Fabio Dell’Avvocata

Ospedale Santa Maria della Misericordia di Rovigo

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Gianluca Rigatelli

Santa Maria Nuova Hospital

Paolo Cardaioli

Ospedale Santa Maria della Misericordia di Rovigo

Massimo Giordan

Ospedale Santa Maria della Misericordia di Rovigo

Marco Zuin

University of Ferrara

Loris Roncon

Ospedale Santa Maria della Misericordia di Rovigo

Gabriele Braggion

Azienda Ospedaliera Santa Maria Degli Angeli

Federico Ronco

Ospedale dell' Angelo

Mauro Chinaglia

Ospedale Santa Maria della Misericordia di Rovigo

Silvio Aggio

Ospedale Santa Maria della Misericordia di Rovigo

Ramesh Daggubati

West Virginia University

Cooperative Institutions

Cambridge University Press

Ospedale Santa Maria della Misericordia di Rovigo

University of Padua

Johns Hopkins Hospital

University of Verona

University Hospital Complex Of Vigo

MedStar Washington Hospital Center

Ospedale Santa Maria

Misericordia University

Maastricht University

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The American Journal of Cardiology (2020)

Alejandro Lemor Sarah Gorgis Pedro Villablanca Mir Basir Michele Voeltz

10.1016/s0002-9149(20)30353-2

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Citations (0)

Successful pulmonary valvuloplasty in combined pulmonary valve stenosis and selective left pulmonary artery ectasia

Journal of Cardiovascular Medicine (2011)

Fabio Dell’Avvocata Gianluca Rigatelli Paolo Cardaioli Fiorenzo Scaranello

Dell’Avvocata, Fabio; Rigatelli, Gianluca; Cardaioli, Paolo; Scaranello, Fiorenzo Author Information

Ectasia

Left pulmonary artery

10.2459/jcm.0b013e32834dc4a9

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Citations (1)

Impact of Interatrial Septum Anatomic Features on Short‐ and Long‐Term Outcomes After Transcatheter Closure of Patent Foramen Ovale: Single Device Type Versus Anatomic‐Driven Device Selection Strategy

Journal of Interventional Cardiology (2013)

Gianluca Rigatelli Fabio Dell’Avvocata Ramesh Daggubati Ho Thuong Dung Nguyen Thuong Nghia

We reported the short- and long-term results of our institutional single center registry Interatrial Septum Interventions Study (ISIS) about the impact of different anatomic characteristics and related device selection in patent foramen ovale (PFO) closure.Over a 9 year period (September 2003-September 2012) we prospectively enrolled 340 consecutive patients (mean age 44 ± 15. 5 years, 198 females) who had been referred to our center for PFO catheter-based closure. The first 105 patients received a single type of device independently from the anatomy (single device strategy). The remaining 235 patients received a different device based on intracardiac echocardiographic study of interatrial septum anatomy (anatomic strategy).Immediate success rate was 100% in both groups, whereas the rate of immediate complications was 10.4% and 2.5% (P<0.01) in the single strategy group and anatomic strategy group, respectively. During a mean follow-up of 59.3 ± 28.9 months, the occlusion rate was 86.6% and 94%, whereas the incidence of recurrences was 1.8% and 0% in the single device strategy group and anatomic strategy group, respectively.The results from ISIS registry showed that anatomy of interatrial septum associated with PFO is quite complex leading to an increased rate of complications and a slightly lower closure rate if treated with a single device strategy.

Interatrial septum

Single Center

10.1111/joic.12048

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Citations (14)

Usefulness of intracardiac echocardiography with a mechanical probe for catheter‐based interventions: A 10‐year prospective registry

Journal of Clinical Ultrasound (2014)

Gianluca Rigatelli Fabio Dell’Avvocata Massimo Giordan Nicola Viceconte Rocco Aldo Osanna

