Malgorzata Szkutnik

Medical University of Silesia in Katowice, Catowice, Silesian Voivodeship, Poland

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Publications (67)117.19 Total impact

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    Roland Fiszer · Grzegorz Smolka · Malgorzata Szkutnik · Jacek Białkowski

    Full-text · Article · Jul 2015 · Postepy w Kardiologii Interwencyjnej / Advances in Interventional Cardiology
  • Roland Fiszer · Jacek Bialkowski · Beata Chodór · Szymon Pawlak · Malgorzata Szkutnik
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    ABSTRACT: The aim of this study is to present our experience with a new type of extra-large stent, namely the AndraStent XL/XXL. AndraStents were implanted in 46 patients, 38 with native coarctation of the aorta (CoA) and eight with recurrent coarctation of the aorta following previous surgery (ReCoA). All patients had arterial hypertension in the upper limbs, absent or weak femoral pulses, and continuous flow in the abdominal aorta on Doppler examination. The median age of patients was 25 years (range from nine to 65). The stents (cobalt-chromium with semi-open cell design) were manually mounted on balloon catheters and delivered through 10 to 14 Fr Mullins sheaths using a conventional femoral approach. All procedures were successful (no stent migration, proper expansion, no aorta dissection/rupture, major bleeding or major vessel injury). The systolic gradient across the aorta decreased from 40.6 mmHg before the procedure to 11.6 mmHg after the procedure (p<0.001). The mean fluoroscopy time was 5.7 minutes. Imaging examinations were scheduled and performed between six and 12 months after the initial procedure in 40 patients (angiography or angio CT or both). Procedural outcome remained favourable during a mean 2.4 years of follow-up. Neither stent fracture nor dislocation was observed in any patient at follow-up. In two patients, small aneurysm formation was observed six and eight months after the procedure -they were treated successfully with subsequent covered stent implantation. Re-dilatation of the implanted stent was performed between four and 26 months in 14 patients. Implantation of new large cobalt-chromium stents is a good therapeutic option for the treatment of native and recurrent CoA.
    No preview · Article · Jun 2015 · EuroIntervention: journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology
  • Roland Fiszer · Malgorzata Szkutnik · Beata Chodor · Jacek Bialkowski
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    ABSTRACT: Background: Transcatheter closure has become the method of choice for treatment of many heart defects. Recently, Lifetech Scientific introduced the Cera occluder (CO), a self-expandable nitinol wire-mesh device covered with ceramic coating. We present our preliminary experience in transcatheter closure of atrial septal defect (ASD), patent foramen ovale (PFO), patent ductus arteriosus (PDA), and post-infarction ventricular septal defect (PIVSD) with the CO. Methods: The study population consisted of 25 patients (17 female) ages 1.1-82 years (median age, 34.0 years) with either ASD (n = 7), PFO (n = 11), PDA (n = 6), or PIVSD (n = 1). All patients were treated percutaneously with appropriate CO devices, without any preliminary patient selection. The implantation technique applied in these procedures was the same as previously described for Amplatzer occluders. Results: All procedures were performed successfully. Complete shunt closure was achieved in all but 1 patient with PIVSD. No complications were observed during procedures or during follow-up of 0.5-4 months. Conclusions: Our preliminary experience in the clinical application of COs for transcatheter closure of ASD, PFO, PDA, and PIVSD has confirmed their utility, feasibility, and safety, at least in the short-term follow-up.
    No preview · Article · Aug 2014 · The Journal of invasive cardiology
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    J. Bialkowski · M. Szkutnik · R. Fiszer
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    ABSTRACT: Purpose: Stenting in Coarctation of the Aorta (CoA) has been performed with different stents. Recently new bare metal stent made of a Cobalt-Chromium (Co-Cr) alloy was introduced to clinical practice. They have hybrid open/closed cell design and are laser cut. We evaluated immediate result and midterm follow-up of implantation of this stents in the management of CoA at a single tertiary care center. Methods: Thirty five new type Co-Cr stents were implanted in 35 patients (pts): 30 with native CoA and 5 with recurrent after previous surgery (ReCoA). All had arterial hypertension in upper limbs, absent or weak femoral puls and continuous flow in abdominal aorta in Doppler examination. Mean patient age was 28,3±15,6 (ranged from 9 to 65) years. The stents were manually mounted on high pressure balloons and delivered through 10 to 14 Fr Mullins sheaths using a conventional femoral approach. Andrastent XL have expansion range till 25 mm, Andrastent XXL till 32 mm and both