Transfemoral versus transapical transcatheter aortic valve implantation: a single-centre experience.

Objectives: Transapical transcatheter aortic valve implantation (TAVI) is associated with increased mortality as compared to the transfemoral (TF) access. Possible mechanisms include different patient risk profiles as well as an intrinsic injury caused by the access route itself.

Methods: All consecutive patients scheduled for TAVI between January 2009 and June 2016 at a single centre were evaluated.

Impact of right and left ventricular systolic dysfunction on perioperative outcome and long-term survival after transcatheter aortic valve replacement.

Background: Aim of the study was to determine the impact of right- and left-ventricular systolic dysfunction on perioperative outcome and long-term survival after TAVR.

Methods: Study population consisted of 702 TAVRs between 2009 and 2014, 345 by TF, 357 by TA route. RV and LV function were determined by TAPSE and LVEF measurement during baseline echocardiography.

Presentation of a quality management program in off-pump coronary bypass surgery.

Objective: To increase the number of off-pump coronary procedures at our institution, a new surgical team was formed. The first 3 years of "learning period" were accompanied by a quality management program aimed to control and adjust the surgical process and to ensure the safety and quality of the procedure.

Methods: All patients were operated on by the same surgeon between January 2004 and December 2006; all procedures were performed under the following quality management protocol.

Concomitant coronary intervention is associated with poorer early and late clinical outcomes in selected elderly patients receiving transcatheter aortic valve implantation.

Objectives: Significant coronary artery disease (CAD) is common among patients currently evaluated for transcatheter aortic valve implantation (TAVI). Limited data exist on the outcome of patients undergoing combined transcatheter treatment of aortic valve disease and CAD. The aim of the study was to analyse the impact of concomitant percutaneous coronary intervention (PCI) on early and late clinical outcomes of patients receiving TAVI.

Simple, effective and safe vascular access site closure with the double-ProGlide preclose technique in 162 patients receiving transfemoral transcatheter aortic valve implantation.

Objectives: Aim of this study was to analyze feasibility, efficacy, and safety of a double-ProGlide preclose technique for access site closure after transfemoral transcatheter aortic valve implantation (TAVI).

Background: An effective and safe transcutaneous closure device is advantageous in transfemoral TAVI to avoid surgical cut down of the large caliber sheath insertion site. The use of two ProGlide sutures has not been described in this context in a large patient cohort.

Emergency cardiac surgery during transfemoral and transapical transcatheter aortic valve implantation: incidence, reasons, management, and outcome of 411 patients from a single center.

Objectives And Background: Transcatheter aortic valve implantation (TAVI) is increasingly performed in high-risk patients with severe aortic valve stenosis. Incidence and impact of emergency cardiac surgery (ECS) during TAVI is unclear.

Methods And Results: Two-hundred twenty one transapical (TA) and 190 transfemoral (TF) TAVIs were performed at our hospital between 01/2009 and 12/2012.

Valve-in-valve transcatheter aortic valve implantation for degenerated bioprosthetic heart valves.

Objectives: We sought to analyze outcomes of patients with degenerated surgically implanted bioprosthetic heart valves undergoing valve-in-valve (viv) transcatheter aortic valve implantation (TAVI).

Background: Redo cardiac surgery for degenerated bioprosthetic heart valves is associated with increased risks, particular in elderly patients with comorbidities. For these patients, TAVI may be an attractive, less invasive treatment option.

Insufficient unilateral cerebral perfusion during emergent aortic arch surgery.

A rare case of insufficient right-sided unilateral cerebral perfusion during emergent aortic arch replacement in a patient with an acute aortic dissection is reported. On the basis of intraoperative monitoring using near-infrared spectroscopy, the insufficient perfusion of the contralateral hemisphere was detected and the bilateral perfusion was performed, which led to normalization of cerebral perfusion and an uncomplicated neurological outcome.

Thrombocytopenia after aortic valve replacement with the Sorin Freedom Solo prosthesis.

Background And Aim Of The Study: Thrombocytopenia after implantation of the Sorin Freedom Solo (FS) stentless aortic bioprosthesis has been described previously. Thus, relevant data acquired at the authors' institution were analyzed.

Methods: A comparison of platelet counts was made in patients operated on between January and August 2008 following implantation of either the FS valve (n = 26) or a stented pericardial prosthesis (n = 238).

Foreign material reaction to BioGlue® as a possible cause of cardiac tamponade.

