An Artificial Intelligence-Based Automatic Classifier for the Presence of False Lumen Thrombosis After Frozen Elephant Trunk Operation.

Objective: To develop an unsupervised artificial intelligence algorithm for identifying and quantifying the presence of false lumen thrombosis (FL) after Frozen Elephant Trunk (FET) operation in computed tomography angiographic (CTA) images in an interdisciplinary approach.

Methods: CTA datasets were retrospectively collected from eight patients after FET operation for aortic dissection from a single center. Of those, five patients had a residual aortic dissection with partial false lumen thrombosis, and three patients had no false lumen or thrombosis.

The Surgical Treatment of Infective Endocarditis: A Comprehensive Review.

Infective endocarditis (IE) is a severe cardiac complication with high mortality rates, especially when surgical intervention is delayed or absent. This review addresses the expanding role of surgery in managing IE, focusing on the variation in surgical treatment rates, the impact of patient demographics, and the effectiveness of different surgical approaches. Despite varying global data, a notable increase in surgical interventions for IE is evident, with over 50% of patients undergoing surgery in tertiary centres.

Antibacterial copper-filled TiO coating of cardiovascular implants to prevent infective endocarditis-A pilot study.

Background: Infective endocarditis (IE) poses a significant health risk, especially in patients with prosthetic heart valves. Despite advances in treatment, mortality rates remain high. This study aims to investigate the antibacterial properties of a copper titanium dioxide (4× Cu-TiO) coating on cardiovascular implants against Staphylococcus aureus, a common causative agent of IE.

Short-term mechanical support with the Impella 5.x for mitral valve surgery in advanced heart failure-protected cardiac surgery.

Introduction: Surgical treatment of patients with mitral valve regurgitation and advanced heart failure remains challenging. In order to avoid peri-operative low cardiac output, Impella 5.0 or 5.

Hostile Hemodynamics in Distal Stent Graft-Induced New Entry Prior to Aortic Rupture: A Comparison of Transient versus Steady-State CFD Simulations.

Background:  Computational fluid dynamics (CFD) simulations model blood flow in aortic pathologies. The aim of our study was to understand the local hemodynamic environment at the site of rupture in distal stent graft-induced new entry (dSINE) after frozen elephant trunk with a clinically time efficient steady-flow simulation versus transient simulations.

Methods:  Steady-state simulations were performed for dSINE, prior and after its development and prior to aortic rupture.

Single-Center Real-World Experience with Sutureless Aortic Valve Prosthesis in Isolated and Combined Procedures.

Introduction: Due to their favourable hemodynamic performance and the ability to enable minimally invasive access procedures, sutureless aortic valve prostheses have found their place in the armamentarium of cardiothoracic surgeons. In this study, we sought to review our institutional experience of sutureless aortic valve replacement (SU-AVR).

Methods: We carried out a retrospective analysis of 200 consecutive patients who underwent an SU-AVR with a Perceval valve between December 2019 and February 2023.

First insights into the role of wall shear stress in the development of a distal stent graft induced new entry through computational fluid dynamics simulations.

Background: Distal stent graft induced new entry (dSINE) is an emerging complication after frozen elephant trunk (FET) procedure. The aim of this computational fluid dynamics (CFD) study was to investigate the role of wall shear stress (WSS) after the development of dSINE based on hemodynamic changes.

Methods: Aortic diameter and WSS of five patients who developed a dSINE after FET procedure were retrospectively analyzed before and after the occurrence of dSINE.

Development and evaluation of a novel combined perfusion decellularization heart-lung model for tissue engineering of bioartificial heart-lung scaffolds.

Background: Bioengineered transplantable heart-lung scaffolds could be potentially lifesaving in a large number of congenital and acquired cardiothoracic disorders including terminal heart-lung disease.

Methods: We decellularized heart-lung organ-blocks from rats (n = 10) by coronary and tracheal perfusion with ionic detergents in a modified Langendorff circuit.

Results: In the present project, we were able to achieve complete decellularization of the heart-lung organ-block.

Sutureless aortic valve replacement in pure aortic regurgitation: expanding the indications.

Background: In the era of transcatheter methods, patients presenting with a pure aortic regurgitation (AR) are not considered eligible for transcatheter treatment and therefore require another less invasive surgical option. We sought to review our experience with sutureless aortic valve replacement (SU-AVR) in patients presenting with symptomatic pure AR, which until now is a contraindication for implementation of sutureless valve prostheses in Europe.

Methods: Between April 2018 and June 2021, 80 consecutive patients underwent a SU-AVR for various indications at our institution.

Non-Inferiority of Sutureless Aortic Valve Replacement in the TAVR Era: David versus Goliath.

Background: The rapid development of transcatheter treatment methods has made transcatheter aortic valve replacement (TAVR) a feasible alternative to conventional surgical aortic valve replacement (SAVR). Recently, indications for TAVR have been expanded to intermediate- and low-risk patients, although there still remains a portion of ineligible patients. We sought to evaluate and compare our experience with sutureless SAVR and transapical TAVR in the "grey-area" of patients unsuitable for transfemoral access.

Articulation is essential: First in cardiovascular surgery implementation of 360° surgeon-powered robotic instruments.

