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Papers by Silvia Farruggio

Research paper thumbnail of Multiple ventricular septal defects associated to anomalous venous returns, mitral valve disease, myocardium hypertrophy, and right outflow obstruction: a multimodality imaging assessment

Echocardiography-a Journal of Cardiovascular Ultrasound and Allied Techniques, Mar 7, 2023

Research paper thumbnail of Multiple ventricular septal defects associated to anomalous venous returns, mitral valve disease, myocardium hypertrophy, and right outflow obstruction: a multimodality imaging assessment

Research paper thumbnail of Life Threatening Broad QRS Tachycardia in an Infant with Conduction Disorder and SCN5A Mutation

Congenital Heart Disease, 2022

Research paper thumbnail of Anomalous venoatrial connections – CT and MRI assessment

Research paper thumbnail of Double outlet right ventricle in the setting of hypoplastic left ventricle, mitral atresia, interruption of aortic arch, and uncommon intra‐atrial anomalies in Trisomy 18

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.

Research paper thumbnail of Fetal and Neonatal Management of Atrial Flutter in Emergency Room:Adenosine, Amiodarone and Successful Direct Current Cardioversion

Clinical & Experimental Cardiology, 2021

Research paper thumbnail of A Rare Association of Double Outlet Rightventricle with Non-CommittedInterventricular Communication, Aberrant Right Subclavian Artery, Persistent LeftSuperiorvena Cava and Tracheoesophageal Fistula in a Newborn

Clinical & Experimental Cardiology, 2021

Research paper thumbnail of Impact of computerized tomography scan and three-dimensional printing model for surgical procedure in complex congenital heart disease

Journal of Radiological Review, 2021

Research paper thumbnail of Fetal Bradyarrhythmias: Etiopathogenesis, Diagnosis and Treatment: Between Literature Review and Experience of a Tertiary Center

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.

Research paper thumbnail of Gender-related clinical and echocardiographic outcomes at 30-day and 12-month follow up after MitraClip implantation in the GRASP registry

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...

Research paper thumbnail of Epicardial Versus Endocardial Pacemakers in the Pediatric Population: A Comparative Inquiry

Congenital Heart Disease, 2021

Research paper thumbnail of Anomalous right ventricular muscle bands obstructing a large apical muscular ventricular septal defect: From fetal to post‐natal three‐dimensional assessment

Research paper thumbnail of Dextroversion and D-Transposition of the Great Arteries, Left-Handed Ventricular Topology Related to Multiple Ventricular Septal Defects, and Left Juxtaposition of Atrial Appendage in a 1-Year-Old Child

Journal of The Indian Academy of Echocardiography & Cardiovascular Imaging

Research paper thumbnail of Management of “Wall to Wall Heart” in a Transient Neonatal Tricuspid Regurgitation

Congenital Heart Disease, 2021

Research paper thumbnail of Impact of computerized tomography scan and three-dimensional printing model for surgical procedure in complex congenital heart disease

Research paper thumbnail of Double outlet right ventricle in the setting of hypoplastic left ventricle, mitral atresia, interruption of aortic arch, and uncommon intra‐atrial anomalies in Trisomy 18

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.

Research paper thumbnail of Fetal Bradyarrhythmias: Etiopathogenesis, Diagnosis and Treatment: Between Literature Review and Experience of a Tertiary Center

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.

Research paper thumbnail of Arrhythmias in Common Arterial Trunk (CAT): Uncommon Atrial Tachycardia in CAT with Anomalous Pulmonary Venous Connection and Re-entry Atrial Tachycardia in CAT with HIV Seropositive Mother

Congenital Heart Disease, 2021

Research paper thumbnail of Extended use of percutaneous edge-to-edge mitral valve repair beyond EVEREST (Endovascular Valve Edge-to-Edge Repair) criteria: 30-day and 12-month clinical and echocardiographic outcomes from the GRASP (Getting Reduction of Mitral Insufficiency by Percutaneous Clip Implantation) registry

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-...

Research paper thumbnail of P1671Impact of chronic kidney disease on mitral valve repair with the mitraclip system: one-year outcomes frome the GRASP registry stratified by left ventricular dysfunction

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.

