Silvia Farruggio - Academia.edu (original) (raw)
Uploads
Papers by Silvia Farruggio
Echocardiography-a Journal of Cardiovascular Ultrasound and Allied Techniques, Mar 7, 2023
Congenital Heart Disease, 2022
Echocardiography
We present the case of a 1‐day‐old newborn, with prenatal diagnosis of Trisomy 18 and complex con... more We present the case of a 1‐day‐old newborn, with prenatal diagnosis of Trisomy 18 and complex congenital heart disease. Echocardiography at birth showed double outlet right ventricle with non‐committed interventricular communication in the setting of mitral atresia, hypoplastic left ventricle, and patent aortic root with bicuspid aortic valve and type A interrupted aortic arch. Adding anomalies were the typical congenital polyvalvular disease, Chiari network, and left intra‐atrial shelf dividing morphologically left atrium. This is a rare combination of cardiac anatomical malformations in Trisomy 18.
Clinical & Experimental Cardiology, 2021
Clinical & Experimental Cardiology, 2021
Journal of Radiological Review, 2021
Congenital Heart Disease, 2021
Fetal arrhythmias reach up around 10% of the total third-level perinatal cardiology references. S... more Fetal arrhythmias reach up around 10% of the total third-level perinatal cardiology references. Sustained bradycardia is defined as a baseline fetal heart rate (FHR) of less than 110 bpm sustained for at least 10 min. The overall incidence of malignant fetal bradyarrhythmias, such as complete atrioventricular block (AVB) and channellopathies, is relatively rare, 1:5000 pregnancies, but represents a serious emergency for the gynecologist, neonatologists, and pediatric cardiologists. Fetal complete AVB is strongly associated with maternal connective tissue disease, but it can be also associated with congenital heart disease and usually with a poorer prognosis with high risk of fetal hydrops and abortion. Currently, the treatment of severe fetal bradyarrhythmias is principally pharmacological and aims to increase the FHR, besides an early resolution of underlying causes, when possible, and a promptly management of fetal heart failure. Intrauterine electrostimulation nowadays is an experimental pioneering method, reserved for limited selected cases.
Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions, Jan 4, 2014
To assess the influence of patients' gender on the outcomes of percutaneous edge-to-edge mitr... more To assess the influence of patients' gender on the outcomes of percutaneous edge-to-edge mitral valve repair (PMVR) using the MitraClip system. Although gender-related differences have been extensively documented in patients who undergo surgery for moderate-to-severe (3+) and severe (4+) mitral regurgitation (MR), studies assessing whether these differences exist after PMVR are lacking. Clinical and echocardiographic data through 12-month follow up from 171 consecutive patients whom underwent MitraClip implantation and were dichotomized by the gender (106 males and 65 females) were obtained. The primary safety endpoint was the incidence of major adverse events at 30 days and the primary efficacy endpoint was freedom from death, surgery for mitral valve dysfunction, or grade ≥ 3+ MR at 12-month follow up. The primary safety endpoint was observed in four males (3.8%) and four females (6.2%) (P = 0.358). Remarkable reduction in MR postprocedure was revealed in both groups, and thes...
Congenital Heart Disease, 2021
Journal of The Indian Academy of Echocardiography & Cardiovascular Imaging
Congenital Heart Disease, 2021
We present the case of a 1‐day‐old newborn, with prenatal diagnosis of Trisomy 18 and complex con... more We present the case of a 1‐day‐old newborn, with prenatal diagnosis of Trisomy 18 and complex congenital heart disease. Echocardiography at birth showed double outlet right ventricle with non‐committed interventricular communication in the setting of mitral atresia, hypoplastic left ventricle, and patent aortic root with bicuspid aortic valve and type A interrupted aortic arch. Adding anomalies were the typical congenital polyvalvular disease, Chiari network, and left intra‐atrial shelf dividing morphologically left atrium. This is a rare combination of cardiac anatomical malformations in Trisomy 18.
