Luigi Muzzi
University of Siena
Network
Latest external collaboration on country level. Dive into details by clicking on the dots.
Publication
Featured researches published by Luigi Muzzi.
Journal of Clinical Medicine Research | 2014
Charalampos Pierrakos; Dimitrios Velissaris; Federico Franchi; Luigi Muzzi; Menelaos Karanikolas; Sabino Scolletta
Levosimendan, the active enantiomer of simendan, is a calcium sensitizer developed for treatment of decompensated heart failure, exerts its effects independently of the beta adrenergic receptor and seems beneficial in cases of severe, intractable heart failure. Levosimendan is usually administered as 24-h infusion, with or without a loading dose, but dosing needs adjustment in patients with severe liver or renal dysfunction. Despite several promising reports, the role of levosimendan in critical illness has not been thoroughly evaluated. Available evidence suggests that levosimendan is a safe treatment option in critically ill patients and may reduce mortality from cardiac failure. However, data from well-designed randomized controlled trials in critically ill patients are needed to validate or refute these preliminary conclusions. This literature review is an attempt to synthesize available evidence on the role and possible benefits of levosimendan in critically ill patients with severe heart failure.
Interactive Cardiovascular and Thoracic Surgery | 2012
Luigi Muzzi; Giulio Tommasino; Enrico Tucci; Eugenio Neri
We report the successful control of bleeding in two patients who underwent post-cardiotomy extracorporeal circulatory support (ECMO) and then developed life-threatening bleeding due to severe coagulopathy. After the failure of conventional techniques, bleeding control was achieved using Celox Gauze (MedTrade Products Ltd, Cheshire, UK) packed on the sternal edges and pericardial cavity.
Perfusion | 2007
Sabino Scolletta; Igor D. Gregoric; Luigi Muzzi; Branislav Radovancevic; O. Howard Frazier
Measurement of systemic blood flow is of crucial importance in patients on mechanical circulatory support (MCS). We reported the case of a 65-year-old female patient in severe cardiogenic shock undergoing left (Jarvik 2000 axial flow pump) and right (Levitronix-Centrimag centrifugal pump) ventricular assist device implant. Evaluation of blood flow was obtained by ultrasonic flowmetry, continuous thermodilution technique, and pressure recording analytical method (PRAM). This pulse contour system allows beat-by-beat systemic blood flow assessment from the analysis of radial artery pressure waveform. At a Jarvik pump speed ≤ 10 000 rotations per minutes (rpm), thermodilution and PRAM showed similar blood flow values. At a Jarvik pump speed ≥11 000 rpm, the aortic valve did not open and PRAM did not provide blood flow values due to nonpulsatile blood flow. The present paper describes the first experience with PRAM in a single patient on MCS. Further studies are required to assess the validity of PRAM as an additional monitoring system in the setting of ventricular assist device support. Perfusion (2007) 22, 63-66.
Journal of Cardiothoracic Surgery | 2008
Federico Bizzarri; Consalvo Mattia; Massimo Ricci; Flaminia Coluzzi; Vincenzo Petrozza; Giacomo Frati; Giuseppe Pugliese; Luigi Muzzi
A 48 year old man was transferred to our department with cardiogenic shock, pyrexia, a high white cell count and significant serum troponin T level. Clinical evaluation revealed severe mitral regurgitation secondary to a flail of both mitral valve leaflets. An emergency cardiac catheterisation did not reveal any significant coronary artery disease. Left ventricular angiogram and echocardiography demonstrated a good left ventricular function and massive mitral regurgitation. Blood cultures were negative for aerobics, anaerobics and fungi. The patient underwent emergency mitral valve replacement with a mechanical valve. Intraoperatively, the posteromedial papillary muscle was found to be ruptured. Histology of the papillary muscle revealed myocardial necrosis with no signs of infection. Cultures obtained from a mitral valve specimen were negative. The patients recovery was uneventful and he was discharged on the 6th postoperative day.
The Journal of Thoracic and Cardiovascular Surgery | 2018
Eugenio Neri; Enrico Tucci; Giulia Guaccio; Luigi Muzzi
Abstract We herein describe a new technique that aims to address some limitations of standard hemiarch aortic replacement in acute type A aortic dissection repair. This technique combines the advantages of arch replacement to the simplicity of anterior hemiarch repair while providing an elephant trunk configuration for future interventions.
Annals of Vascular Surgery | 2017
Luigi Muzzi; Giulio Tommasino; Giulia Guaccio; Enrico Tucci; Franco Roviello; Eugenio Neri
Aortic dissection is a complex disease associated with high mortality and morbidity. Among the different possible clinical presentations, type A aortic dissection complicated at the onset by mesenteric malperfusion is characterized by poor outcome compared with patients not presenting such complication. We report the case of a patient with acute type A aortic dissection presenting with mesenteric malperfusion, in whom trans-pericardial color Doppler ultrasound (CDUS) examination was used to assess intraoperative and postoperative blood flow in the mesenteric artery. Trans-pericardial CDUS is demonstrated as a fast and simple diagnostic method with a good matching compared with contrast-enhanced computed tomography scan imaging, if correctly approached. We believe that this technique could be an important adjunctive tool for the intraoperative and perioperative management and decision-making in all patients with type A dissection presenting with mesenteric ischemia.