are different available lengths (from 13 till 57 mm). Results: All procedures were successful (no migration, proper expantion, no aorta dissection/rupture) – 15 XL Andrastents and 20 XXL were applied. In one pt (49 years old man) with severe secondary LV failure (EF 15%) the procedure was performed urgently during cardiogenic shock with good clinical result. The systolic gradient across the native CoA decreased from a mean 48,3±20,2 before to 11,9±10,2 mm Hg after the procedure and in case of ReCoA from 37,8±20,7 before to a mean 9,7±12,4 mm Hg after the procedure. The mean fluoroscopy time was 6,1±2,3 min. Procedural outcome remained favorable during mean follow-up 1,2±0,8. No aneurysm formation, stent fracture, dislocation were observed after the procedure in follow-up. Planned redilatation of implanted stent was performed between 4 and 14 months in 9 patients. In another 8 pts controlled angio CT was performed. Conclusions: Implantation of new large cobalt-chromium stents are very good therapeutical option for the treatment of native and recurrent CoA. Its strong radial force, flexibility and good radio-opacity is advantageous in implantation in CoA.
    Full-text · Article · Aug 2013 · European Heart Journal
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    Jacek Bialkowski · Malgorzata Szkutnik · Gejung Zhang · Shilinag Jiang
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    ABSTRACT: Coronary artery fistulas (CAF) are the most common congenital anomaly of this vessel. We present the case of a 26-year-old man with two coexisting congenital cardiac defects: patent ductus arteriosus (PDA) and CAF. The patient 3 months earlier had the transcatheter PDA closed (type A, diameter 4 mm) with a 10/8 mm PDA nitinol wire mesh occluder. After the procedure he continued to have symptoms of fatigue and continuous murmur in the precordial region persisted. In angio-CT a large coronary fistula from the circumflex coronary artery with suspicion of multiple orifices to the right atrium was found. An arteriovenous wire loop was created (guidewire introduced from the aorta through the CAF was snared using a lasso catheter in the superior vena cava and exteriorized through the right femoral vein). Retrogradely an 8 F long sheath and delivery system was introduced to the end of the fistula and a 12/10 mm Cardio-O-Fix PDA occluder (Starway Comp, China, Beijing) was implanted, closing one orifice of the CAF. Another leak (orifice of CAF - 3.5 mm diameter) was closed using a similar technique with a 10/8 mm PDA Cardio-O-Fix device. Complete closure of the coronary artery fistula and disappearance of the heart murmur were observed after the procedure. The patient was discharged home 4 days later on acetylsalicylic acid 150 mg/day. During 6 months of follow-up he was doing well without any complaints or pathological symptoms. In control angio-CT performed 3 months after the procedure complete closure of the CAF was confirmed.
    Preview · Article · Mar 2013 · Postepy w Kardiologii Interwencyjnej / Advances in Interventional Cardiology
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    ABSTRACT: Introduction: Percutaneous closure of patent foramen ovale (PFO) in patients with paradoxical tromboembolic events using Amplatzer devices is a common clinical practice. Recently new device very similar to Amplatzer namely Cardio-O-Fix was introduced as a new armamentarium. This occluder is cheaper than Amplatzer. There is lack of published data comparing results of applications of both devices. Aim of the study: A comparative study of Amplatzer PFO Occluder and Cardio-O-Fix PFO Occluder used to transcatheter closure of patent foramen ovale (PFO). Material and methods: Overall, 63 consecutive patients underwent percutaneous closure of PFO - 38 with Amplatzer device and the results were compared to those in 25 patients treated with Cardio-O-Fix Occluder. Before and at least 6 month after the procedure right to left shunting were evaluated with intravenous contrast injection by continuous transcranial Doppler examination (c-TCD). Results: The procedure was successfully completed in all patients in both groups. No procedure related complications were observed during hospitalization. Residual large right to left shunting was noted at 6 months in 8/38 patients (21%) in Amplatzer group and 6/25 (24%) in the Cardio-O-Fix group. In the first group 3/38 patients (7.9%) had postprocedural new neurological events: one patient suffered from transient ischemic attack and two new strokes. From these patients in one c-TCD and TEE were positive, but new atherosclerotic changes in vertebral arteries also developed. No recurrence of tromboembolic event was recorded in the Cardio-O-Fix group. Conclusions: Transcatheter closure of PFO with Amplatzer and Cardio-O-Fix occluders are clinically safe and effective. The latter device has similar outcome when compared to Amplatzer device in midterm follow-up.
    No preview · Article · Jan 2013 · Polski Przeglad Kardiologiczny
  • Jacek Bialkowski · Malgorzata Szkutnik · Marian Zembala