Since the development of endoscopic vision in the late 1970s, the implementation of minimally invasive surgical methods has been rapidly progressing throughout a wide range of surgical disciplines, including cardiovascular surgery. The benefits of minimally invasive procedures including a reduction in operative trauma and postoperative morbidity, have been well-documented and compared to open-heart procedures, eventually becoming the preferred modality of treatment by many centers. Due to the cost ineffectiveness of the robotic systems for numerous institutions, new technologies have been developed to provide the advantages of robotic surgical systems at a lower price, thus making them more widely available.

Impact of severe mitral regurgitation on postoperative outcome after durable left-ventricular assist device implantation.

Background: Mitral valve regurgitation (MR) is a common finding in patients with end-stage heart failure. The aim of the study was to analyze the impact of preoperative moderate-to-severe MR on postoperative outcomes and survival after durable left-ventricular assist device (LVAD) implantation.

Methods: From August 2010 to May 2021, 246 patients underwent a durable LVAD implantation.

The frozen elephant trunk technique: impact of proximalization and the four-sites perfusion technique.

Objectives: To improve organ protection with the frozen elephant trunk (FET) procedure, a so-called four-sites perfusion in combination with proximalization for the distal aortic anastomosis was performed. The impact of these techniques on patient outcome is reported.

Methods: Between February 2005 and April 2020, a total of 357 patients underwent the FET procedure for acute (54%) or chronic (22%) aortic dissection or aneurysmal disease (24%).

Changes of stent-graft orientation after frozen elephant trunk treatment in aortic dissection.

Objectives: Our goal was to evaluate the extent of stent-graft (SG) elastic recoil in the descending aorta after the frozen elephant trunk procedure in acute (AAD) and chronic (CAD) aortic dissection as well as the impact of SG movement on distal stent graft-induced new entry (d-SINE).

Methods: We retrospectively analysed 149 (105 AAD, 44 CAD) of 259 aortic dissection patients after the frozen elephant trunk procedure between January 2005 and April 2019. Inclusion criteria were at least 1-year computed tomography angiography (CTA) aortic examinations during a follow-up time of 3.

Geometric changes in aortic root replacement using Freestyle prosthesis.

Background: The Medtronic Freestyle prosthesis has proven to be a promising recourse for aortic root replacement in various indications. The present study aims to evaluate clinical outcomes and geometric changes of the aorta after Freestyle implantation.

Methods: Between October 2005 and November 2020, the computed tomography angiography (CTA) data of 32 patients were analyzed in a cohort of 68 patients that underwent aortic root replacement using Freestyle prosthesis.

Sutureless aortic valve replacement in multivalve procedures.

Background: Despite the rapid expansion of transcatheter approaches for aortic valve implantation, surgical aortic valve replacement remains the treatment of choice in patients presenting with multiple valvular heart disease. We sought to review our clinical experience with sutureless aortic valve replacement (SU-AVR) in the setting of multivalve procedures, addressing the postoperative outcomes and technical challenges.

Methods: Between December 2019 and December 2020, 20 consecutive high-risk patients at our institution underwent SU-AVR and concomitant mitral valve procedure for various indications.

Surgical treatment of infective endocarditis in intravenous drug abusers.

Background: Despite current progress in antibiotic therapy and medical management, infective endocarditis remains a serious condition presenting with high mortality rates. It also is a life-threatening complication in patients with a history of chronic intravenous drug abuse. In this study, we analyzed our institutional experience on the surgical therapy of infective endocarditis in patients with active intravenous drug abuse.

Impact of gender in patients with continuous-flow left ventricular assist device therapy in end-stage heart failure.

Background: There is an ongoing debate about the influence of the female gender on postoperative outcomes after durable left ventricular assist device (LVAD) implantation. Despite the differences in pathophysiology of heart failure in females, therapy concepts are the same as in the male population. The aim of this study was to investigate the role of the female gender in surgical heart failure therapy.

TEVAR Following FET: Current Outcomes of Rendezvous Procedures in Clinical Practice.

Background: The treatment of extensive thoracic/thoracoabdominal aortic pathologies with arch involvement remains a challenging task in aortic surgery. The introduction of the frozen elephant trunk (FET) technique offered a link between open surgery and thoracic endovascular aortic repair (TEVAR). Despite a decade of experience, data on the complementary use of these techniques are scant.

On-pump versus off-pump coronary artery bypass surgery for multi-vessel coronary revascularization.

Background: This study aims to compare the operative and postoperative results of on-pump (ONCAB) and off-pump (OPCAB) coronary artery bypass surgery (CABG) for multi-vessel coronary revascularization (≥4 anastomoses).

Methods: From May 2018 to August 2019, a total of 120 patients (22.5% women, mean age 61.

Tricuspid valve repair in isolated tricuspid pathology: a 12-year single center experience.

Objectives: Long-term data on isolated surgical tricuspid valve procedures is limited. Current guidelines on heart valve disease recommend valve repair over valve replacement. In this study we report our 12-year single-center experience with isolated surgical tricuspid valve repair in patients with various tricuspid valve pathologies.

Essen-Commando: How we do it.

In rare cases of extensive aortic root or mitral valve infective endocarditis (IE), severe calcification of the aortic and mitral valves, or double-valve procedures in patients with small aortic and mitral annuli, surgical reconstruction of the intervalvular fibrous body (IVFB) is required. A high mortality is generally associated with this procedure, and it is frequently avoided by surgeons due to a lack of experience. It is crucial to radically resect all tissues that are severely affected by IE to prevent recurrence in the patient.