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Papers by Gaetano Santoro

Research paper thumbnail of Coronary Unroofing Does Not Fits All Anomalous Aortic Origin of Coronary Arteries

Research paper thumbnail of Institutional report - Congenital Preliminary experience in the use of an extracellular matrix to repair congenital heart diseases

Congenital heart diseases are corrected early in life, so the surgical procedure has to maintain ... more Congenital heart diseases are corrected early in life, so the surgical procedure has to maintain the maximum potential for growth. The quest for the ideal material for cardiac tissue repair is still ongoing. Here, we describe our preliminary experience with an extracellular matrix for cardiac and vascular tissue repair. Between August 2009 and April 2011, 26 patients underwent cardiac surgery using the CorMatrix patch for vascular repair (10 pulmonary artery, four ascending aorta, three aortic arch and one right ventricular outflow tract) or for valve recon struction (five aortic, two tricuspid, one mitral and one pulmonary valve); in four cases, the repair was associated with pericardial closure using the same patch. There were no deaths, and at a mean follow-up of 13.2 months, there was no evidence of patch-related complications either in the vascular position or when used for valve repair. The ideal material for cardiac tissue repair should be haemostatic and resistant to tearing...

Research paper thumbnail of Preliminary experience in the use of an extracellular matrix to repair congenital heart diseases

Interactive CardioVascular and Thoracic Surgery, 2011

Congenital heart diseases are corrected early in life, so the surgical procedure has to maintain ... more Congenital heart diseases are corrected early in life, so the surgical procedure has to maintain the maximum potential for growth. The quest for the ideal material for cardiac tissue repair is still ongoing. Here, we describe our preliminary experience with an extracellular matrix for cardiac and vascular tissue repair. Between August 2009 and April 2011, 26 patients underwent cardiac surgery using the CorMatrix patch for vascular repair (10 pulmonary artery, four ascending aorta, three aortic arch and one right ventricular outflow tract) or for valve reconstruction (five aortic, two tricuspid, one mitral and one pulmonary valve); in four cases, the repair was associated with pericardial closure using the same patch. There were no deaths, and at a mean follow-up of 13.2 months, there was no evidence of patch-related complications either in the vascular position or when used for valve repair. The ideal material for cardiac tissue repair should be haemostatic and resistant to tearing and calcification, and possibly one that will not induce an inflammatory cascade. In the last 25 months, we used an extracellular matrix for cardiac and vascular tissue repair. The patch is advocated to induce the patient's own tissue regeneration. The early results are encouraging, but a longer follow-up is needed to understand the real potential of this material.

Research paper thumbnail of Intraaortic Balloon Pump After Treatment of Anomalous Origin of Left Coronary Artery

The Annals of Thoracic Surgery, 1998

Minimally invasive direct coronary artery bypass grafting operations, which have undoubtedly open... more Minimally invasive direct coronary artery bypass grafting operations, which have undoubtedly opened a new era in the treatment of isolated disease of the left anterior descending coronary artery, are facilitated by the development of suitable instrumentation. The use of a rib spreader that permits optimal exposure of the LIMA through a small incision with effective reduction of heart motility is key to the success of this surgical approach. Although the results are encouraging, surgeons must be aware of the possible harmful side effects that may appear when executing this new technique. Approximately 60% of the breast receives blood from the anterior and posterior perforating branches of the internal mammary artery [6]. The sternocostal segment of the pectoralis major is supplied by the internal mammary branches emerging through the cranial five or six intercostal spaces, whereas its dominant blood supply is derived from the thoracoacromial artery. When the LIMA is mobilized and ligated, musculocutaneous arterial perforators are severed, reducing blood supply to the medial and posterior left breast. In addition, in the presence of a large breast, 40 minutes of unrelieved pressure of the IMA Retractor, the mean time required for LIMA harvesting, further compresses the already compromised overlaying and intervening tissues. As a result, reduction of blood supply to the breast ensues and ischemic necrosis may develop. There is no evidence available in the current literature documenting a case of breast necrosis after standard coronary artery bypass grafting; therefore, minimally invasive direct coronary artery bypass grafting via a small anterolateral thoracotomy may not be the approach of choice in women with large breasts. During the operation direct compression force of the retractor arms on the breast should be reduced by supplying appropriate padding or by periodically relieving the pressure and removing the retractor from the breast tissue. Alternatively, modifications in the design of the retractor arms, intended to avoid possible pressure points during its application, are warranted.

