ORCID Profile
0000-0003-4476-6051
Current Organisations
University of Oxford
,
Royal North Shore Hospital
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Publisher: Elsevier BV
Date: 10-2023
Publisher: MDPI AG
Date: 03-2021
DOI: 10.3390/JCM10050946
Abstract: Coronary artery disease (CAD) is highly prevalent in patients with severe aortic stenosis (AS). The management of CAD is a central aspect of the work-up of patients undergoing transcatheter aortic valve implantation (TAVI), but few data are available on this field and the best percutaneous coronary intervention (PCI) practice is yet to be determined. A major challenge is the ability to elucidate the severity of bystander coronary stenosis independently of the severity of aortic valve stenosis and subsequent impact on blood flow. The prognostic role of CAD in patients undergoing TAVI is being still debated and the benefits and the best timing of PCI in this context are currently under evaluation. Additionally, PCI in the setting of advanced AS poses some technical challenges, due to the complex anatomy, risk of hemodynamic instability, and the increased risk of bleeding complications. This review aims to provide a comprehensive synthesis of the available literature on myocardial revascularization in patients with severe AS undergoing TAVI. This work can assist the Heart Team in in idualizing decisions about myocardial revascularization, taking into account available diagnostic tools as well as the risks and benefits.
Publisher: Elsevier BV
Date: 2021
Publisher: Elsevier BV
Date: 03-2020
DOI: 10.1016/J.ATHORACSUR.2019.05.085
Abstract: Coronary occlusion is a rare but well-described complication of heart valve surgery. The left circumflex coronary artery, especially when it is dominant, is particularly at risk owing to the proximity of the mitral valve annulus. We report three cases of acute coronary complications of different valvular surgical procedures diagnosed and treated in the cardiac catheterization laboratory. Intracoronary optical coherence tomography was used to identify the cause of coronary flow impairment and provided important insights into the mechanism of intraoperative vascular damage.
Publisher: Elsevier BV
Date: 12-2021
Publisher: BMJ
Date: 09-2021
Publisher: Future Medicine Ltd
Date: 03-2021
Abstract: Improvements in systems, technology and pharmacotherapy have significantly changed the prognosis over recent decades in patients presenting with ST-segment elevation myocardial infarction. These clinical achievements have, however, begun to plateau and it is becoming increasingly necessary to consider novel strategies to further improve outcomes. Approximately a third of patients treated by primary percutaneous coronary intervention for ST-segment elevation myocardial infarction will suffer from coronary no-reflow (NR), a condition characterized by poor myocardial perfusion despite patent epicardial arteries. The presence of NR impacts significantly on clinical outcomes including left ventricular dysfunction, heart failure and death, yet conventional management algorithms neither assess the risk of NR nor treat NR. This review will provide a contemporary overview on the pathogenesis, diagnosis and treatment of NR.
Publisher: Wiley
Date: 10-2022
DOI: 10.1111/IMJ.15882
Publisher: Elsevier BV
Date: 05-2020
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for Jonathan Ciofani.