    No preview · Article · Apr 2010 · International Journal of Cardiology
  • Malgorzata Szkutnik · Jacek Bialkowski

    No preview · Article · Apr 2010 · International Journal of Cardiology
  • M. Knop · S. Smerdziński · M. Szkutnik · J. Białkowski
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    ABSTRACT: Introduction: Pulmonary stenosis (PS) is the major cause of the right ventricular outflow tract obstruction (RVOTO) to normal blood flow in the pulmonary arterial system. Pulmonary stenosis represents 10% of congenital heart diseases. The most common cause of the pathology is lack of normal separation of the edges of the valve leaflets (called fusion of the valve commissures). Severe PS may become apparent as cyanosis (skin blueness) in newborn. Level of the hemodynamic disorders depend on the blood flow in the pulmonary arterial system. Aim of study: To evaluate the effectiveness of balloon pulmonary valvuloplasty (BPV) as the treatment for relief of PS. Material and methods: The study 88 patients included (43 female, 45 male). Included only patients with isolated defects. 4 isolated populations in age from neonatal period to 77 years of age (mean 9.6±13.8) hospitalized in the Silesian Center for Heart Diseases in Zabrze in the years 1999-2007. Group I consisted of children aged newborn (n=6), group II infants aged 2-12 months years (n=22), group III children aged 1-14 years (n=40) and group IV consisted of juveniles and adults over 15 years of age (n=20). In all groups, a hemodynamically significant PS was diagnosed and BPV was performed using oversized balloon (1,2-1,5x pulmonary track diameter). Complications were assessed, the pressure before and after BWP (gradient between the right ventricle - (RV) and the pulmonary artery - (PA), and during the period (follow-up)was recorded in each group. The average time after surgery was 5.8±2.3 years. Results: Outcome was assessed on the basis of changes in the gradient was as follows: group I gradient before 63.8±33.3, gradient after 22.5±12.6; in group II, a gradient before 56.1±12.9, gradient after 19.4±14.6, in group III, the gradient before 58.6 28.0, gradient after 19.1±17.0; in group IV, a gradient before 67.8±36.2, gradient after 29.3±28.3. In total, the average gradient between the RV and the PA in all age groups before treatment was 59.5±27.6, and after treatment 21.2±19.0. Conclusions: BPV has been proven effective and resulted in reduction of transvalvular gradients, and right ventricular systolic pressure. Newborns represented a particular group at higher complications risk. BPV represents a viable alternative to cardiac surgery.
    No preview · Article · Jan 2010 · Polski Przeglad Kardiologiczny
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    Malgorzata Szkutnik · Jacek Kusa · Jan Glowacki · Roland Fiszer · Jacek Bialkowski
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    ABSTRACT: We report the transcatheter closure of six ruptured sinus of Valsalva aneurysms (RSVAs) in five patients aged 18-51 years. The RSVA extended into the right atrium in three patients, into the right ventricular outflow tract in one, and into the pulmonary artery in one. In all patients, the RSVA was entered from the aorta, an arteriovenous loop was created, and the Amplatzer occluders were implanted using a venous approach. Six procedures were performed in five patients. Five Amplatzer duct occluders and one Amplatzer atrial septal occluder were implanted. In one patient who had a left RSVA after deployment of an Amplatzer duct occluder, ST-segment depression was observed on the ECG and the procedure was abandoned. In the other four patients, complete closure of the RSVA was confirmed by color Doppler echocardiography. No complications were observed during 9-19 months of follow-up. Percutaneous closure of an RSVA is feasible and can be used as an alternative to surgery.
    Full-text · Article · Nov 2009 · Revista Espa de Cardiologia
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    Malgorzata Szkutnik · Jacek Kusa · Jan Glowacki · Roland Fiszer · Jacek Bialkowski
