Gestione medica dopo la chirurgia dello scompenso cardiaco avanzato

Masetti, Marco (2015) Gestione medica dopo la chirurgia dello scompenso cardiaco avanzato, [Dissertation thesis], Alma Mater Studiorum Università di Bologna. Dottorato di ricerca in Scienze mediche specialistiche, 27 Ciclo. DOI 10.6092/unibo/amsdottorato/7101.
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The aim of the Research of this Ph D Project is to improve the medical management after surgery for advanced heart failure, both after left ventricular assist devices (LVAD) implantation, and after heart transplantation in the long-term. Regarding heart transplantation (HTx), the Research Project is focused on diagnostics, classification, prevention and treatment of cardiac allograft vasculopathy (CAV), and on treatment of post-HTx cancers; the results are presented in the first part of this Thesis. In particular, the main aspect investigated are the prognostic role of information derived from coronary angiography, coronary tomography and intravascular ultrasound, and the different sensitivity of these techniques in predicting outcomes and in diagnosing CAV. Moreover, the role of mTOR inhibitors on CAV prevention or treatment is investigated, both alone and in combination with different anti-CMV prevention strategies, as well as the impact of mTOR inhibitors on clinical outcomes in the long term. Regarding LVAD, the main focus is on the role of transthoracic echocardiography in the management of patients with a continuous-flow, centrifugal, intrapericardial pump (HVAD, Heartware); this section is reported in the second part of this Thesis. The main aspects investigated are the use of echocardiography in patients with HVAD device and its interaction with the information derived from pump curves' analysis in predicting aortic valve opening status, a surrogate of the condition of support provided by the LVAD.

Tipologia del documento
Tesi di dottorato
Masetti, Marco
Dottorato di ricerca
Scuola di dottorato
Scienze mediche e chirurgiche
Settore disciplinare
Settore concorsuale
Parole chiave
Heart transplantation, Left Ventricular Assist Devices, Cardiac Allograft Vasculopathy, mTOR inhibitors, Intravascular Ultrasound, Coronary Angiography, Coronary Tomography, Cytomegalovirus, Long Term Outcomes, Post-transplant cancers, Echocardiography, Aortic Valve
Data di discussione
17 Aprile 2015

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