Research paper thumbnail of Primary Repair of Isolated Ventricular Septal Defect in Infancy Guided by Echocardiography

The American Journal of Cardiology, 1997

Between 1989 and 1995, 96 consecutive infants affected by isolated ventricular septal defect (VSD... more Between 1989 and 1995, 96 consecutive infants affected by isolated ventricular septal defect (VSD) were submitted for primary correction at a median age of 4 months. Of the 96, 60 (group I) underwent surgery on the base of a 2-dimensional Doppler echocardiographic (DD echo) test alone. The preoperative DD echo anatomic definition of the type of VSD was confirmed at surgery in all 60 patients without false-positive results in terms of additional cardiac anomalies. There were 2 false-negatives: in 2 patients an associated cardiac anomaly was not detected by DD echo and required a second surgical procedure after postoperative cardiac catheterization. During the same period 36 infants (group II) underwent surgical closure of isolated VSD on the basis of cardiac catheterization and angiocardiography in addition to DD echo. The retrospective comparison between the 2 groups revealed no significant difference in terms of sensitivity and specificity of the diagnostic tools, early and late mortality after surgical correction, postoperative hospital stay, and need for late cardiac catheterization and surgery. We conclude that after an accurate selection, most of the infants with uncomplicated VSD can safely undergo primary repair on the basis of DD echo alone.

Research paper thumbnail of Valve leaflet reconstruction in pediatrics with extracellular matrix patch

The Journal of heart valve disease, 2012

Valve Leaflet Reconstruction in Pediatrics with Extracellular Matrix Patch. Andrea Quarti, Stefan... more Valve Leaflet Reconstruction in Pediatrics with Extracellular Matrix Patch. Andrea Quarti, Stefania Nardone, Massimo Colaneri, Gaetano Santoro, Marco Pozzi Department of Congenital and Paediatric Cardiac Surgery and Cardiology, Ospedali Riuniti, Ancona, Italy. ...

Research paper thumbnail of Coronary Unroofing Does Not Fits All Anomalous Aortic Origin of Coronary Arteries

Research paper thumbnail of Institutional report - Congenital Preliminary experience in the use of an extracellular matrix to repair congenital heart diseases

Congenital heart diseases are corrected early in life, so the surgical procedure has to maintain ... more Congenital heart diseases are corrected early in life, so the surgical procedure has to maintain the maximum potential for growth. The quest for the ideal material for cardiac tissue repair is still ongoing. Here, we describe our preliminary experience with an extracellular matrix for cardiac and vascular tissue repair. Between August 2009 and April 2011, 26 patients underwent cardiac surgery using the CorMatrix patch for vascular repair (10 pulmonary artery, four ascending aorta, three aortic arch and one right ventricular outflow tract) or for valve recon struction (five aortic, two tricuspid, one mitral and one pulmonary valve); in four cases, the repair was associated with pericardial closure using the same patch. There were no deaths, and at a mean follow-up of 13.2 months, there was no evidence of patch-related complications either in the vascular position or when used for valve repair. The ideal material for cardiac tissue repair should be haemostatic and resistant to tearing...

Research paper thumbnail of Preliminary experience in the use of an extracellular matrix to repair congenital heart diseases

Interactive CardioVascular and Thoracic Surgery, 2011

Congenital heart diseases are corrected early in life, so the surgical procedure has to maintain ... more Congenital heart diseases are corrected early in life, so the surgical procedure has to maintain the maximum potential for growth. The quest for the ideal material for cardiac tissue repair is still ongoing. Here, we describe our preliminary experience with an extracellular matrix for cardiac and vascular tissue repair. Between August 2009 and April 2011, 26 patients underwent cardiac surgery using the CorMatrix patch for vascular repair (10 pulmonary artery, four ascending aorta, three aortic arch and one right ventricular outflow tract) or for valve reconstruction (five aortic, two tricuspid, one mitral and one pulmonary valve); in four cases, the repair was associated with pericardial closure using the same patch. There were no deaths, and at a mean follow-up of 13.2 months, there was no evidence of patch-related complications either in the vascular position or when used for valve repair. The ideal material for cardiac tissue repair should be haemostatic and resistant to tearing and calcification, and possibly one that will not induce an inflammatory cascade. In the last 25 months, we used an extracellular matrix for cardiac and vascular tissue repair. The patch is advocated to induce the patient's own tissue regeneration. The early results are encouraging, but a longer follow-up is needed to understand the real potential of this material.

