Publications by authors named "Gabriele M Iacona"

9 Publications

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Radical pericardiectomy for pericardial diseases.

Multimed Man Cardiothorac Surg 2021 Oct 25;2021. Epub 2021 Oct 25.

Heart Vascular & Thoracic Institute, Cleveland Clinic, OH, USA.

Pericarditis is the most common form of pericardial disease. Its exact incidence remains unknown, probably because many cases resolve without diagnosis. Indications for pericardiectomy from the standpoint of the cardiac surgeon are based mainly on the physiopathology of 2 different entities that can overlap: inflammatory or relapsing pericarditis and constrictive pericarditis. Surgical indications are not always straightforward. Patients with inflammatory or relapsing pericarditis may undergo radical pericardiectomy because they experience severe symptoms despite maximal medical treatment or have sequelae from the medical treatment. Pericardiectomy is the standard treatment in patients with chronic constrictive pericarditis and persistent symptoms who are in New York Heart Association functional class III or IV and a class I recommendation in the European Society of Cardiology/European Association of Cardio-Vascular Surgery guidelines. The goal of surgery is always complete removal of any site of inflammation through a radical pericardiectomy.
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http://dx.doi.org/10.1510/mmcts.2021.069DOI Listing
October 2021

Percutaneous Coronary Intervention with Stenting versus Coronary Artery Bypass Grafting in Stable Coronary Artery Disease.

Int J Angiol 2021 Sep 31;30(3):221-227. Epub 2021 Aug 31.

Medstar Health Cardiac Surgery, Heart and Vascular Institute, Medstar Washington Hospital Center, Washington, District of Columbia.

The debate over coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI) with stent placement for the treatment of stable multivessel coronary artery disease (CAD) continues in spite of numerous studies investigating the issue. This paper reviews the most recent randomized control trials (RCT) and meta-analyses of pooled RCT data to help address this issue. General trends demonstrated that CABG was superior in all-cause mortality and fulfilling the need for repeat revascularization. These advantages tended to be more pronounced in multivessel CAD and diabetes, and less so in left main CAD. PCI showed a consistently lower rate of cerebrovascular events. CABG continues to offer significant advantages over PCI, even as drug-eluting stent technology continues to evolve. The ideal endpoint for comparing PCI and CABG remains to be determined. Furthermore, additional research is required to further refine patient selection criteria for each intervention.
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http://dx.doi.org/10.1055/s-0041-1735238DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8580606PMC
September 2021

High take-off of the left coronary artery from the distal ascending aorta.

JTCVS Tech 2021 Aug 2;8:53-55. Epub 2021 Jun 2.

Department of Thoracic and Cardiovascular Surgery, Coronary Center, Heart Vascular & Thoracic Institute, Cleveland Clinic, Cleveland, Ohio.

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http://dx.doi.org/10.1016/j.xjtc.2021.05.020DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8350948PMC
August 2021

Commentary: Postcardiac surgery myocardial ischemia: Be on the lookout and sort it out!

J Thorac Cardiovasc Surg 2021 Jun 25. Epub 2021 Jun 25.

Department of Thoracic and Cardiovascular Surgery, Coronary Center, Heart Vascular & Thoracic Institute, Cleveland Clinic, Cleveland, Ohio. Electronic address:

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http://dx.doi.org/10.1016/j.jtcvs.2021.06.036DOI Listing
June 2021

Patch Repair of Aortic Mitral Continuity Pseudoaneurysm Through Transverse Sinus.

Ann Thorac Surg 2021 04 26;111(4):e309. Epub 2020 Dec 26.

Heart Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio. Electronic address:

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http://dx.doi.org/10.1016/j.athoracsur.2020.09.084DOI Listing
April 2021

Paediatric cardiac surgery in a peripheral European region: is a joint programme a safe alternative to regionalisation?

Cardiol Young 2017 Mar 18;27(2):273-283. Epub 2016 Apr 18.

2Division of Cardiac Surgery,IRCCS Policlinico San Donato,San Donato Milanese,Milan,Italy.

