Economic aspects of long-term left ventricular assist device treatment for chronic heart failure.

Aims: Technological advances and the current shortage of donor organs have contributed to an increase in the number of left ventricular assist device (LVAD) implantations in patients with end-stage heart failure. Demographic change and medical progress might raise the number of these patients, resulting in a further increase in the number of LVAD implantations. The aim of this study was to evaluate the long-term costs of LVAD therapy and identify diagnoses resulting in expensive stays.

External validation of the REMEMBER score.

Background: The use of venoarterial extracorporeal membrane oxygenation (VA-ECMO) after coronary artery bypass grafting (CABG) is associated with high in-hospital mortality rates. The pRedicting mortality in patients undergoing venoarterial Extracorporeal MEMBrane oxygenation after coronary artEry bypass gRafting (REMEMBER) score has been created to predict in-hospital mortality in this subgroup of patients. The aim of this study is to externally validate the REMEMBER score.

In-Hospital Mortality and Risk Prediction in Minimally Invasive Sutureless versus Conventional Aortic Valve Replacement.

Objective. Available evidence suggests that a minimally invasive approach with the use of sutureless bioprostheses has a favorable impact on the outcome of patients undergoing aortic valve replacement (AVR). Methods.

Transversal Arch Clamping for Complete Resection of Aneurysms of the Distal Ascending Aorta without Open Anastomosis.

Background: The extent of aortic replacement for aneurysms of the distal ascending aorta remains controversial and opinions vary between standard cross-clamp resection and open hemiarch anastomosis in circulatory arrest and selective cerebral perfusion. As the deleterious effects of extended circulatory arrest are well-known, borderline indication for distal ascending aorta aneurysm repair must be outweighed against the potential risk of complications related to the open anastomosis. In the present study, we describe our own approach consisting of "transversal arch clamping" for exhaustive resection of aneurysms of the distal ascending aorta without open anastomosis and we present the postoperative outcomes.

Comparison between the age, creatinine and ejection fraction II score and the European System for Cardiac Operative Risk Evaluation II: which score for which patient?

Objectives: Each surgical risk prediction model requires a validation analysis within a large 'real-life' sample. The aim of this study is to validate the age, creatinine and ejection fraction (ACEF) II risk score compared with the European System for Cardiac Operative Risk Evaluation (EuroSCORE) II.

Methods: All patients operated on at 8 Italian cardiac surgery centres in the period 2009-2019 with available data for the calculation of EuroSCORE II and ACEF II were included in the study.

Surgical treatment of valve endocarditis in high-risk patients and predictors of long-term outcomes.

Infective endocarditis represents a surgical challenge associated with perioperative mortality. The aim of this study is to evaluate the predictors of operative mortality and long-term outcomes in high-risk patients. We retrospectively analyzed 123 patients operated on for infective endocarditis from January 2011 to December 2020.

Sutureless versus transcatheter aortic valve replacement: A multicenter analysis of "real-world" data.

Background: Recent data suggested that transcatheter aortic valve replacement (TAVR) may be indicated also for low-risk patients. However, robust evidence is still lacking, particularly regarding valve performance at follow-up that confers a limitation to its use in young patients. Moreover, a literature gap exists in terms of 'real-world' data analysis.

Quantification of volume changes in the descending aorta after frozen elephant trunk procedure using the Thoraflex hybrid prosthesis for type A aortic dissection.

Background: Frozen elephant trunk (FET) is an established approach to reduce late complications of type A aortic dissection (AADA) by diminishing false lumen perfusion. Currently, surface size of aortic lumina are evaluated using Computed tomography (CT). However, this 2D method is prone to error as it evaluates dissection progression slice by slice.

Acute kidney injury following coronary artery bypass grafting and control angiography: a comprehensive analysis of 221 patients.

Postoperative coronary angiography offers the basis for prompt management of ischemic complications after coronary artery bypass grafting (CABG). Little is known about the effects of postoperative angiography on renal function. The current study aims to assess the incidence and risk factors for acute kidney injury (AKI) following postoperative coronary angiography.

Stent erosion after treatment of coarctation of right-sided aorta and successful surgical management.

We present a case of surgical treatment of a pseudoaneurysm of the right-sided aortic arch after stent implantation for primary coarctation in a 36-year-old woman with a previous history of ventricle septal defect closure in early childhood. As a first step, she underwent a left carotid to subclavian artery bypass for an aberrant left subclavian artery and as a second step a 'beating heart' aortic arch and descending aorta replacement via resternotomy. The postoperative course was uneventful.

Risk factors for paravalvular leak after transcatheter aortic valve replacement.

Objective: To assess risk factors for paravalvular leak (PVL) after transcatheter aortic valve implantation in a large single-center cohort, including measurement of aortic valve calcification using a reproducible method.

Methods: We retrospectively analyzed preoperative contrast-enhanced multidetector computed tomography scans of patients who underwent transcatheter aortic valve implantation in our center between 2009 and 2016. Calcium volume was calculated for each aortic cusp in the aortic valve, left ventricular outflow tract, and device landing zone.

Do Patients Supported With Continuous-flow Left Ventricular Assist Device Have a Sufficient Risk of Death to Justify a Priority Allocation? A Propensity Score Matched Analysis of Patients Listed in UNOS Status 2.

Background: Outcomes of continuous flow left ventricular assist devices (CF-LVADs) as bridge to transplant have significantly improved. The question has arisen whether patients on CF-LVADs have an increased risk of death on the waiting list as to justify a priority allocation (status 1). The aim of this study was to compare the survival after implantation of CF-LVADs with the survival on the waiting list for patients initially listed in United Network for Organ Sharing (UNOS) status 2.

