Gianluca Santise

Publications (16)37.58 Total impact

• Article: Can Learning to Interpret Pump Messages Help Lead to an Early Diagnosis of HeartWare Ventricular Assist Device Thrombosis?

  Gianluca Santise, Sergio Sciacca, Roberto Baglini, Francesco Clemenza, Michele Pilato
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  ABSTRACT: Left ventricular assist device thrombosis is a detrimental complication that, if not properly diagnosed and treated, can lead to low output syndrome and death. When ongoing thrombus formation is caused by inappropriate anticoagulation, timely identification is possible, and could perhaps be the key to successful treatment.
  ASAIO journal (American Society for Artificial Internal Organs: 1992) 10/2012; · 1.39 Impact Factor
• Article: Intraoperative validation of a new system for invasive continuous cardiac output measurement

  Giuseppe D’Ancona, Matteo Parrinello, Gianluca Santise, Domenico Biondo, Francesco Pirone, Sergio Sciacca, Marco Turrisi, Antonio Arcadipane, Michele Pilato
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  ABSTRACT: ObjectiveAlthough bolus thermodilution technique for cardiac output (CO) measurement has widespread acceptance, new systems are currently available. We evaluated a continuous CO system (TruCCOMS, Aortech International Inc.) that operates on the thermal conservation principle and we compared it with the reference standard transit time flow measurement (TTFM). Materials and methodsNine consecutive cardiac surgery patients were evaluated. After general anesthesia and intubation, a TruCCOMS catheter was percutaneously placed in the pulmonary artery (PA). After median sternotomy and pericardiotomy, a TTFM probe was placed around the main PA. Right ventricular (RV) CO measurements were recorded with both TruCCOMS and TTFM at different times: before cardiopulmonary bypass (CPB) (T0), during weaning from CPB (T1), and prior to sternal closure (T2). Data analysis included paired student t test, Pearson correlation test, and Bland–Altman plotting. ResultsTruCCOMS CO values were significantly lower at T0 (TruCCOMS 4.0±1.0 vs. TTFM 4.5±1.0L/min; P<0.0001) and T1 (TruCCOMS 3.6±0.5 vs. TTFM 4.2±0.7L/min; P<0.0001), and comparable at T2 (TruCCOMS 4.5±0.7 vs. TTFM 4.6±0.8L/min; P=0.4). Pearson test showed a significant correlation between TruCCOMS and TTFM CO measurements (RT0=0.9, RT1=0.8, RT2=0.6; P<0.0001). Bland–Altmann plotting showed a bias of −0.53±0.43L (−12%) at T0, −0.64±0.43L (−14.5%) at T1, and −0.1±0.66L (−0.8%) at T2. ConclusionAlthough TruCCOMS may significantly underestimate CO, measurement trends correlate with TTFM. For this reason, a negative trend in RV output should trigger more specific diagnostic procedures.
  Intensive Care Medicine 04/2012; 35(5):943-947. · 5.40 Impact Factor
• Article: Hybrid treatment of inferior vena cava obstruction after orthotopic heart transplantation.

  Gianluca Santise, Giuseppe D'Ancona, Roberto Baglini, Michele Pilato
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  ABSTRACT: Caval stenosis with subsequent thrombosis may occur after orthotopic heart transplantation (HT). Management of this complication may include a percutaneous approach or an open surgical one. Here, we report the case of an obstruction and severe thrombosis of the inferior vena cava, following orthotopic HT, that was managed in a hybrid fashion with surgical venous thrombectomy, inferior vena cava stenting, and atrio-caval patch-plasty.
  Interactive cardiovascular and thoracic surgery 12/2010; 11(6):817-9.
• Article: Echocardiography in acute native aortic valve endocarditis.

  Gianluca Santise, Giuseppe D'Ancona, Giuseppe Mamone, Settimo Caruso, Antonella Frenda, Sergio Sciacca, Francesco Pirone, Michele Pilato
  Journal of cardiothoracic and vascular anesthesia 07/2009; 24(3):516-8. · 1.06 Impact Factor
• Article: Donor pharmacological hemodynamic support is associated with primary graft failure in human heart transplantation.

