Long-term cerebral thromboembolic complications of transapical endocardial resynchronization therapy.

Purpose: Cardiac resynchronization therapy (CRT) is an established therapeutic option in selected heart failure patients (pts). However, the transvenous left ventricular (LV) lead implantation remains ineffectual in a considerable number of pts. Transapical LV (TALV) lead implantation is an alternative minimally invasive, surgical, endocardial implantation technique.

Highly-functionalised difluorinated (hydroxymethyl)conduritol analogues via the Diels-Alder reactions of a difluorinated dienophile.

A difluorodienophile, synthesised using a Stille coupling reaction underwent tin(iv)-catalysed cycloaddition with three furans to afford oxa[2.2.1]bicycloheptenes in good yield.

DOTTADs--readily made novel metal ligands with multivariant functionality--trans-DOTTADs and semi-DOTTADs.

Two new ligand systems related to the previously described DOTTADs have been generated in a simple one step reaction. The first, trans-DOTTADs, were formed by Vilsmeier formylation (followed by cyclisation and N-demethylation) of 2,6-dimethyl-3,5-pyrazine-dicarboxylic acid, to give the novel bis-pyridinopyrazine dialdehyde ligands. The corresponding pyrazine diester, reacted similarly to an intermediate iminium ion stage, which gave trans-DOTTAD imines on work-up with amines.

DOTTADs--readily made novel metal ligands with multivariant functionality.

The interaction of Hantzsch pyridinecarboxylic acids with dialkylformamides and POCl3, followed by treatment with NH4OH yields 1,8-dioxo-1,2,7,8-tetrahydro-2,7,10-triazaanthracenes (DOTTADs), which have great potential as useful ligands for Group I and II metals and some transition metals. The corresponding Hantszch esters similarly for DOTTADs or their bis-imines by way of isolable intermediates, which are then treated with an amine RNH2. DOTTAD-imines are also available from DOTTADs with amines and this reaction is also effective with 1,8-diamino-3,6-dioxaoctane to give macrocyclic analogues, as well as with chiral amines.