Research paper thumbnail of Multiple ventricular septal defects associated to anomalous venous returns, mitral valve disease, myocardium hypertrophy, and right outflow obstruction: a multimodality imaging assessment

Echocardiography-a Journal of Cardiovascular Ultrasound and Allied Techniques, Mar 7, 2023

Research paper thumbnail of Multiple ventricular septal defects associated to anomalous venous returns, mitral valve disease, myocardium hypertrophy, and right outflow obstruction: a multimodality imaging assessment

Research paper thumbnail of Life Threatening Broad QRS Tachycardia in an Infant with Conduction Disorder and SCN5A Mutation

Congenital Heart Disease, 2022

Research paper thumbnail of Anomalous venoatrial connections – CT and MRI assessment

Research paper thumbnail of Double outlet right ventricle in the setting of hypoplastic left ventricle, mitral atresia, interruption of aortic arch, and uncommon intra‐atrial anomalies in Trisomy 18

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.

Research paper thumbnail of Fetal and Neonatal Management of Atrial Flutter in Emergency Room:Adenosine, Amiodarone and Successful Direct Current Cardioversion

Clinical & Experimental Cardiology, 2021

Research paper thumbnail of A Rare Association of Double Outlet Rightventricle with Non-CommittedInterventricular Communication, Aberrant Right Subclavian Artery, Persistent LeftSuperiorvena Cava and Tracheoesophageal Fistula in a Newborn

Clinical & Experimental Cardiology, 2021

Research paper thumbnail of Impact of computerized tomography scan and three-dimensional printing model for surgical procedure in complex congenital heart disease

Journal of Radiological Review, 2021

Research paper thumbnail of Fetal Bradyarrhythmias: Etiopathogenesis, Diagnosis and Treatment: Between Literature Review and Experience of a Tertiary Center

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.

Research paper thumbnail of Gender-related clinical and echocardiographic outcomes at 30-day and 12-month follow up after MitraClip implantation in the GRASP registry

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...

Research paper thumbnail of Epicardial Versus Endocardial Pacemakers in the Pediatric Population: A Comparative Inquiry

Congenital Heart Disease, 2021

Research paper thumbnail of Anomalous right ventricular muscle bands obstructing a large apical muscular ventricular septal defect: From fetal to post‐natal three‐dimensional assessment

Research paper thumbnail of Dextroversion and D-Transposition of the Great Arteries, Left-Handed Ventricular Topology Related to Multiple Ventricular Septal Defects, and Left Juxtaposition of Atrial Appendage in a 1-Year-Old Child

Journal of The Indian Academy of Echocardiography & Cardiovascular Imaging

Research paper thumbnail of Management of “Wall to Wall Heart” in a Transient Neonatal Tricuspid Regurgitation

Congenital Heart Disease, 2021

Research paper thumbnail of Impact of computerized tomography scan and three-dimensional printing model for surgical procedure in complex congenital heart disease

Research paper thumbnail of Double outlet right ventricle in the setting of hypoplastic left ventricle, mitral atresia, interruption of aortic arch, and uncommon intra‐atrial anomalies in Trisomy 18

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.

Research paper thumbnail of Fetal Bradyarrhythmias: Etiopathogenesis, Diagnosis and Treatment: Between Literature Review and Experience of a Tertiary Center

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.

Research paper thumbnail of Arrhythmias in Common Arterial Trunk (CAT): Uncommon Atrial Tachycardia in CAT with Anomalous Pulmonary Venous Connection and Re-entry Atrial Tachycardia in CAT with HIV Seropositive Mother

Congenital Heart Disease, 2021

Research paper thumbnail of Extended use of percutaneous edge-to-edge mitral valve repair beyond EVEREST (Endovascular Valve Edge-to-Edge Repair) criteria: 30-day and 12-month clinical and echocardiographic outcomes from the GRASP (Getting Reduction of Mitral Insufficiency by Percutaneous Clip Implantation) registry

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-...

Research paper thumbnail of P1671Impact of chronic kidney disease on mitral valve repair with the mitraclip system: one-year outcomes frome the GRASP registry stratified by left ventricular dysfunction

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.