Treating the patients in the 'grey-zone' with aortic valve disease: a comparison among conventional surgery, sutureless valves and transcatheter aortic valve replacement.

Objectives: Although the use of transcatheter aortic valve replacement (TAVR) has recently become an attractive strategy in extremely high-risk patients undergoing aortic valve replacement (AVR), the most appropriate treatment option in patients with an intermediate- to high-risk profile with conventional surgery (sAVR), TAVR or novel options, such as sutureless valves, has been widely debated.

Methods: One hundred and sixty-three consecutive patients with intermediate to high risk were prospectively enrolled and selected to undergo sAVR (Group 1: G1, n = 55), sutureless valve implantation (Group 2: G2, n = 53) or TAVR (Group 3: G3, n = 55) following a multidisciplinary evaluation including frailty, anatomy and degree of atherosclerotic disease of the aorta/peripheral vessels. The mean logistic EuroSCORE (G1 = 21.

Endoscopic vessel harvesting: good or bad?

Purpose Of Review: The use of less invasive approaches for saphenous vein or radial artery procurement in CABG surgery has gained popularity during the past decade. The purpose of the present review is to focus on the safety and the potential advantages of minimally invasive conduit harvesting in coronary surgery.

Recent Findings: There is ample evidence in literature that the use of a less invasive approach for conduit (either saphenous vein or radial artery) procurement could yield consistent advantages over the conventional approach, in particular with respect to a lower incidence of wound complications, pain reduction and improved cosmetic results.

Hybrid revascularization in multivessel coronary artery disease.

Objectives: Minimally invasive hybrid revascularization (MIHR) by means of the left mammary artery on the left anterior descending artery [minimally invasive direct coronary artery bypass (MIDCAB)] combined with percutaneous coronary interventions (PCI) stenting may be an alternative to conventional coronary artery bypass grafting through sternotomy or multiple PCI. The purpose of this study is to retrospectively evaluate the long-term outcomes of this strategy.

Methods: Since May 1997 up to January 2011, 810 MIDCAB have been performed as isolated revascularization in 644 patients.