  Gianluca Santise, Giuseppe D'Ancona, Calogero Falletta, Francesco Pirone, Sergio Sciacca, Marco Turrisi, Domenico Biondo, Michele Pilato
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  ABSTRACT: The aim of this study was to test the impact of donor and recipient characteristics on the development of primary graft failure (PGF) after heart transplantation (HT) by focusing on the donor's inotropic support. Heart donors and matched recipients data were prospectively collected. Univariate and multivariate analyses were used to determine independent predictors for PGF and peri-operative mortality. The donor's high inotrope requirement was defined as sustained need for dopamine exceeding 10 microg/kg/min and/or alpha agonists exceeding 0.06 microg/kg/min. PGF instead was defined as need for immediate post-HT mechanical circulatory support. Since 2006, we have performed 37 HTs. PGF occurred in six patients (16.2%). Although four patients (66.6%) were weaned off circulatory support, two of them (33.3%) died on mechanical assistance. Total in-hospital mortality was 10.8% (4/37). Upon multivariate analysis, pre-harvesting donor high inotrope dosage was the major determinant for PGF (P=0.03, OR=10.8). Given the organ shortage, many centers accepted marginal hearts assuming the donor's pre-harvest hemodynamic managing has a reduced impact on PGF development. As PGF remains the most lethal postoperative complication, the hazards should be carefully considered when using pre-harvesting high inotrope infusion rates.
  Interactive cardiovascular and thoracic surgery 07/2009; 9(3):476-9.
• Article: Intraoperative validation of a new system for invasive continuous cardiac output measurement.

  Giuseppe D'Ancona, Matteo Parrinello, Gianluca Santise, Domenico Biondo, Francesco Pirone, Sergio Sciacca, Marco Turrisi, Antonio Arcadipane, Michele Pilato
  [show abstract] [hide abstract]
  ABSTRACT: Although bolus thermodilution technique for cardiac output (CO) measurement has widespread acceptance, new systems are currently available. We evaluated a continuous CO system (TruCCOMS, Aortech International Inc.) that operates on the thermal conservation principle and we compared it with the reference standard transit time flow measurement (TTFM). Nine consecutive cardiac surgery patients were evaluated. After general anesthesia and intubation, a TruCCOMS catheter was percutaneously placed in the pulmonary artery (PA). After median sternotomy and pericardiotomy, a TTFM probe was placed around the main PA. Right ventricular (RV) CO measurements were recorded with both TruCCOMS and TTFM at different times: before cardiopulmonary bypass (CPB) (T0), during weaning from CPB (T1), and prior to sternal closure (T2). Data analysis included paired student t test, Pearson correlation test, and Bland-Altman plotting. TruCCOMS CO values were significantly lower at T0 (TruCCOMS 4.0 +/- 1.0 vs. TTFM 4.5 +/- 1.0 L/min; P < 0.0001) and T1 (TruCCOMS 3.6 +/- 0.5 vs. TTFM 4.2 +/- 0.7 L/min; P < 0.0001), and comparable at T2 (TruCCOMS 4.5 +/- 0.7 vs. TTFM 4.6 +/- 0.8 L/min; P = 0.4). Pearson test showed a significant correlation between TruCCOMS and TTFM CO measurements (RT0 = 0.9, RT1 = 0.8, RT2 = 0.6; P < 0.0001). Bland-Altmann plotting showed a bias of -0.53 +/- 0.43 L (-12%) at T0, -0.64 +/- 0.43 L (-14.5%) at T1, and -0.1 +/- 0.66 L (-0.8%) at T2. Although TruCCOMS may significantly underestimate CO, measurement trends correlate with TTFM. For this reason, a negative trend in RV output should trigger more specific diagnostic procedures.
  European Journal of Intensive Care Medicine 01/2009; 35(5):943-7. · 5.17 Impact Factor
• Article: Ischemic mitral valve regurgitation in patients with depressed ventricular function: cardiac geometrical and myocardial perfusion evaluation with magnetic resonance imaging.

  Giuseppe D'Ancona, Domenico Biondo, Giuseppe Mamone, Gianluca Marrone, Francesco Pirone, Gianluca Santise, Sergio Sciacca, Michele Pilato
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  ABSTRACT: To investigate geometrical and functional changes involving the left ventricle (LV) and mitral valve (MV) apparatus in patients with depressed LV ejection fraction (LVEF) and ischemic MV regurgitation (IMVR). A series of patients with three vessels coronary artery disease (CAD) and depressed LVEF underwent cardiac magnetic resonance imaging to investigate MV/LV geometry and function, and myocardial perfusion/vitality. Geometrical data were indexed by anterior MV leaflet length. Two groups were identified: CAD without IMVR (group CAD), and with IMVR (group IMV). Eleven patients were enrolled in the CAD group and 13 in the IMV group. IMVR volume was significantly higher in the IMV group (24.0+/-12.0 vs 4.5+/-5.2; p<0.0001). LVEF% was comparable (IMV 34.6+/-13.0 vs CAD 31.5+/-13.0; p=ns). Indexed MV/LV geometrical variables were comparable in the two groups. Perfusion/vitality study showed inferior myocardial necrosis occurred more often in the IMV group (p=0.01). At Pearson test, MV regurgitation occurrence correlated with inferior myocardial necrosis (r=0.5; p=0.006), non-indexed systolic/diastolic annular inter-commissural diameters (r=0.4; p=0.04) and MV annular areas (r=0.4; p=0.04). Papillary muscles distance (PMD) and LV volumes inversely correlated with LVEF% (r=-0.6; p<0.05 and r=-0.8; p<0.001). At multivariable analysis, no independent determinants for IMVR were identified and LV volumes were the sole determinants for LVEF% (p<0.05). In patients with depressed LVEF%, IMV cannot be explained by LV geometrical modifications alone. Although PMD, LV volumes, and LVEF% are correlated, they have no direct impact in the development of IMVR. In contrast, inferior myocardial necrosis and increased inter-commissural MV diameters may lead to deformity of MV complex and subsequent IMV.
  European journal of cardio-thoracic surgery: official journal of the European Association for Cardio-thoracic Surgery 09/2008; 34(5):964-8. · 2.40 Impact Factor
• Article: Circulatory support system as a bridge to decision in patients with refractory acute cardiogenic shock: is there a space for extracorporeal membrane oxygenation?