ABSTRACT Background The clinical outcome benefit of intracardiac echocardiography (ICE) with a mechanical probe during congenital heart disease interventions has not been fully investigated. We reported the long‐term results of a prospective registry of interatrial shunt closure guided by mechanical ICE. Methods We enrolled 537 patients (mean age 48 ± 19.0 years, 378 females) submitted to ICE‐aided procedures in a prospective registry over a 10‐year period (September 2003‐September 2013). All patients underwent transesophageal echocardiography (TEE) before the planned procedure. We evaluated (1) structure identification capability, (2) fossa ovale and interatrial septum component measurement, (3) procedure monitoring capability, (4) procedural and fluoroscopy times, and radiograph dose, (5) probe‐related complications. Results ICE was successfully performed and was able to correctly identify the structures previously assessed by TEE in all patients. In 24 patients (4.5%), ICE allowed better anatomy definition than TEE. In 35 other patients (6.5%), ICE identified structures not observed by TEE, which led to change indications to interventions or the operative technique to be used. In 131 patients (24.4%), ICE evaluation led to change the planned device to be implanted. There was only one probe‐related complication (0.2%). Conclusions Mechanical ICE may offer a valid alternative to conventional TEE in guiding congenital heart disease interventional procedures. © 2014 Wiley Periodicals, Inc. J Clin Ultrasound 42 :534–543, 2014

Interatrial septum

10.1002/jcu.22177

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Citations (8)

Prolonged high-pressure balloon angioplasty of femoropopliteal lesions: Impact on stent implantation rate and mid-term outcome.

PubMed (2014)

Gianluca Rigatelli Mariano Palena Paolo Cardaioli Fabio Dell’Avvocata Massimo Giordan

To assess the impact on stent implantation rate and mid-term outcomes of prolonged high pressure angioplasty of femoropopliteal lesions.We retrospectively enrolled 620 consecutive patients from January 2011 to December 2011 (75.6 ± 12.3 years, 355 males, 76.5% in Rutherford class 5-6), referred for critical limb ischemia and submitted to prolonged high-pressure angioplasty of femoropopliteal lesions. The definition of prolonged high-pressure angioplasty includes dilation to at least 18 atm for at least 120 s. Procedural data, and clinical and instrumental follow-up were analyzed to assess stent implantation rate and mid-term outcomes.The preferred approach was ipsilateral femoral antegrade in 433/620 patients (69.7%) and contralateral cross-over in 164/620 (26.4%) and popliteal retrograde + femoral antegrade in 23/620 (3.7%). Techniques included subintimal angioplasty in 427/620 patients (68.8%) and endoluminal angioplasty in 193/620 patients (31.2%). The prolonged high pressure balloon angioplasty procedure was successful in 86.2% (minor intra-procedural complications rate 15.7 %), stent implantation was performed in 74 patients (11.9%), with a significant improvement of ankle-brachial index (0.29 ± 0.6 vs. 0.88 ± 0.3, P < 00.1) and Rutherford class (5.3 ± 0.8 vs. 0.7 ± 1.9, P < 0.01), a primary patency rate of 86.7%, restenosis of 18.6 % on Doppler ultrasound and a target lesion revascularization of 14.8% at a mean follow-up of 18.1 ± 6.4 months (range 1-24 months). Secondary patency rate was 87.7%.Prolonged high pressure angioplasty of femoropopliteal lesions appears to be safe and effective allowing for an acceptable patency and restenosis rates on mid-term.

10.3969/j.issn.1671-5411.2014.02.012

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Citations (8)

Primary Transcatheter Patent Foramen Ovale Closure Is Effective in Improving Migraine in Patients With High-Risk Anatomic and Functional Characteristics for Paradoxical Embolism

КАРДИОЛОГИЯ УЗБЕКИСТАНА (2010)

Gianluca Rigatelli Fabio Dell’Avvocata Federico Ronco Paolo Cardaioli Massimo Giordan

Paradoxical Embolism

Transcranial Doppler

Right-to-left shunt

10.1016/j.jcin.2009.11.019

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Citations (55)

Pathophysiology of paradoxical embolism: evaluation of the role of interatrial septum anatomy based on the intracardiac echocardiography assessment of patients with right-to-left shunting

Cardiology in the Young (2013)

Gianluca Rigatelli Fabio Dell’Avvocata Dobrin Vassiliev Ramesh Daggubati Ashesh N. Buch

