Cardiovascular research

Cardiac surgery, innovation and research

Head

Michele De Bonis

The Unit of Cardiac Surgery, Innovation and Research is set up as an engine of innovation and clinical and translational research in the field of cardiac surgery through the study, introduction and clinical application of cutting-edge therapies for the treatment of heart disease.

Advanced search >

Organization

The Unit works very closely with the Alfieri Heart Foundation, whose support is essential in order to provide resources, projects and an extraordinary team of trial coordinators, data managers, bioengineers and biostatistics. The integration of this research facility within a high volume Cardiac Surgery Department offers a unique opportunity to put the clinical research at the service of the patient, making it an irreplaceable tool for constantly improving the treatment options which are offered.

Research activity

The main areas of clinical and research activity are:

Mitral and tricuspid repairs:

Since ever the main topics of our research, they have contributed in a decisive way to the recognition of our Institute as an international center of excellence also for the minimally invasive and trans-catheter approaches.
Over 550 mitral and tricuspid repair operations are performed annually. The results obtained also with conventional as well as original technical solutions introduced by our team center continue to be periodically published in the main international journals.

Surgical treatment of heart failure:

The different surgical and percutaneous options for the treatment of heart failure represent a rapidly expanding area of our clinical research conducted by dedicated multidisciplinary teams (VAD/ ECMO-Team, Arrhythmia-Team, Valve-Team).
Areas of excellence:

- surgical and trans-catheter therapy of functional mitral and tricuspid insufficiency in the context of idiopathic or ischemic dilated cardiomyopathy;

- cardiogenic shock and terminal heart failure treated by all types of circulatory support systems (ECMO, VAD, TAH).

Percutaneous treatment of valvulopathies:

Participation in national and international multicenter studies on percutaneous technologies for aortic valve replacement (TAVI), mitral valve replacement (TMVR with Tiara, Tendyne) and tricuspid valve replacement (Navigate) and for mitral repair (Mitraclip, Cardioband, Neochord, Harpoon) and tricuspid ( Tricinch, MitraClip, Trialign, Forma, Cardioband).

Surgical treatment of atrial fibrillation and arrhythmias:

The clinical and research program is aimed at treating all forms of atrial fibrillation (paroxysmal, persistent and permanent, isolated or in association with structural heart disease). Recently, innovative minimally invasive and thoracoscopic techniques have been developed to treat even in the most refractory forms.
Methods of electrophysiological validation of the devices used for surgical ablation have being studied together with the alterations of the atrial wall in patients with atrial fibrillation (at the cellular, molecular and metabolic level).

Collaborations

Participation in national and international registers (European Register on Endocarditis – EuroEndo; VAD registers- ITAMACS, EUROMACS; multiple registers of trans-catheter therapies)
Cardiovascular Research Unit, Faculty of Health Sciences, University of Cape Town, South Africa (center where Prof. Barnard performed the first cardiac transplant)
Cardiac Surgery Department of Derriford Hospital, Plymouth NHS Trust, Plymouth, United Kingdom
European Society of Cardiac Surgery (EACTS Academy and Task Force on mitral and tricuspid surgery)
Mitral and Tricuspid Research Network of the Heart Valve Society
Council on Cardiovascular Surgery and Anesthesia of the American Heart Association
Working Group for Cardiovascular Surgery of the European Society of Cardiology
Politecnico di Milano

selected publications

Gammie JS, Bartus K, Gackowski A, D'Ambra MN, Szymanski P, Bilewska A, Kusmierczyk M, Kapelak B, Rzucidlo-Resil J, Moat N, Duncan A, Yadev R, Livesey S, Diprose P, Gerosa G, D'Onofrio A, Pitterello D, Denti P, La Canna G, De Bonis M, Alfieri O, Hung J, Kolsut P. Beating-Heart Mitral Valve Repair Using a Novel ePTFE Cordal Implantation Device: A Prospective Trial. J Am Coll Cardiol. 2018 Jan 2;71(1):25-36

De Bonis M, Lapenna E, Del Forno B, Di Sanzo S, Giacomini A, Schiavi D, Vicentini L, Latib A, Pozzoli A, Pappalardo F, La Canna G, Alfieri O. Minimally invasive or conventional edge-to-edge repair for severe mitral regurgitation due to bileaflet prolapse in Barlow's disease: does the surgical approach have an impact on the long-term results? Eur J Cardiothorac Surg. 2017 Jul 1;52(1):131-136.