Journal of Visceral Surgery | 2018
Eugenio Neri; Enrico Tucci; Giulio Tommasino; Giulia Guaccio; Carmelo Ricci; Pierleone Lucatelli; Marco Cini; Roberto Ceresa; Antonio Benvenuti; Luigi Muzzi
Background Residual false channel is common after repair of type A acute aortic dissection (TAAAD). Starting from our recent series of TAAAD patients we carried out a retrospective analysis, regarding the failure of primary exclusion at the time of the initial operation. We classified the location of the principal entry tears perfusing the residual false channel. The proposed technique represents our attempt to correct the mechanism of false channel perfusion during primary repair. We describe a new technique designed to address some limitations of standard hemiarch aortic replacement. Its goal are: (I) to reinforce the intimal layer at the arch level; (II) to eliminate inter-luminal communications at the arch level using suture lines around the arch vessels; (III) to provide an elephant trunk configuration for further interventions. Methods Between August 2016 and January 2018, 11 patients underwent emergency surgery using this technique; 7 were men; the median age was 74 years. All patients were treated using systemic circulatory arrest under moderate hypothermia (26 °C) and selective cerebral perfusion. All patients had supra-coronary repair; 1 patient had aortic valve replacement + CABG. In the first two patients a manual suture around supra-aortic trunks was used; the subsequent seven patients were treated with a mechanical suture bladeless device. CT scan follow up was performed in all survivors with controls before discharge 3 months and 1 year after operation. Results No patient died in the operating room and no neurologic deficit was observed in this initial experience. One patient died in POD 5th for low cardiac output syndrome. Median ICU stay was 3 days (IQR, 2-6 days). Hospital mean length of stay was 15.2±8 days. Median cardiopulmonary bypass time was 130 min (IQR, 110-141 min); median arrest time for re-layering was 17 min (IQR, 16-20 min); median total arrest was 36 min (IQR, 29-39 min). Distal aortic anastomosis was performed in zone 0 in 4 patients, zone 1, with innominate replacement, in 5 patients, in zone 2, with branches to innominate and left common carotid arteries, in 2 patients. Median follow up (closing date 06/01/2018) was 443 days (IQR, 262-557 days); no late deaths occurred. No dehiscence at the level of stapler or manual sutures was observed. Proximal 1/3 of the thoracic aorta false channel was obliterated in all cases but one; in 3 cases complete exclusion of the false channel was obtained after operation. In one case stent graft completion was required. Conclusions This technique combines the advantages of arch replacement to the simplicity of anterior hemiarch repair. This study demonstrates the safety of the procedure and the possibility to induce aortic remodeling without complex arch replacement.
Interactive Cardiovascular and Thoracic Surgery | 2018
Eugenio Neri; Enrico Tucci; Giulio Tommasino; Luigi Muzzi
We herein report an emergency technique of composite Bentall operation using a fast release valve. The technique was successfully performed in 2 emergency cases after failed supracoronary ascending aortic replacement in acute Type A aortic dissection. The speed and ease of execution are the main advantages of the procedure.
Journal of Endovascular Therapy | 2013
Claudio Ceccherini; Carmelo Ricci; Marco Cini; Francesco Vigni; Sara Leonini; Giulio Tommasino; Luigi Muzzi; Enrico Tucci; Antonio Benvenuti; Eugenio Neri
Involvement of the iliac arteries with an abdominal aortic aneurysm (AAA) is seen in 20% to 30% of AAA patients. Treatment options have been dramatically changed over the last 10 years. At first, the only endovascular option was embolization of the internal iliac artery (IIA) using coils or plugs to extend the iliac limbs of the aortic stent-graft past the IIA. In a significant number of patients, however, IIA embolization may cause chronic symptoms, such as buttock claudication and sexual dysfunction, whether transient or permanent. The most successful endovascular options to preserve IIA flow have been branched stent-grafts and the bell-bottom technique. Implantation of branched stentgrafts has been shown to be feasible and safe, with good long-term outcome, even if the device is significantly more expensive. The bell-bottom technique was developed to approach IIAs with diameters between 18 and 24 mm, which precludes its use in aneurysms with larger distal landing zones. In 2011, Lobato et al. described the sandwich technique for aortoiliac aneurysms, which included 5 steps: (1) bifurcated stentgraft main body insertion through an ipsilateral femoral approach and positioned such that the distal end of the iliac limb is 1 cm above the IIA origin; (2) catheterization of the ipsilateral IIA through a left brachial access; (3) placement of a covered self-expanding stent 2 cm inside the IIA with a 6-cm overlap into the iliac limb, followed by positioning of an iliac limb extension 1 cm below the covered stent’s proximal end; (4) modeling of the iliac limb stent-grafts using a latex balloon and dilation of the covered stent with an angioplasty balloon; and (5) deployment of the contralateral iliac limb. As performed by the authors, the sandwich technique was favorably accepted by other investigators, and midterm results seem promising. In our institution, we have used this technique in 12 patients to date (7 described in a previous article). Cannulating the IIA from the brachial artery and advancing an endograft from the upper extremity proved uncomplicated. Sealing the commissural angles was successful, as oversizing the limb grafts in relation to the diameter of the main graft produces a tight apposition of the components. The technique satisfactorily recanalized the IIA and was free from intraprocedural complications. Now with a mean follow-up of 20 months (range 6–47), we have seen no endoleak in any patient. The iliac aneurysm sac diameter has shrunk (range 1–15 mm) in
The Journal of Thoracic and Cardiovascular Surgery | 2001
Federico Bizzarri; Sabino Scolletta; Enrico Tucci; Mara Lucidi; Giuseppe Davoli; Thomas Toscano; Eugenio Neri; Luigi Muzzi; Giacomo Frati