.5 W + 0.0025 W(2), F = 86.7, P is less than 0.001). Finally, PEP/LVET ratio is correlated both in the supine and upright position with maximal BP, HR and W; however, the influence of HR and BP is different in the two positions (supine: PEP/LVET = 0.259 + 0.00047 BP + 0.00068 HR - 0.00167 W + 0.000013 W(2), F = 5.68, P is less than 0.01; upright: PEP/LVET = 0.201 + 0.0011 HR - 0.00371 W + 0.00016 W(2), F = 4.79, P is less than 0.01).
PubMed, Jun 1, 2009
Objective: We sought to evaluate the short- and longterm outcomes of Amplatzer Multi-Fenestrated ... more Objective: We sought to evaluate the short- and longterm outcomes of Amplatzer Multi-Fenestrated Septal Occluder Cribriform (AMF) device use in the percutaneous closure of patent foramen ovale (PFO) associated with atrial septal aneurysm (ASA). Background: Since patients with PFO, associated with ASA, are at higher risk of embolic events (EE), the AMF device might offer advantages in this subgroup of patients. Methods: Overall, 38 consecutive patients, with both PFO and ASA, underwent percutaneous closure of the defect with the AMF device, and the results were compared to those in 38 patients with PFO and ASA treated with the Amplatzer PFO device (APO). Death due to embolism, stroke or transient ischemic attack (TIA) were considered recurrent EE. Pre- and post-intervention shunting and 6-month residual shunting were evaluated echocardiographically with intravenous contrast injection. Results: The procedure was successfully completed in all patients in both groups. No procedure-related complications were observed during hospitalization. Immediate closure was achieved in all patients in the AMF group, whereas 3 patients in the APO group showed a small residual shunt. Residual shunting was observed at 6 months in 2 patients in the APO group. No recurrence of EE was recorded in the AMF group. Recurrent TIA was observed in 3 patients in the APO group; 2/3 patients had a small residual shunt following the procedure and at 6-month follow up. Conclusion: The AMF device might offer advantages in terms of rate of EE recurrence or residual shunt compared to the APO device in PFO patients associated with ASA.
International Journal of Cardiology, Dec 1, 2019
The impact of diabetes mellitus (DM) on clinical outcomes after transcatheter aortic valve replac... more The impact of diabetes mellitus (DM) on clinical outcomes after transcatheter aortic valve replacement (TAVR) remains unclear. The aim of this study was to investigate the impact of DM on shortterm clinical outcomes after TAVR in a large randomized trial population. Methods and results: BRAVO-3 trial randomized 802 patients undergoing trans-femoral TAVR to procedural anticoagulation with bivalirudin or unfractionated heparin. The study population was divided according to the presence of DM, and further stratified according to the use of insulin. Net adverse cardiovascular outcomes (NACE e death, myocardial infarction (MI), stroke or major bleeding by Bleeding Academic Research Consortium (BARC) type 3b or above) was the primary outcome in-hospital and at 30-days. Of the total 802 randomized patients, 239 (30%) had DM at baseline, with 87 (36%) being treated with insulin. At 30-days, DM patients experienced numerically higher rates of net adverse cardiovascular events (16.3% vs. 14.4%, p ¼ 0.48) and acute kidney injury (19.7% vs. 15.1%, p ¼ 0.11), while non-DM (NDM) patients had numerically higher rates of cerebrovascular accidents (3.6% vs. 1.7%, p ¼ 0.22). After multivariable adjustment, DM patients had higher odds of vascular complications at 30-days (OR 1.57, p ¼ 0.03) and life-threatening bleeding both in-hospital (OR 1.50, p ¼ 0.046) and at 30-days (OR 1.50, p ¼ 0.03) with the excess overall risk primarily attributed to the higher rates observed among noninsulin dependent DM patients.
Catheterization and Cardiovascular Interventions, Apr 10, 2023
heart failure patients. Using these tools together may be helpful in guiding patient management a... more heart failure patients. Using these tools together may be helpful in guiding patient management and appropriate transitions of care. 289 One-Year Mortality among the Spectrum of Myopericardial Diseases
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Papers by Roberto Violini