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    ABSTRACT: We report the transcatheter closure of six ruptured sinus of Valsalva aneurysms (RSVAs) in five patients aged 18-51 years. The RSVA extended into the right atrium in three patients, into the right ventricular outflow tract in one, and into the pulmonary artery in one. In all patients, the RSVA was entered from the aorta, an arteriovenous loop was created, and the Amplatzer occluders were implanted using a venous approach. Six procedures were performed in five patients. Five Amplatzer duct occluders and one Amplatzer atrial septal occluder were implanted. In one patient who had a left RSVA after deployment of an Amplatzer duct occluder, ST-segment depression was observed on the ECG and the procedure was abandoned. In the other four patients, complete closure of the RSVA was confirmed by color Doppler echocardiography. No complications were observed during 9-19 months of follow-up. Percutaneous closure of an RSVA is feasible and can be used as an alternative to surgery.
    Full-text · Article · Nov 2009 · Revista Espa de Cardiologia
  • Jacek Bialkowski · Malgorzata Szkutnik · Jacek Kusa · Roland Fiszer
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    ABSTRACT: According to our previous observation application of Muscular Amplatzer Ventricular Septal Occluder (MVSDO) in the closure of perimembranous Ventricular Septal Defect (VSD) can produce less rhythm disturbances than use of asymmetric VSD device (due to longer waist of MVSDO?). Application of MVSDO in adult patients with muscular VSD should be done with precaution in the case of thicker interventricular septum because of the risk of subsequent embolization.
    No preview · Article · Jun 2009 · International journal of cardiology
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    ABSTRACT: Aim: A case of 2 children (8 and 11-year-old), in whom muscular vetricular septal defect (mVSD) (in echo 5 and 6 mm of diameter respectively) was closed interventionally. Both had symptoms of significant left-right shunt. Methods and results: In the first patient 6 mm Amplatzer Muscular VSD Occluder (MVSDO) was implanted from the arterial side. The reason were technical problems to cross VSD with delivery system from the venous side. In the second child (with inlet defect) 8 mm MSDO was applied. During both procedures no complications were observed. In the latter case 3 days after the procedure important tricuspid valve incompetence was noted. The implant was removed, VSD closed and damaged tricuspid valve reconstructed surgically. Conclusion: During and after transcatheter closure of muscular ventricular septal defects unpredictable problems and complications can occur.
    No preview · Article · Jun 2009 · Postepy w Kardiologii Interwencyjnej / Advances in Interventional Cardiology
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    ABSTRACT: Transcatheter closure of atrial septal defects (ASDs) was performed mainly in children and adolescents. Information about outcome and complications in adults was limited. From November 1997 to November 2005, percutaneous closure of ASDs using the Amplatzer septal occluder was attempted in 650 consecutive adult patients. Median patient age was 45.8 +/- 16.2 years (range 18 to 90), mean systolic artery pressure was 33.3 +/- 10.6 mm Hg (range 11 to 85), and mean pulmonary and systemic blood flow (Qp/Qs) ratio was 1.9 +/- 0.7 (range 0.8 to 6.6). Mean stretched diameter of the ASD was 21.2 +/- 5.1 mm (range 3.1 to 43). Seventy-eight patients (12%) had multiple defects. Of 572 patients with a single ASD, device implantation was successful in 563 patients (98%). During follow-up, complete closure could be achieved in 96% of patients with a single ASD and 71% of patients with multiple defects. Mean systolic artery pressure decreased to 28.3 +/- 10.1 mm Hg and mean Qp/Qs ratio decreased to 1 +/- 0.3. The 3 complications that occurred during the procedure were device embolization (2 patients; 0.3%) and transient ST depression (1 patient; 0.2%). The most common complication immediately after the procedure and during follow-up was new-onset atrial fibrillation (28 patients; 4.3%). Electrical cardioversion was successfully in most. Complications requiring emergency or elective surgery occurred in 6 patients (0.9%; hemopericardium, 2 patients, 0.3%; device embolization, 3 patients, 0.5%, and pericardial tamponade, 1 patient, 0.2%). In conclusion, closure of ASDs using the Amplatzer septal occluder in adults was efficient and safe, with excellent long-term success rates. Serious complications were rare.
    No preview · Article · Mar 2009 · The American journal of cardiology
  • J. Białkowski · M. Szkutnik