  Gianluca Santise, Sergio Sciacca, Giuseppe D'Ancona, Michele Pilato
  The Journal of thoracic and cardiovascular surgery 04/2008; 135(3):717; author reply 717-8. · 3.41 Impact Factor
• Article: Ischemic mitral valve regurgitation: the new challenge for magnetic resonance imaging.

  Giuseppe D'Ancona, Giuseppe Mamone, Gianluca Marrone, Francesco Pirone, Gianluca Santise, Sergio Sciacca, Michele Pilato
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  ABSTRACT: Ischemic mitral valve regurgitation (IMVR) refers to mitral regurgitation in patients with ischemic heart disease (IHD) in the presence of a structurally normal mitral valve. IMVR contributes significantly to morbidity and mortality in patients with IHD. The thresholds for clinical management, surgical intervention, and the choice of surgical procedure continue to evolve and independent determinants for surgical success in the pre- and post-operative evaluation of IMVR are still controversial. Although echocardiography has been valued as the gold standard in the evaluation of IMVR, new technologies such as magnetic resonance imaging (MRI) may be seen as applicable to the investigation of this complex pathology. MRI may allow for detection of parameters that could help clinicians and surgeons to better assess IMVR and eventually guide appropriate treatment whenever necessary. The present article discusses the main parameters that should be routinely investigated while adopting MRI technology to assess patients with IMVR. The review is the result of a multidisciplinary approach to this complex etiopathogenic entity and involves expertise spanning from radiology, cardiology, to cardiac surgery.
  European Journal of Cardio-Thoracic Surgery 10/2007; 32(3):475-80. · 2.55 Impact Factor
• Article: A suspicious abdominal computed tomography scan finding after aortic valve replacement.

  Gianluca Santise, Giuseppe D'Ancona, Sergio Sciacca, Francesco Pirone, Salvatore Gruttadauria, Bruno Gridelli, Michele Pilato
  Journal of Cardiothoracic and Vascular Anesthesia 09/2007; 21(4):612-4. · 1.64 Impact Factor
• Article: Protruding left intercostal mass after left ventricular aneurysmectomy.

  Giuseppe D'Ancona, Giuseppe Mamone, Gianluca Marrone, Francesco Pirone, Gianluca Santise, Sergio Sciacca, Michele Pilato
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  ABSTRACT: In this report we summarize a case of myocardial infarction that developed an apical ventricular aneurysm, which was surgically removed to re-expand and reappear as a pulsating chest wall mass 16 years later.
  The Annals of thoracic surgery 09/2007; 84(2):657-9. · 3.74 Impact Factor
• Article: Simplified left atrial volume reduction and modified maze procedure as treatment for permanent atrial fibrillation during concomitant mitral surgery.

  Giuseppe D'Ancona, Gianluca Santise, Sergio Sciacca, Francesco Pirone, Michele Pilato
  The Annals of thoracic surgery 08/2007; 84(1):357; author reply 357-8. · 3.74 Impact Factor
• Article: Left anterior descending coronary artery bridge: contraindication to cardiac transplantation?

  Giuseppe D'Ancona, Roberto Baglini, Francesco Clemenza, Francesco Pirone, Gianluca Santise, Cesare Scardulla, Sergio Sciacca, Michele Pilato
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  ABSTRACT: We report two cases of cardiac transplantation of donor hearts with left anterior descending (LAD) myocardial bridging (MB). In the first case, the diagnosis was done only days after transplant. In the second case, a pre-operative angiography showed evidence of LAD myocardial bridging and the organ was used for a marginal recipient. Both patients tolerated the procedure very well and did not have peri-operative cardiac complications. In this study, MB is discussed and its relationship to rejection of donor hearts is evaluated. In light of the growing demand for donated hearts, and in consideration of the relatively high and often undiagnosed occurrence of MB, a liberalized approach to acceptance of this anatomic variant could be adopted in the selection of donor hearts. Identification of MB in the prospective donor heart should not be an absolute contraindication for transplantation.
  The Journal of heart and lung transplantation: the official publication of the International Society for Heart Transplantation 07/2007; 26(6):637-8. · 3.54 Impact Factor
• Article: Levitronix as a short-term salvage treatment for primary graft failure after heart transplantation.

