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Luca Lorini

Publications and source records attributed to Luca Lorini.

5 recordsLinked to original sources
PubMed2006

Surgical ventricular reverse remodeling in severe ischemic dilated cardiomyopathy: the relevance of the left ventricular equator as a prognostic factor.

OBJECTIVES: Surgical ventricular reverse remodeling has been shown to possibly improve hemodynamics and symptoms, but effects on long-term mortality are not established. No consistent data are available on which patients will benefit most from this procedure. This study was designed to analyze the predictors of long-term survival after surgical ventricular reverse remodeling in patients with ischemic cardiomyopathy. METHODS: Eighty-five patients who underwent surgical ventricular reverse remodeling between May 1991 and October 2003 were retrospectively analyzed. Left ventricular wall motion and left ventricular equatorial diameter were assessed by means of angioventriculography. Left ventricular ejection fraction and volumes were measured by means of echocardiography. Cox regression analysis was used in several combinations to create a final model for identifying predictors of death. RESULTS: Actuarial survival after 1, 3, 5, and 10 years was 89%, 79%, 75%, and 75%, respectively. New York Heart Association class improved from 2.9 +/- 1.0 to 1.3 +/- 0.5 (P < .0001), left ventricular ejection fraction increased from 27.6% +/- 6.3% to 43.0% +/- 10.1% (P < .0001), and left ventricular end-systolic volume index decreased from 89.6 +/- 27.6 mL/m2 to 56.5 +/- 34.5 mL/m2 (P < .0001). Multivariate analysis identified left ventricular equatorial diameter of 70 mm or greater (hazard ratio, 5.28; 95% confidence interval, 1.79-11.71; P = .020) and segmental akinesia (hazard ratio, 4.46; 95% confidence interval, 1.23-17.12; P = .024) as the only independent predictors of death. CONCLUSIONS: In this analysis of a single cohort of patients, surgical ventricular reverse remodeling improves the symptoms of ischemic cardiomyopathy, as well as left ventricular function, shape, and volume, with encouraging long-term outcomes, particularly in patients with dyskinesia. A left ventricular equatorial diameter of 70 mm or greater appears to be an important independent prognostic factor, which suggests the relevance of the left ventricular equatorial region for effective surgical reverse remodeling.

Adult↗
PubMed2006

Treatment of refractory heart failure with a percutaneous circulatory support device.

End-stage heart failure refractory to medical therapy is a clinical challenge. Heart transplantation is considered the best strategy, but it remains burdened with substantial limitations due to the scanty availability of facilities with a transplant programme, donor shortage, and unpredictable waiting lists. Alternatively, assist devices may allow an improvement of the haemodynamic conditions, modifying the history of end-stage heart failure and introducing new management strategies. The goal of a minimally invasive short-term circulatory support device in the treatment of end-stage heart failure patients awaiting heart transplant is to restore the haemodynamic conditions and to improve end-organ dysfunction, with a low incidence of major adverse cardiac events. This report describes the first implantation in Italy of a new percutaneous circulatory support device, the Cancion cardiac recovery system, in a patient with severe end-stage heart failure listed for transplantation.

Aged↗
PubMed2004

IEN-CsF1 accuracy evaluation and two-way frequency comparison.

In this paper we report the accuracy evaluation of the Italian primary frequency standard IEN-CsF1. We discuss the shifts the frequency standard is corrected for and the procedure used for the accuracy evaluation. In the last section we report frequency comparisons of our fountain with those of remote laboratories and with International Atomic Time.

Journal Article↗
PubMedDate not supplied

Ineffectiveness of local wound anesthesia to reduce postoperative pain after median sternotomy.

Postoperative pain control still represents a major challenge in every surgical field. Bupivacaine wound infiltration is frequently used to reduce the pain related to the surgical incision itself. In this randomized study, we investigated the efficacy of bupivacaine local anesthesia after median sternotomy to reduce postoperative pain. Forty-seven patients undergoing major cardiac surgery procedures were allocated randomly to group A (bupivacaine wound infiltration 0.5%; 10 mL, followed by continuous infusion: 10 mg/24 H) or to group C (controls). Extubation time, postoperative arterial blood gases, postoperative pain (assessed by means of a visual analog scale), and morphine consumption were the endpoints of the study. Patients of group C were extubated earlier; blood gases and VAS values were similar in both group. Bupivacaine local analgesia did not improve postoperative pain control after median sternotomy.

Aged↗