Outcome of patients supported with the HeartMate 3 after extracorporeal life support: On behalf of the Durable Mechanical Circulatory Support After Extracorporeal Life Support Study Group.

Objectives: The Durable Mechanical Circulatory Support System After Extracorporeal Life Support registry is a multicenter registry of patients who were bridged from extracorporeal life support to a durable mechanical circulatory support system. Although numerous studies have highlighted the favorable outcomes after implantation of the HeartMate 3 (Abbott), the objective of our study is to examine the outcomes of patients who received HeartMate 3 support after extracorporeal life support.

Methods: Data of patients undergoing HeartMate 3 implantation from January 2016 to April 2022 at 14 centers were collected and evaluated.

The impact of socio-demographic factors on health-related quality of life after coronary artery bypass surgery.

Objectives: To achieve a beneficial impact on long-term outcome after coronary artery bypass grafting (CABG), the goal of the present study was the early identification of patients at risk of impaired postoperative health-related quality of life (HRQoL), particularly evaluating the significance of socio-demographic variables.

Methods: In this prospective, single-centre cohort study of patients having an isolated CABG (January 2004-December 2014), preoperative socio-demographic (preSOC) and preoperative medical variables as well as 6-month follow-up data including the Nottingham Health Profile were analysed in 3,237 patients.

Results: All preSOC (gender, age, marriage and employment) and follow-up (chest pain, dyspnoea) variables proved to have significant influence on HRQoL (P < 0.

The quality of afterlife: surviving extracorporeal life support after therapy-refractory circulatory failure-a comprehensive follow-up analysis.

Aims: Extracorporeal life support (ECLS) represents a popular treatment option for therapy-refractory circulatory failure and substantially increases survival. However, comprehensive follow-up (FU) data beyond short-term survival are mostly lacking. Here, we analyse functional recovery and quality of life of longer-term survivors.

Postcardiotomy Veno-Arterial Extracorporeal Membrane Oxygenation: Does the Cannulation Technique Influence the Outcome?

Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) may be cannulated using either central (cannulation of aorta) or peripheral (cannulation of femoral or axillary artery) access. The ideal cannulation approach for postcardiotomy cardiogenic shock (PCS) is still unknown. The aim of this study is to compare the outcome of patients with PCS who were supported with central vs.

Preoperative percutaneous carotid artery recanalization in a patient with aortic dissection type A.

Management of patients with acute type A aortic dissection (ATAAD) presenting with cerebral malperfusion due to carotid artery obstruction is still a major challenge and often associated with poor prognosis despite successful surgical aortic repair, due to prolonged cerebral perfusion deficit. Here, we present the first report regarding successful percutaneous recanalization of an internal carotid artery occlusion in the setting of an ATAAD before open surgical aortic repair with excellent clinical outcome after three year follow-up, including almost full neurological recovery.

Degeneration of Aortic Valves in a Bioreactor System with Pulsatile Flow.

Calcific aortic valve disease is the most common valvular heart disease in industrialized countries. Pulsatile pressure, sheer and bending stress promote initiation and progression of aortic valve degeneration. The aim of this work is to establish an ex vivo model to study the therein involved processes.

Impact of standardized computed tomographic angiography for minimally invasive mitral and tricuspid valve surgery.

Background: Femoral cannulation for extracorporeal circulation (ECC) is a standard procedure for minimally invasive cardiac surgery (MICS) of the atrio-ventricular valves. Vascular pathologies may cause serious complications. Preoperative computed tomography-angiography (CT-A) of the aorta, axillary and iliac arteries was implemented at our department.

Less-invasive ventricular assist device implantation: A multicenter study.

Background: Left ventricular assist device has been shown to be a safe and effective treatment option for patients with end-stage heart failure. However, there is limited evidence showing the effect of the implantation approach on postoperative morbidities and mortality. We aimed to compare left ventricular assist device implantation using conventional sternotomy versus less-invasive surgery including hemi-sternotomy and the minithoracotomy approach.

Sex-Specific Outcomes of Patients Treated With Extracorporeal Cardiopulmonary Resuscitation.

Introduction: Patients after cardiac arrest (CA) treated with extracorporeal cardiopulmonary resuscitation (eCPR) evidence high mortality. Recently, women were reported to evidence even worse outcomes after CA. However, sex-specific data on CA patients treated with eCPR are lacking.

The Impact of Intraoperative Patient Blood Management on Quality Development in Cardiac Surgery.

Objectives: Patient blood management (PBM) is increasingly introduced into clinical practice. Minimizing effects on transfusion have been proven, but relevance for clinical outcome has been sparsely examined. In regard to this, the authors analyzed the impact of introducing intraoperative PBM to cardiac surgery.

Osteopontin as novel biomarker for reversibility of pressure overload induced left ventricular hypertrophy.

The aim of this study was to evaluate the prognostic value of osteopontin (OPN) as a marker for left ventricular (LV) hypertrophy and its reversibility after surgical aortic valve replacement (SAVR). Echocardiographic data and OPN plasma levels of 149 consecutive patients undergoing SAVR were obtained preoperatively and 3 months postoperatively. OPN was measured by Quantikine Human OPN immunoassay.

Fibrinolysis and the Influence of Tranexamic Acid Dosing in Cardiac Surgery.

Objective: The present study aimed to determine whether underlying disease, performed surgery, and dose of tranexamic acid influence fibrinolysis measured with D-dimer levels.