Congenital Heart Disease, 2021
Fetal arrhythmias reach up around 10% of the total third-level perinatal cardiology references. S... more Fetal arrhythmias reach up around 10% of the total third-level perinatal cardiology references. Sustained bradycardia is defined as a baseline fetal heart rate (FHR) of less than 110 bpm sustained for at least 10 min. The overall incidence of malignant fetal bradyarrhythmias, such as complete atrioventricular block (AVB) and channellopathies, is relatively rare, 1:5000 pregnancies, but represents a serious emergency for the gynecologist, neonatologists, and pediatric cardiologists. Fetal complete AVB is strongly associated with maternal connective tissue disease, but it can be also associated with congenital heart disease and usually with a poorer prognosis with high risk of fetal hydrops and abortion. Currently, the treatment of severe fetal bradyarrhythmias is principally pharmacological and aims to increase the FHR, besides an early resolution of underlying causes, when possible, and a promptly management of fetal heart failure. Intrauterine electrostimulation nowadays is an experimental pioneering method, reserved for limited selected cases.
Congenital Heart Disease, 2021
OBJECTIVES This study sought to compare, in high-risk patients with 3+ to 4+ mitral regurgitation... more OBJECTIVES This study sought to compare, in high-risk patients with 3+ to 4+ mitral regurgitation (MR) dichotomized by baseline echocardiographic features, acute, 30-day, and 12-month outcomes following percutaneous mitral valve repair using the MitraClip. BACKGROUND The feasibility and mid-term outcomes after MitraClip implantation in patients with echocardiographic features different from the EVEREST (Endovascular Valve Edge-to-Edge Repair) I and II trials have been scarcely studied. METHODS Clinical and echocardiographic outcomes through 12-month follow-up of consecutive patients who underwent MitraClip implantation were obtained from an ongoing prospective registry. Two different groups, divided according to baseline echocardiographic criteria (investigational group [EVERESTOFF] and control group [EVERESTON]), were compared. RESULTS Seventy-eight patients were included in EVERESTOFF and 93 patients in EVERESTON groups. Important and comparable acute reductions in MR and no clip-...
European Heart Journal
Background: Chronic kidney disease (CKD) is common in patients with mitral regurgitation (MR) ref... more Background: Chronic kidney disease (CKD) is common in patients with mitral regurgitation (MR) referred for therapy, often being associated with heart failure (HF) and poor prognosis. Purpose: The aim of this prospective, observational study was to evaluate the impact of baseline CKD on one-year outcomes of MitraClip therapy in high surgical risk patients with moderate-to-severe or severe MR presenting with HF and reduced ejection fraction (HFrEF) or HF and mid-range ejection fraction (HFmrEF). Methods: Patients enrolled in the prospective Getting Reduction of Mitral Insufficiency by Percutaneous Clip Implantation (GRASP) with left ventricular (LV) EF <50% and functional MR eligible at one-year follow-up (FU) were included. The primary efficacy endpoint was the composite of death, surgery for mitral valve dysfunction and grade 3/4 + MR at one-year FU. Secondary endpoints were the components of the primary endpoint, re-hospitalization rates and functional NYHA class. Also echocardiographic parameters were assessed. Results: A total of 250 patients were included: 202 with HFrEF and 48 with HFm-rEF. Baseline CKD occurred in 62.8% of patients with HFrEF and in 56.2% of patients with HFmrEF. Post-procedural residual MR≤2+ was present in 96.8% of patients. At one-year FU, no significant differences were reported in primary endpoint (26.8% in CKD vs. 20% in no-CKD, p 0.148, within HFrEF group; 14.8% in CKD vs. 14.3% in no-CKD, p 0.693, within HFmrEF group). Secondary endpoints rates are reported in Table 1. Cox regression analysis identified baseline CKD as a marker of poor prognosis and independent predictor of re-hospitalization in HFrEF patients (HR 2.8, 95% CI 1.2-6.5, p=0.013). At one-year FU, a significant reduction in LV volumes was observed in both groups regardless of CKD.