Background: In 2007, a partnership was initiated between a small-volume paediatric cardiac surgery unit located in Las Palmas de Gran Canaria, Spain, and a large-volume cardiac surgery unit located in Milan, Italy. The main goal of this partnership was to provide surgical treatment to children with CHD in the Canary Islands.

Methods: An operative algorithm for performing surgery in elective, urgent, and emergency cases was adopted by the this joint programme. Demographic and in-hospital variables were collected from the medical records of all the patients who had undergone surgical intervention for CHD from January, 2009 to March, 2013. Data were introduced into the congenital database of the European Congenital Heart Surgeons Association Congenital Database and the database was interrogated.

Results: In total, 65 surgical mission trips were performed during the period of this study. The European Congenital Heart Surgeons Association Congenital Database documented 214 total patients with a mean age at operation of 36.45 months, 316 procedures in total with 198 cardiopulmonary bypass cases, 46 non-cardiopulmonary bypass cases, 26 cardiovascular cases without cardiopulmonary bypass, 22 miscellaneous other types of cases, 16 interventional cardiology cases, six thoracic cases, one non-cardiac, non-thoracic procedure on a cardiac patient with cardiac anaesthesia, and one extracorporeal membrane oxygenation case. The 30-day mortality was 6.07% (13 patients).

Conclusions: A joint programme between a small-volume centre and a large-volume centre may represent a valid and reproducible model for safe paediatric cardiac surgery in the context of a peripheral region.
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http://dx.doi.org/10.1017/S1047951116000469DOI Listing
March 2017

Fontan operation for patients with complex anatomy: the intra-atrial conduit technique.

World J Pediatr Congenit Heart Surg 2012 Apr;3(2):251-4

Pediatric Cardiac Surgery Service, Complejo Hospitalario Universitario Insular Materno Infantil, Las Palmas de Gran Canaria, Spain.

The extracardiac conduit type of total cavopulmonary connection (TCPC) is the most common variation of the modified Fontan operation in current use. For patients with some forms of complex anatomy (eg, dextrocardia in situs solitus or asplenia syndrome), we have adopted a different technique: interposition of an intra-atrial conduit between the inferior vena cava (IVC) and the superior vena cava-right pulmonary artery (SVC-RPA) connection. We report our experience with six patients.
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http://dx.doi.org/10.1177/2150135111426730DOI Listing
April 2012

Intrapericardial teratoma in a low birth weight preterm infant: a successful multidisciplinary approach.

Interact Cardiovasc Thorac Surg 2011 Feb 30;12(2):287-9. Epub 2010 Nov 30.

Unidad Medico Quirúrgica de Cardiología Pediátrica y Cardiopatías Congénitas, Hospital Universitario Materno Infantil, CHUIMI, Avenida Maritima del Sur s/n, 35016 Las Palmas de GC, Spain.

We report the case of an intrapericardial teratoma, a rare tumour in infants, prenatally diagnosed and successfully treated thanks to a multidisciplinary approach. An intrapericardial cystic mass (2.5 cm) with pericardial effusion was identified in a foetus at 32 weeks gestational age (GA). Intrauterine pericardiocentesis was performed immediately (40 ml) and repeated at 33 weeks (25 ml) and then at 34 weeks GA, just before birth (36 ml). Considering the rapid growth of the mass and the risk of hydrops, vaginal delivery was induced. A baby girl weighing 1.98 kg was born without cardiorespiratory compromise. Echocardiography and thoracic CT-scan located the 4.0×3.0 cm cystic mass between the left atrial appendage and the left superior pulmonary vein. At three days of life, the mass was completely removed without cardiobypass. It arose from the ascending aorta. Postoperative course was uneventful. Pathology diagnosed an immature intrapericardial teratoma. As long-term follow-up is required, alpha-fetoprotein can be a valid tool to monitor a possible recurrence. A multidisciplinary approach allows successful prenatal management and postnatal tumour surgery.
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http://dx.doi.org/10.1510/icvts.2010.250746DOI Listing
February 2011
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