Research paper thumbnail of Intraaortic Balloon Pump After Treatment of Anomalous Origin of Left Coronary Artery

The Annals of Thoracic Surgery, 1998

Minimally invasive direct coronary artery bypass grafting operations, which have undoubtedly open... more Minimally invasive direct coronary artery bypass grafting operations, which have undoubtedly opened a new era in the treatment of isolated disease of the left anterior descending coronary artery, are facilitated by the development of suitable instrumentation. The use of a rib spreader that permits optimal exposure of the LIMA through a small incision with effective reduction of heart motility is key to the success of this surgical approach. Although the results are encouraging, surgeons must be aware of the possible harmful side effects that may appear when executing this new technique. Approximately 60% of the breast receives blood from the anterior and posterior perforating branches of the internal mammary artery [6]. The sternocostal segment of the pectoralis major is supplied by the internal mammary branches emerging through the cranial five or six intercostal spaces, whereas its dominant blood supply is derived from the thoracoacromial artery. When the LIMA is mobilized and ligated, musculocutaneous arterial perforators are severed, reducing blood supply to the medial and posterior left breast. In addition, in the presence of a large breast, 40 minutes of unrelieved pressure of the IMA Retractor, the mean time required for LIMA harvesting, further compresses the already compromised overlaying and intervening tissues. As a result, reduction of blood supply to the breast ensues and ischemic necrosis may develop. There is no evidence available in the current literature documenting a case of breast necrosis after standard coronary artery bypass grafting; therefore, minimally invasive direct coronary artery bypass grafting via a small anterolateral thoracotomy may not be the approach of choice in women with large breasts. During the operation direct compression force of the retractor arms on the breast should be reduced by supplying appropriate padding or by periodically relieving the pressure and removing the retractor from the breast tissue. Alternatively, modifications in the design of the retractor arms, intended to avoid possible pressure points during its application, are warranted.

Research paper thumbnail of Primary Repair of Isolated Ventricular Septal Defect in Infancy Guided by Echocardiography

The American Journal of Cardiology, 1997

Between 1989 and 1995, 96 consecutive infants affected by isolated ventricular septal defect (VSD... more Between 1989 and 1995, 96 consecutive infants affected by isolated ventricular septal defect (VSD) were submitted for primary correction at a median age of 4 months. Of the 96, 60 (group I) underwent surgery on the base of a 2-dimensional Doppler echocardiographic (DD echo) test alone. The preoperative DD echo anatomic definition of the type of VSD was confirmed at surgery in all 60 patients without false-positive results in terms of additional cardiac anomalies. There were 2 false-negatives: in 2 patients an associated cardiac anomaly was not detected by DD echo and required a second surgical procedure after postoperative cardiac catheterization. During the same period 36 infants (group II) underwent surgical closure of isolated VSD on the basis of cardiac catheterization and angiocardiography in addition to DD echo. The retrospective comparison between the 2 groups revealed no significant difference in terms of sensitivity and specificity of the diagnostic tools, early and late mortality after surgical correction, postoperative hospital stay, and need for late cardiac catheterization and surgery. We conclude that after an accurate selection, most of the infants with uncomplicated VSD can safely undergo primary repair on the basis of DD echo alone.

Research paper thumbnail of Valve leaflet reconstruction in pediatrics with extracellular matrix patch

The Journal of heart valve disease, 2012

Valve Leaflet Reconstruction in Pediatrics with Extracellular Matrix Patch. Andrea Quarti, Stefan... more Valve Leaflet Reconstruction in Pediatrics with Extracellular Matrix Patch. Andrea Quarti, Stefania Nardone, Massimo Colaneri, Gaetano Santoro, Marco Pozzi Department of Congenital and Paediatric Cardiac Surgery and Cardiology, Ospedali Riuniti, Ancona, Italy. ...