    No preview · Article · Jan 2009 · Kardiologia polska
  • M. Zyła-Frycz · J. Kusa · T. Kurek · M. Szkutnik · J. Białkowski
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    ABSTRACT: Background: Congenital unilateral absence of pulmonary artery (UAPA) may involve the right or left branch. Absent left pulmonary artery is more often associated with congenital heart diseases, while absent right pulmonary artery is usually present as an isolated form. Early diagnosis of UAPA, especially of the isolated form, is very important because of later consequences. Aim: Having our own material as well as published data we present symptoms, clinical data and diagnostic methods useful in making the diagnosis of UAPA as well as therapeutic procedures. Material and Methods: We analyzed a group or 6 patients (3 children and 3 adults). X-ray, ECG, and ECO were done in all cases; in some of them we performed angioCT, MRI or haemodynamic investigation. Results: UAPA was recognized in all cases, isolated absence of RPA in one case, absence of LPA was found in 5 cases and in 4 of them it was associated with congenital heart diseases. There was diminished pulmonary marking on X-ray in all patients and ECO examination revealed the possibility of UAPA. In 2 cases the diagnosis was established during catheterization and in other cases angioCT or MRI was done. In one patient three interventional procedures were performed. Conclusions: 1. The clinical data of UAPA are not specific. In cases with associated congenital diseases the most characteristic are symptoms caused by this malformation. 2. The early diagnosis is done on the basis of X-ray and ECO. MRI, angioCT and haemodynamic investigation allow the final diagnosis to be established.
    No preview · Article · Jan 2009
  • Roland Fiszer · Malgorzata Szkutnik · Jocek Kusa · J. Białkowski
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    ABSTRACT: Introduction: Atrial septal defect (ASD) makes up 6-8% of congenital heart defects. Results of surgical correction are good with low mortality, but 1-1.5% of patients have residual shunt requiring intervention. Material and methods: In years 1996-2008 we performed 21 percutaneous residual ASD closures after cardiac surgery. First group - 7 patients after surgical ASD closures; second group - 14 patients after cardiac surgery other than ASD closure with residual IAS shunt. Results: In the first group 6 ASO devices 8-24 mm and in one patient Amplatzer Cribriform 25 mm were used. In the second group as primary surgery were tetralogy of Fallot and correction of right ventricular outflow tract obstruction - 6 patients, Fontan fenestration - 4 patients. One patient - with Ebstein anomaly after cavo-pulmonary shunt, ventricular septal defect (VSD), and transposition of great arteries (TGA) correction and CABG procedure. In 12 of 14 patients 5-30 mm Amplatzer Septal Occluder (ASO), in one case Star-Flex 33 mm and IMWCE-5-PDA-3 coil were used. Patients with right-left shunt presented a significant (77 to 90%) rise in arterial blood saturation directly after the procedure. Conclusions: Percutaneous residual interatrial septum (IAS) shunt closure in patients after previous surgical ASD correction or other cardiac surgery procedures is not difficult technically and the results are satisfactory.
    No preview · Article · Dec 2008 · Postepy w Kardiologii Interwencyjnej / Advances in Interventional Cardiology
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    ABSTRACT: Background: Aortic coarctation is an aortic stenosis at the level of the isthmus, next to the ductus arteriosus or attachment of the ligament arteriosus, below the beginning of the left subclavian artery. This defect occurs as an isolated stenosis or associated with other failures. Aim: The aim of the study was to compare the occurrence frequency of aortic coarctation and anomalies of aortic arch arteries. Material and Methods: Retrospective analysis included 53 patients with diagnosed coarctation of aorta with 64-slice CT in the Silesian Centre of Heart Diseases in the last 13 months. Results: The structure of aortic arch arteries was typical in 37 cases, brachio-cephalic trunk, left common carotid artery and left subclavian artery. Anomalies of aortic arch arteries were observed in 15 cases (28.85%). Conclusions: Multislice computed tomography proved to be very useful in the evaluation of coarctation and coexisting anatomic structures. A diagnostic examination can significantly influence the choice of treatment type (angioplasty, stenting, surgery); the analyses of CT examinations can indicate an increased frequency of the coexistence of aortic coarctation and anomalies of aortic arch arteries in comparison to normal aorta.
    Full-text · Article · Sep 2008 · Polish journal of cardio-thoracic surgery
  • Jacek Kusa · Malgorzata Szkutnik · J. Białkowski