De Bonis M, Taramasso M, Lapenna E, Denti P, La Canna G, Buzzatti N, Pappalardo F, Di Giannuario G, Cioni M, Giacomini A, Alfieri O. MitraClip therapy and surgical edge-to-edge repair in patients with severe left ventricular dysfunction and secondary mitral regurgitation: mid-term results of a single-centre experience. Eur J Cardiothorac Surg. 2016 Jan;49(1):255-62

Latib A, Naim C, De Bonis M, Sinning JM, Maisano F, Barbanti M, Parolari A, Lorusso R, Testa L, Actis Dato GM, Miceli A, Sponga S, Rosato F, De Vincentiis C, Werner N, Fiorina C, Bartorelli A, Di Gregorio O, Casilli F, Muratori M, Alamanni F, Glauber M, Livi U, Nickenig G, Tamburino C, Alfieri O, Colombo A. TAVR-associated prosthetic valve infective endocarditis: results of a large, multicenter registry. J Am Coll Cardiol. 2014 Nov 18-25;64(20):2176-8

De Bonis M, Lapenna E, Taramasso M, Pozzoli A, La Canna G, Calabrese MC, Alfieri O. Is commissural closure associated with mitral annuloplasty a durable technique for the treatment of mitral regurgitation? A long-term (≤15 years) clinical and echocardiographic study. J Thorac Cardiovasc Surg. 2014;147(6):1900-6.

De Bonis M, Lapenna E, Taramasso M, La Canna G, Buzzatti N, Pappalardo F, Alfieri O. Very long-term durability of the edge-to-edge repair for isolated anterior mitral leaflet prolapse: Up to 21 years of clinical and echocardiographic results. J Thorac Cardiovasc Surg. 2014 Nov;148(5):2027 32.

De Bonis M, Lapenna E, Maisano F, Barili F, La Canna G, Buzzatti N, Pappalardo F, Calabrese M, Nisi T, Alfieri O. Long-Term Results (≤18 Years) of the Edge-to-Edge Mitral Valve Repair Without Annuloplasty in Degenerative Mitral Regurgitation: Implications for the Percutaneous Approach. Circulation. 2014 Sep 9;130(11 Suppl 1):S19-24.

De Bonis M, Taramasso M, Verzini A, Ferrara D, Lapenna E, Calabrese MC, Grimaldi A, Alfieri O. Long-term results of mitral repair for functional mitral regurgitation in idiopathic dilated cardiomyopathy. Eur J Cardiothorac Surg. 2012;42(4):640-6.

De Bonis M, Lapenna E, Lorusso R, Buzzati N, Gelsomino S, Taramasso M, Vizzardi E, Alfieri O. Very long-term results (up to 17 years) with the double orifice mitral valve repair combined with ring annuloplasty for degenerative mitral regurgitation. J Thorac Cardiovasc Surg. 2012; 144(5):1019-24.

De Bonis M, Taramasso M, Grimaldi A, Maisano F, Calabrese MC, Verzini A, Ferrara D, Alfieri O. The GeoForm annuloplasty ring for the surgical treatment of functional mitral regurgitation in advanced dilated cardiomyopathy. Eur J Cardiothorac Surg. 2011; 40 (2):488-95.

M. De Bonis, E. Lapenna, A. Verzini, G. La Canna, A. Grimaldi, L. Torracca, F. Maisano, O. Alfieri. Recurrence of mitral regurgitation parallels the absence of left ventricular reverse remodeling after mitral repair in advanced dilated cardiomyopathy. Ann Thorac Surg. 2008 Mar;85(3):932-9.

M. De Bonis, E. Lapenna, F. Sorrentino, G. La Canna, A. Grimaldi, F. Maisano, L. Torracca, O. Alfieri. Evolution of tricuspid regurgitation after mitral valve repair for functional mitral regurgitation in dilated cardiomyopathy. Eur J Cardiothorac Surg. 2008 Apr;33(4):600-6.

M. De Bonis, R. Lorusso, E. Lapenna, S. Kassem, G. De Cicco, L. Torracca, F. Maisano, G. La Canna, O. Alfieri. Similar long-term results of mitral valve repair for anterior compared with posterior leaflet prolapse. J Thorac Cardiovasc Surg. 2006 Feb;131(2):364-70.

M. De Bonis, E. Lapenna, G. La Canna, E. Ficarra, M. Pagliaro, L. Torracca, F. Maisano, O. Alfieri. Mitral valve repair for functional mitral regurgitation in end-stage dilated cardiomyopathy: the role of the “edge-to-edge” technique. Circulation 2005;112[suppl I]:I 402-I408.

De Bonis M, Lapenna E, La Canna G, Grimaldi A, Maisano F, Torracca L, Caldarola A, Alfieri O. A novel technique for correction of severe tricuspid valve regurgitation due to complex lesions. Eur J Cardiothorac Surg. 2004 May;25(5):760-5.