Detailed anatomic variants of the interatrial septum in patients with right-to-left shunt and contribution of specific anatomies to the risk of ischaemic recurrences has not yet been comprehensively classified.To report a classification of the anatomic variants of the interatrial septum as observed by intracardiac echocardiography and its correlation with clinical and functional characteristics.We retrospectively reviewed the medical and instrumental data of 520 consecutive patients (mean age 44±15. 5 years, 355 women) who had over a 10-year period undergone intracardiac echocardiography and right-to-left shunt catheter-based closure. The four main features used to analyse were: (a) diameter of the oval fossa, (b) presence and length of the channel, (c) presence and degree of atrial septal aneurysm, and (d) rim thickness. The presence of Eustachian valve was also tabulated.The combinations of interatrial septum anatomical features were classified into six main anatomical subgroups. Recurrent embolism, multiple ischaemic foci on brain magnetic resonance imaging, high grade shunt, and permanent shunt before transcatheter closure procedure were associated with type 2, type 4, and type 6. Type 4 anatomical subtype (OR 4.1, 1.5-8 [95% CI], p<0.001) and type 2+presence of Eustachian valve (OR 4.3, 1.6-9 [95% CI], p<0.001) were the strongest predictors of recurrent ischaemic events before transcatheter closure.Our study showed that interatrial septum anatomy greatly differs among patients with right-to-left shunt, as well as the risk of ischaemic recurrences in different anatomies.

Interatrial septum

Shunting

Septum secundum

Fossa ovalis

Paradoxical Embolism

Right-to-left shunt

10.1017/s1047951113001480

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Citations (6)

Atrial fibrillation and patent foramen potentially share same atrial flow dynamic profile and thrombotic mechanism

European Journal of Internal Medicine (2017)

Gianluca Rigatelli Marco Zuin Fabio Dell’Avvocata

10.1016/j.ejim.2017.07.029

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Citations (1)

Emergent coronary stent-graft placement for coronary artery aneurysm occlusion.

Minerva Cardioangiologica (2008)

Gianluca Rigatelli Paolo Cardaioli Fabio Dell’Avvocata Massimo Giordan

Coronary artery aneurysm

Coronary artery occlusion

Coronary occlusion

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Transcatheter patent foramen ovale closure in spite of interatrial septum hypertrophy or lipomatosis: a case series

Journal of Cardiovascular Medicine (2010)

Gianluca Rigatelli Fabio Dell’Avvocata Massimo Giordan Federico Ronco Gabriele Braggion

Hypertrophy and lipomatosis of the interatrial septum have been thought to be contraindications for transcatheter patent foramen ovale (PFO) and atrial septal defect closure because of the limits of current devices and the risk of suboptimal results. No reports have been produced yet about PFO closure in patients with such conditions. We retrospectively assessed the safety and effectiveness of PFO closure in patients with hypertrophy or lipomatosis of fossa ovalis rims.We searched our database of 140 consecutive patients (mean age 43 +/- 15. 5 years, 98 female patients) who underwent transcatheter PFO closure for cases of hypertrophy or lipomatosis of the interatrial septum. All patients were screened with transesophageal echocardiography before the operation. All patients underwent intracardiac echocardiography study and attempted closure.Ten patients (7.1%) underwent an attempt at transcatheter closure in the presence of hypertrophy of the rims (eight patients) or lipomatosis (two patients). All patients were aged more than 50 years and has multiple recurrent stroke events (nine patients) or need for a posterior cerebral surgical procedure (one patient) making closure mandatory. After intracardiac echocardiography study and measurements, two 25 mm Amplatzer and eight 25 mm Premere Occlusion System devices have been implanted successfully. On mean follow-up of 36.6 +/- 14.8 months, two patients had a small residual shunt: no recurrence of stroke or aortic erosion or device thrombosis was observed during this period.Transcatheter PFO closure in the presence of hypertrophy or lipomatosis of fossa ovalis rims is not contraindicated per se: careful evaluation of rim thickness with intracardiac echocardiography and selection of soft and asymmetrically opening devices may allow for a safe and effective PFO closure, at least in patients with no severe atrial septal aneurysm.

Lipomatosis

Interatrial septum

Fossa ovalis

10.2459/jcm.0b013e32832f4046

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Citations (7)