    No preview · Article · Jul 2008 · Postepy w Kardiologii Interwencyjnej / Advances in Interventional Cardiology
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    ABSTRACT: Increased prevalence of patent ductus arteriosus (PDA) at high altitude (HA) is a known occurrence. Transcatheter treatment of patients with PDA living at a HA is assessed in this study. Thirteen consecutive patients (all habitants of La Paz, Bolivia) underwent transcatheter closure of PDA. The minimal diameter of PDA was 5.8 (1.5-11) mm and the mean pulmonary artery pressure was 37 (7-80) mm Hg. In 12 patients, the Amplatzer Duct Occluder (ADO) was used; in one child with PDA with a 1.5-mm diameter, a detachable coil was implanted. All procedures, except for one, were completed successfully. The ADO (diameter: 12/10 mm) implantation failed in one child with pulmonary hypertension because the device could not be properly secured in position in a 6-mm PDA. Subsequent surgery was performed without any complications. No residual shunt after 24 h was observed in any case after treatment. No complications were encountered during the procedure and follow-up of 1.5 (from 0.1 to 2.8) years. PDA in native residents of high land have different physiopathologies and anatomies. ADO appears to be a suitable device for transcatheter occlusion for most such patients. Interventional cardiology in countries with residents at high altitudes can be helpful in addressing this issue.
    No preview · Article · Jun 2008 · Pediatric Cardiology

Publication Stats

465 Citations
117.19 Total Impact Points

Institutions

  • 2007-2015
    • Medical University of Silesia in Katowice
      • Department of Cardiology
      Catowice, Silesian Voivodeship, Poland
  • 1998-2010
    • Śląskie Centrum Chorób Serca
      • Department of Cardiac Surgery and Transplantology
      Hindenburg, Silesian Voivodeship, Poland
  • 2003-2009
    • Silesian University of Technology
      Gleiwitz, Silesian Voivodeship, Poland
  • 1999
    • Ospedale Pediatrico Bambino Gesù
      Roma, Latium, Italy