Design: Retrospective analysis.

Setting: Single institution (Department of Cardiac Surgery and Section of Clinical Hemostaseology at the Düsseldorf University Hospital).

Health-related quality of life after heart surgery - Identification of high-risk patients: A cohort study.

Background: This cohort study evaluated factors, which have been shown to be relevant for Health-Related Quality of Live (HRQL) after cardiac surgery and investigated the combinatory impact on HRQL. Additionally, the aim was to introduce a first attempt to developing a risk estimation model which could identify patients at risk for impaired HRQL.

Methods: For this single-centre cohort study, 6099 cardiac surgical patients (60% isolated coronary bypass surgery) filled in the Nottingham Health Profile (NHP) for the evaluation of HRQL six months after surgery and provided information regarding their medical and socio-demographic status.

Heart transplantation in patients with ventricular assist devices: Impacts of the implantation technique and support duration.

Background: Orthotopic heart transplantation (HTx) is the gold standard treatment for patients with terminal heart failure. As donor organs are limited, patients are often on ventricular assist device (VAD) support before receiving HTx. We aimed to compare the outcome after HTx in patients with and without preoperative VADs as well as in patients who underwent different VAD implantation techniques.

The age-adjusted Charlson comorbidity index in minimally invasive mitral valve surgery.

Objectives: Mitral valve repair is the preferred method used to address mitral valve regurgitation, whereas transcatheter mitral valve repair is recommended for high-risk patients. We evaluated the risk-predictive value of the age-adjusted Charlson comorbidity index (aa-CCI) in the setting of minimally invasive mitral valve surgery.

Methods: The perioperative course and 1-year follow-up of 537 patients who underwent isolated or combined minimally invasive mitral valve surgery were evaluated for 1-year mortality as the primary end point and other adverse events.

Validation of National Cardiovascular Data Registry risk models for mortality, bleeding and acute kidney injury in interventional cardiology at a German Heart Center.

Background And Purpose: The National Cardiovascular Data Registry (NCDR) risk scores for mortality, bleeding and acute kidney injury (AKI) are accurate outcome predictors of coronary catheterization procedures in North American populations. However, their application in German clinical practice remained elusive and we thus aimed to verify their use.

Methods: NCDR scores for mortality, bleeding and AKI and corresponding clinical outcomes were retrospectively assessed in patients undergoing catheterization for ST-segment elevation myocardial infarction (STEMI), non-ST-segment elevation myocardial infarction (NSTEMI) or for elective coronary procedures at a German Heart Center from 2014 to 2017.

Lactate Clearance Predicts Good Neurological Outcomes in Cardiac Arrest Patients Treated with Extracorporeal Cardiopulmonary Resuscitation.

Background: We evaluated critically ill patients undergoing extracorporeal cardiopulmonary resuscitation (ECPR) due to cardiac arrest (CA) with respect to baseline characteristics and laboratory assessments, including lactate and lactate clearance for prognostic relevance.

Methods: The primary endpoint was 30-day mortality. The impact on 30-day mortality was assessed by uni- and multivariable Cox regression analyses.

Applying a clampless haemostatic device for left ventricular assist device outflow graft anastomosis.

Performing a left ventricular assist device outflow graft anastomosis in redo cases with a short ascending aorta and open vein grafts requires side clamping of the aorta and may necessitate temporary clamping of the vein grafts to optimize the surgical field. We aim to describe the technique and report our experience with applying the HeartString® device for the anastomosis of the left ventricular assist device outflow graft in 2 male patients with ischaemic cardiomyopathy following coronary artery bypass surgery. The feasibility of using the HeartString device has been shown and no procedure-related complication was documented.

Native aortic valve derived extracellular matrix hydrogel for three dimensional culture analyses with improved biomimetic properties.

Introduction: Calcific aortic valve disease (CAVD) is the most common acquired heart valve disease with complex underlying pathomechanisms that are yet not fully understood. Three-dimensional (3D) cell culture models as opposed to conventional two-dimensional (2D) techniques may reveal new aspects of CAVD and serve as a transitional platform between conventional 2D cell culture and in vivo experiments.

Methods: Here we report on fabrication and characterization of a novel 3D hydrogel derived from cell-free native aortic valves.

Ventricular assist device in a patient with congenitally corrected transposition of the great arteries and situs inversus totalis.

Congenitally corrected transposition of the great arteries and situs inversus totalis are rare congenital anomalies. While congenital heart diseases affect about 0.75%-0.

Additional unloading of the left ventricle using the Impella LP 2.5 during extracorporeal life support in cases of pulmonary congestion.

Extracorporeal life support (ECLS) is used for the treatment of severe cardiogenic shock. However, pulmonary congestion can progress to a severe problem with ECLS therapy. We report our experience with the Impella system for severe pulmonary congestion with ECLS therapy.

A role for very low-dose recombinant activated factor VII in refractory bleeding after cardiac surgery: Lessons from an observational study.

Objectives: Although off-label use of recombinant activated factor VII against refractory bleeding is incorporated in current guideline recommendations, safety concerns persist predominantly with respect to thromboembolic complications. We analyzed the safety and efficacy of recombinant activated factor VII at a very low dose in cardiosurgical patients with refractory bleeding.

Methods: This prospective study includes 1180 cardiosurgical patients at risk of bleeding.