Landscape-scale spatial distribution of the Lanner Falcon (Falco biarmicus feldeggii) breeding population in Italy.

Falco biarmicus feldeggii is one of the most threatened taxa in Europe. Its global population is estimated at a few hundred pairs unequally scattered in a vast and fragmented area stretching from Sicily to the Caspian Sea. Most recent counts showed that Italy hosts a large part (>25%) of the whole population. Consequently, Italian authorities promoted a national action plan. In this framework, we carried out the first national survey for the Lanner Falcon in Italy (2003-2004). Our study area covered the whole breeding range, i.e., Sicily and the Italian peninsula (n = 2909 cells 10 x 10 km). When possible, we considered also additional information from previous regional investigations (1993-2001). First, we estimated size and distribution of each breeding subpopulation. Then, we tried to identify, at landscape level, the main environmental features linked to the spatial distribution of the nesting sites. We found the Lanner Falcon in 184 cells (6.4% of the total grid map), but we estimated no more than 140-172 pairs (70-80 of which are in Sicily) in the same breeding season. Higher levels of isolation characterize the continental breeding cells whereas in Sicily cells are much more clustered. Altitude is the main factor influencing cell aggregations in Italy; nevertheless, other environmental variables, such as climate, precipitation, and vegetation may be important. Our results show that the conservation measures adopted in Italy are somewhat inadequate given the low number of breeding pairs included in protected areas (23%-28%). Many small and scattered special areas of conservation (SAC) devoted to conserve priority habitats fit the irregular spatial aggregations of Lanner Falcon sites better than several large special protection areas (SPA).

Long-term results of aortic valve replacement with Edwards Prima Plus stentless bioprosthesis: eleven years' follow up.

BACKGROUND AND AIM OF THE STUDY: The Edwards Lifesciences Prima Plus stentless valve (ELSV) is a bioprosthesis manufactured from a porcine aortic root. The study aim was to evaluate late clinical outcomes after aortic valve replacement (AVR) with ELSV implanted as a miniroot in patients with aortic valve disease. METHODS: Between 1993 and 2004, 318 patients (232 males, 86 females; mean age 69 +/- 9 years; range: 37-83 years) underwent AVR with the ELSV. Preoperatively, 102 patients (32%), 162 (51%) and 54 (17%) were in NYHA classes I/II, III and IV, respectively. Aortic stenosis, aortic regurgitation and combined lesions were present in 124 patients (39%), 114 (36%) and 41 (13%), respectively. Twenty patients (6%) were referred for an acute aortic dissection, 20 (6%) for an aortic root aneurysm, and 139 (44%) had an associated aneurysmal dilatation of the ascending aorta. The ascending aorta was replaced in 159 patients (50%); aortic arch replacement was required in 10 (3%). Coronary artery bypass graft was performed in 86 patients (27%). The follow up was based on clinical data. RESULTS: Operative mortality was 5% (n = 17). There were 49 late deaths (5.2%/pt-yr). Valve-related mortality occurred in 10 patients (1%/pt-yr). Actuarial survival at five and 10 years was 78% and 33%, respectively. Actuarial freedom from valve reoperation and structural valve deterioration at 10 years were 100% and 64%. Actuarial freedom from embolic events and endocarditis at 10 years were 84% and 81%, respectively. CONCLUSION: The ELSV, when implanted as a miniroot, provided good early and long-term results in terms of survival and freedom from major complications.

Suitability of stentless bioprostheses for combined replacement of the aortic valve and ascending aorta.

BACKGROUND: The Edwards Prima stentless valve (EPSV) is a bioprosthesis made of the porcine aortic root which, owing to its versatility, may be implanted with different techniques depending on the underlying disease. The aim of this study was to demonstrate the usefulness of the EPSV implanted as a miniroot in patients with disease of the aortic valve and ascending aorta. METHODS: Between January 1998 and July 2002, 91 patients (mean age 67 +/- 7 years) underwent combined replacement of the aortic valve and ascending aorta with an EPSV for aortic stenosis (n = 12), incompetence (n = 45) or mixed disease (n = 26); all had aneurysmal dilation of the ascending aorta and 8 had an acute aortic dissection. The EPSV was implanted using the miniroot (or inclusion) technique and by extending the aorta with a tubular graft; aortic arch replacement was required in 5 patients. Hospital survivors underwent clinical and echocardiographic follow-up at 6 and 12 months and yearly thereafter. RESULTS: The hospital mortality was 11% (10 patients). Causes of death included stroke (n = 3), septic shock (n = 3), myocardial infarction (n = 2), and low output syndrome (n = 2). The mean follow-up of the 81 discharged patients was 16 +/- 13 months and was 100% complete; there were 6 late deaths due to non-cardiac causes. All patients presented with clinical improvement (95% are in NYHA functional class I) with low transvalvular gradients and significant regression of left ventricular hypertrophy at two-dimensional echocardiography. CONCLUSIONS: The EPSV used as a miniroot has proved to be a valid option in patients requiring simultaneous replacement of the aortic valve and ascending aorta. Due to the limited information available on the long-term fate of the porcine aortic valve and root, the use of this device as a miniroot should presently be limited to elderly patients.