  Gianluca Santise, Mario Petrou, John R Pepper, Gilles Dreyfus, Asghar Khaghani, Emma J Birks
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  ABSTRACT: Primary graft failure after heart transplantation is a well-recognized catastrophic complication with a high mortality rate. It is becoming more frequent due to the increasing use of marginal donors. In these difficult cases a ventricular assist device (VAD) as a bridge to recovery or as a bridge to re-transplantation can be used. The recently introduced Levitronix Centrimag centrifugal pump might be an ideal device for this purpose. In this study we describe 2 patients with primary graft failure who received a Levitronix in the last 2 years, immediately after failure to wean from cardiopulmonary bypass. Biventricular support was necessary in both patients. One patient was successfully re-transplanted after 2 days of support, and subsequently discharged. After 16 months she has good ventricular function with no symptoms of cardiac failure. The second patient showed signs of ventricular recovery after a few days and was weaned from the device after 7 days, with good graft function. No device-related complications were recorded. After 14 days he was discharged from the intensive care unit (ICU), and a post-operative echocardiogram showed normal dimensions, good ejection fraction and no valvular regurgitation. He was discharged home 26 days after the transplant. In our experience, the Levitronix Centrimag seems to be safe and effective in the treatment of primary graft failure, achieving effective circulatory support and ventricular off-loading. We propose its use in isolated or biventricular graft failure either as bridge to re-transplant or as a bridge to recovery.
  The Journal of heart and lung transplantation: the official publication of the International Society for Heart Transplantation 06/2006; 25(5):495-8. · 3.54 Impact Factor
• Article: Protruding Left Intercostal Mass After Left Ventricular Aneurysmectomy

  Giuseppe D’Ancona, Giuseppe Mamone, Gianluca Marrone, Francesco Pirone, Gianluca Santise, Sergio Sciacca, Michele Pilato
  [show abstract] [hide abstract]
  ABSTRACT: In this report we summarize a case of myocardial infarction that developed an apical ventricular aneurysm, which was surgically removed to re-expand and reappear as a pulsating chest wall mass 16 years later.
  The Annals of Thoracic Surgery.
• Article: Ischemic mitral valve regurgitation in patients with depressed ventricular function: cardiac geometrical and myocardial perfusion evaluation with magnetic resonance imaging

  Giuseppe D’Ancona, Domenico Biondo, Giuseppe Mamone, Gianluca Marrone, Francesco Pirone, Gianluca Santise, Sergio Sciacca, Michele Pilato
  [show abstract] [hide abstract]
  ABSTRACT: Objective: To investigate geometrical and functional changes involving the left ventricle (LV) and mitral valve (MV) apparatus in patients with depressed LV ejection fraction (LVEF) and ischemic MV regurgitation (IMVR). Methods: A series of patients with three vessels coronary artery disease (CAD) and depressed LVEF underwent cardiac magnetic resonance imaging to investigate MV/LV geometry and function, and myocardial perfusion/vitality. Geometrical data were indexed by anterior MV leaflet length. Two groups were identified: CAD without IMVR (group CAD), and with IMVR (group IMV). Results: Eleven patients were enrolled in the CAD group and 13 in the IMV group. IMVR volume was significantly higher in the IMV group (24.0 ± 12.0 vs 4.5 ± 5.2; p < 0.0001). LVEF% was comparable (IMV 34.6 ± 13.0 vs CAD 31.5 ± 13.0; p = ns). Indexed MV/LV geometrical variables were comparable in the two groups. Perfusion/vitality study showed inferior myocardial necrosis occurred more often in the IMV group (p = 0.01). At Pearson test, MV regurgitation occurrence correlated with inferior myocardial necrosis (r = 0.5; p = 0.006), non-indexed systolic/diastolic annular inter-commissural diameters (r = 0.4; p = 0.04) and MV annular areas (r = 0.4; p = 0.04). Papillary muscles distance (PMD) and LV volumes inversely correlated with LVEF% (r = −0.6; p < 0.05 and r = −0.8; p < 0.001). At multivariable analysis, no independent determinants for IMVR were identified and LV volumes were the sole determinants for LVEF% (p < 0.05). Conclusion: In patients with depressed LVEF%, IMV cannot be explained by LV geometrical modifications alone. Although PMD, LV volumes, and LVEF% are correlated, they have no direct impact in the development of IMVR. In contrast, inferior myocardial necrosis and increased inter-commissural MV diameters may lead to deformity of MV complex and subsequent IMV.
  European Journal of Cardio-Thoracic Surgery.