Echocardiography-a Journal of Cardiovascular Ultrasound and Allied Techniques, Mar 7, 2023
Congenital Heart Disease, 2022
Echocardiography
We present the case of a 1‐day‐old newborn, with prenatal diagnosis of Trisomy 18 and complex con... more We present the case of a 1‐day‐old newborn, with prenatal diagnosis of Trisomy 18 and complex congenital heart disease. Echocardiography at birth showed double outlet right ventricle with non‐committed interventricular communication in the setting of mitral atresia, hypoplastic left ventricle, and patent aortic root with bicuspid aortic valve and type A interrupted aortic arch. Adding anomalies were the typical congenital polyvalvular disease, Chiari network, and left intra‐atrial shelf dividing morphologically left atrium. This is a rare combination of cardiac anatomical malformations in Trisomy 18.
Clinical & Experimental Cardiology, 2021
Clinical & Experimental Cardiology, 2021
Journal of Radiological Review, 2021
Congenital Heart Disease, 2021
Fetal arrhythmias reach up around 10% of the total third-level perinatal cardiology references. S... more Fetal arrhythmias reach up around 10% of the total third-level perinatal cardiology references. Sustained bradycardia is defined as a baseline fetal heart rate (FHR) of less than 110 bpm sustained for at least 10 min. The overall incidence of malignant fetal bradyarrhythmias, such as complete atrioventricular block (AVB) and channellopathies, is relatively rare, 1:5000 pregnancies, but represents a serious emergency for the gynecologist, neonatologists, and pediatric cardiologists. Fetal complete AVB is strongly associated with maternal connective tissue disease, but it can be also associated with congenital heart disease and usually with a poorer prognosis with high risk of fetal hydrops and abortion. Currently, the treatment of severe fetal bradyarrhythmias is principally pharmacological and aims to increase the FHR, besides an early resolution of underlying causes, when possible, and a promptly management of fetal heart failure. Intrauterine electrostimulation nowadays is an experimental pioneering method, reserved for limited selected cases.
Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions, Jan 4, 2014
To assess the influence of patients' gender on the outcomes of percutaneous edge-to-edge mitr... more To assess the influence of patients' gender on the outcomes of percutaneous edge-to-edge mitral valve repair (PMVR) using the MitraClip system. Although gender-related differences have been extensively documented in patients who undergo surgery for moderate-to-severe (3+) and severe (4+) mitral regurgitation (MR), studies assessing whether these differences exist after PMVR are lacking. Clinical and echocardiographic data through 12-month follow up from 171 consecutive patients whom underwent MitraClip implantation and were dichotomized by the gender (106 males and 65 females) were obtained. The primary safety endpoint was the incidence of major adverse events at 30 days and the primary efficacy endpoint was freedom from death, surgery for mitral valve dysfunction, or grade ≥ 3+ MR at 12-month follow up. The primary safety endpoint was observed in four males (3.8%) and four females (6.2%) (P = 0.358). Remarkable reduction in MR postprocedure was revealed in both groups, and thes...
Congenital Heart Disease, 2021
Journal of The Indian Academy of Echocardiography & Cardiovascular Imaging
Congenital Heart Disease, 2021
We present the case of a 1‐day‐old newborn, with prenatal diagnosis of Trisomy 18 and complex con... more We present the case of a 1‐day‐old newborn, with prenatal diagnosis of Trisomy 18 and complex congenital heart disease. Echocardiography at birth showed double outlet right ventricle with non‐committed interventricular communication in the setting of mitral atresia, hypoplastic left ventricle, and patent aortic root with bicuspid aortic valve and type A interrupted aortic arch. Adding anomalies were the typical congenital polyvalvular disease, Chiari network, and left intra‐atrial shelf dividing morphologically left atrium. This is a rare combination of cardiac anatomical malformations in Trisomy 18.