Metabolic volume performs better than SUVmax in the detection of left ventricular assist device driveline infection.

Purpose: A continuous-flow left ventricular assist device (LVAD) is a new and highly promising therapy in supporting end-stage heart failure patients, either bridging them to heart transplantation or as a destination therapy. Infection is one of the major complications associated with LVAD implants. F-FDG PET/CT has already been shown to be useful in the detection of LVAD infection.

Cardiac reoperations in octogenarians: Do they really benefit?

Aim: According to the demographic development of our society, the numbers of octogenarians referred to cardiac surgery are continuously growing. Although the benefit of first-time cardiac procedures for these patients is well documented, the fate of octogenarians after redo-procedures, with special regard to long-term survival, functional status and quality of life, is poorly investigated.

Methods: We retrospectively identified 84 consecutive patients aged ≥80 years, who underwent a cardiac reoperation at the department for Cardiothoracic Surgery in the Heart & Vessel Center Bad Bevensen between January 2007 and 2013.

Sutureless aortic valve replacement with Perceval bioprosthesis: are there predicting factors for postoperative pacemaker implantation?

Objectives: Aortic valve replacement (AVR) with sutureless bioprostheses has become an alternative to conventional AVR for patients with intermediate to high operative risk. However, this technique is associated with an increased risk of postoperative conduction disorders.

Methods: We analysed 258 patients who underwent AVR with the Perceval prosthesis from July 2010 to September 2014 at our centre.

Contributory Role of Fluorine 18-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography in the Diagnosis and Clinical Management of Infections in Patients Supported With a Continuous-Flow Left Ventricular Assist Device.

Background: The current study sought to demonstrate the advantages offered by fluorine 18-fluorodeoxyglucose ((18)F-FDG) positron emission tomography/computed tomography (PET/CT) in patients supported with continuous-flow left ventricular assist devices (CF-LVADs) in detecting infection and the consequent effect on clinical decisions.

Methods: Between April 2009 and September 2013, 40 PET examinations were performed in 31 patients (78.1% men; mean age, 51.

Is Implantation of a Left Ventricular Assist Device in Patients With Critical or Impending Cardiogenic Shock an Absolute Contraindication? Looking Back at Our Past Experience Trying to Identify Contraindicative Risk Factors.

Poor survival has been demonstrated after ventricular assist device (VAD) implantation for Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) profile 1 and 2 patients compared with more stable levels. However, risk factors within this high-risk cohort have not been determined so far. The aim of the present study was to identify risk factors associated with this very high mortality rate.

Biological and clinical outcomes in the elderly with left ventricular dysfunction: Are there differences between on-pump and off-pump coronary artery bypass grafting?

Aim: To compair biological and clinical outcomes after off-pump coronary artery bypass grafting (OPCABG) and conventional on-pump coronary artery bypass grafting (CCABG) in the elderly with left ventricular (LV) dysfunction.

Material Of Study: We retrospectively reviewed 90 consecutive patients aged more than 75 years with preoperative left ventricular ejection fraction (LVEF) < 50% who underwent isolated coronary artery bypass grafting at our Institution between January 2000 and July 2009. According to operative technique, patients were categorized in to the OPCABG group (39 patients) or in to the CCABG group (51 patients).

Coronary artery bypass grafting in the octogenarian. Is complete revascularization always necessary?

Aim: The aim of this study was to investigate whether the completeness of revascularization affects the outcomes in the octogenarian.

Material Of Study: We retrospectively reviewed 130 consecutive octogenarians who underwent isolated coronary artery bypass grafting (CABG) between January 2003 and September 2010. According to operative technique, patients were categorized in Complete Revascularization (CRV) Group (96 patients) and in Incomplete Revascularization (IRV) Group (34 patients).

Neutrophil gelatinase-associated lipocalin (NGAL) in heart transplant recipients after conversion to everolimus therapy.

Background: Due to the lack of nephrotoxic activity, proliferation signal inhibitors (PSI) such as everolimus are recommended for immunosuppression after heart transplantation, but the assessment of renal function in patients receiving PSI has led to conflicting results. We examined renal integrity and function using neutrophil gelatinase-associated lipocalin (NGAL) and conventional markers [plasma creatinine, cystatin C, urine albumin, α1-microglobulin (α1M)] in heart transplant patients, who underwent conversion to everolimus due to allograft vasculopathy, graft rejection episodes, or renal function deterioration, and in patients maintained on calcineurin inhibitors (CNI).

Methods: This cross-sectional study included 121 consecutive heart transplant recipients: 44 patients received CNI-free immunosuppressive therapy with everolimus and 77 patients received CNI.

Implanting a Nonpulsatile Axial Flow Left Ventricular Assist Device as a Bridge to Transplant for Systemic Ventricular Failure After A Mustard Procedure.

Right (systemic) ventricular failure is well described after a Mustard procedure for transposition of the great arteries. Sixty-one percent of patients have been reported to show moderate-to-severe dysfunction of the systemic ventricle, 25 years after repair of transposition of the great arteries by a Mustard procedure. In such cases, heart transplant often seems to be the only option.

Better short-term outcome by using sutureless valves: a propensity-matched score analysis.

Background: Sutureless aortic valve prostheses have the potential of shortening ischemic time. However, whether shorter operative times may also result in improved patient outcomes and have an effect on hospital costs remains to be established.

Methods: From March 2010 to April 2013, 566 patients underwent aortic valve replacement with bioprostheses; of these, 166 received a sutureless valve, and 400 received a stented valve.