Congenital Heart Disease, 2021
Fetal arrhythmias reach up around 10% of the total third-level perinatal cardiology references. S... more Fetal arrhythmias reach up around 10% of the total third-level perinatal cardiology references. Sustained bradycardia is defined as a baseline fetal heart rate (FHR) of less than 110 bpm sustained for at least 10 min. The overall incidence of malignant fetal bradyarrhythmias, such as complete atrioventricular block (AVB) and channellopathies, is relatively rare, 1:5000 pregnancies, but represents a serious emergency for the gynecologist, neonatologists, and pediatric cardiologists. Fetal complete AVB is strongly associated with maternal connective tissue disease, but it can be also associated with congenital heart disease and usually with a poorer prognosis with high risk of fetal hydrops and abortion. Currently, the treatment of severe fetal bradyarrhythmias is principally pharmacological and aims to increase the FHR, besides an early resolution of underlying causes, when possible, and a promptly management of fetal heart failure. Intrauterine electrostimulation nowadays is an experimental pioneering method, reserved for limited selected cases.
Congenital Heart Disease, 2021
OBJECTIVES This study sought to compare, in high-risk patients with 3+ to 4+ mitral regurgitation... more OBJECTIVES This study sought to compare, in high-risk patients with 3+ to 4+ mitral regurgitation (MR) dichotomized by baseline echocardiographic features, acute, 30-day, and 12-month outcomes following percutaneous mitral valve repair using the MitraClip. BACKGROUND The feasibility and mid-term outcomes after MitraClip implantation in patients with echocardiographic features different from the EVEREST (Endovascular Valve Edge-to-Edge Repair) I and II trials have been scarcely studied. METHODS Clinical and echocardiographic outcomes through 12-month follow-up of consecutive patients who underwent MitraClip implantation were obtained from an ongoing prospective registry. Two different groups, divided according to baseline echocardiographic criteria (investigational group [EVERESTOFF] and control group [EVERESTON]), were compared. RESULTS Seventy-eight patients were included in EVERESTOFF and 93 patients in EVERESTON groups. Important and comparable acute reductions in MR and no clip-...
European Heart Journal
Background: Chronic kidney disease (CKD) is common in patients with mitral regurgitation (MR) ref... more Background: Chronic kidney disease (CKD) is common in patients with mitral regurgitation (MR) referred for therapy, often being associated with heart failure (HF) and poor prognosis. Purpose: The aim of this prospective, observational study was to evaluate the impact of baseline CKD on one-year outcomes of MitraClip therapy in high surgical risk patients with moderate-to-severe or severe MR presenting with HF and reduced ejection fraction (HFrEF) or HF and mid-range ejection fraction (HFmrEF). Methods: Patients enrolled in the prospective Getting Reduction of Mitral Insufficiency by Percutaneous Clip Implantation (GRASP) with left ventricular (LV) EF <50% and functional MR eligible at one-year follow-up (FU) were included. The primary efficacy endpoint was the composite of death, surgery for mitral valve dysfunction and grade 3/4 + MR at one-year FU. Secondary endpoints were the components of the primary endpoint, re-hospitalization rates and functional NYHA class. Also echocardiographic parameters were assessed. Results: A total of 250 patients were included: 202 with HFrEF and 48 with HFm-rEF. Baseline CKD occurred in 62.8% of patients with HFrEF and in 56.2% of patients with HFmrEF. Post-procedural residual MR≤2+ was present in 96.8% of patients. At one-year FU, no significant differences were reported in primary endpoint (26.8% in CKD vs. 20% in no-CKD, p 0.148, within HFrEF group; 14.8% in CKD vs. 14.3% in no-CKD, p 0.693, within HFmrEF group). Secondary endpoints rates are reported in Table 1. Cox regression analysis identified baseline CKD as a marker of poor prognosis and independent predictor of re-hospitalization in HFrEF patients (HR 2.8, 95% CI 1.2-6.5, p=0.013). At one-year FU, a significant reduction in LV volumes was observed in both groups regardless of CKD.