We describe the case of a 65-year-old female patient who underwent aortic valve reconstruction for aortic valve stenosis. During the operation, repair of a left ventricular laceration produced by a left ventricular vent was necessary. BioGlue® (CryoLife, Atlanta, GA, USA) and pledgeted sutures were used for repair.

Transmyocardial laser revascularization combined with intramyocardial endothelial progenitor cell transplantation in patients with intractable ischemic heart disease ineligible for conventional revascularization: preliminary results in a highly selected small patient cohort.

Objective: Transmyocardial laser revascularization for angina relief and intramyocardial autologous endothelial progenitor cell injection for neoangiogenesis may offer a new treatment strategy for patients with intractable ischemic heart disease.

Methods: Transmyocardial laser revascularization and intramyocardial injection of bone marrow-derived CD133+ cells was performed in six highly symptomatic patients. Transmyocardial laser channels were created and isolated CD133+ cells were injected intramyocardially.

Influence of clamp duration and pressure on endothelial damage in aortic cross-clamping.

Aortic cross-clamping during cardiac operations may injure the vessel wall and cause tissue lesions. This experimental study analyses the influence of the intravascular and external pressure and the duration of aortic cross-clamping on endothelial tissue damage. Fresh porcine aortas (n=20) were tested with intravascular pressures from 30 to 80 mmHg.

Impact of graft size and commissural resuspension height on aortic valve competence in valve-sparing aortic replacement under physiological pressures.

Background: Valve competence in valve-sparing aortic root replacement has been described as being influenced by commissural height as well as graft size. The aim of this study was to investigate the impact of a gradual reduction of commissural height and graft diameter on aortic insufficiency under physiological conditions in an IN VITRO model.

Methods: Porcine aortic valves were reimplanted into a tubular graft and a native commissural height was obtained.

Simultaneous surgery of the aortic valve and sternal osteomyelitis.

A 64-year-old man was referred for aortic valve replacement due to severe stenosis. He also suffered chronic sternal osteomyelitis with skin fistula subsequent to radiation therapy. Both pathologies were approached simultaneously by sternal resection, omental plasty, and valve replacement, which led to favorable primary and mid-term result.

Contained rupture of the aorta in acute Stanford type A aortic dissection causing right ventricular wall dissection.

We describe a rare case of an acute aortic type A dissection after previous aortic valve replacement and coronary artery revascularization complicated by a contained rupture and right ventricular wall dissection. Although preoperatively echocardiography and CT scan described a pericardial hematoma, intraoperatively no intrapericardial hematoma was found; instead an extended right ventricular wall dissection caused by a large thrombus formation within the right ventricular muscle layers was demonstrated. After replacement of the ascending aorta and removal of the thrombus as the sole treatment for right ventricular wall dissection, the two dissected layers of the right ventricular wall were contracting synchronously again.

In-vitro hemodynamics of stented bioprosthetic heart valves in the tilted implantation position.

Background And Aim Of The Study: Although, in small aortic annulus or aortic annulus calcification, it is recommended that valves are implanted in a tilted position, mechanical valves show impaired hemodynamic performance when positioned in this way. To date, no investigations have been conducted with biological valves implanted in a tilted position.

Methods: Measurements were performed in a pulsatile flow simulator.

An air gun pellet retained in the heart: a case report.

We report the rare case of an air gun pellet retained within the myocardium. The pellet passed through the right ventricle and the interventricular septum and was retained in the posterior left ventricular wall. The patient presented with cardiac tamponade requiring urgent surgical treatment.

Impact of graft size and resuspension level of the commissures on aortic insufficiency after reimplantation of the aortic valve.

Background: In addition to the size of the graft, the resuspension of the commissures has been described as important for valve function in valve-sparing aortic root replacement procedures. This study describes the influence of a stepwise reduction of the fixation level of the commissures within the graft as well as a stepwise reduction of graft size on valve insufficiency.

Method: Porcine aortic valves were reimplanted into a tubular graft and the height of the commissures was reduced in a stepwise manner.

Serum S100B levels in patients after cardiac surgery: possible sources of contamination.

Background: S100B protein is considered to be a potential marker of brain damage. The aim of our study was to determine the contamination effect of retransfused blood on the serum S100B concentrations in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB) and to differentiate between this simple contamination effect and its possible enhancement by haemolysis.

Methods: The first part of the study was performed in a group of 10 patients scheduled for coronary artery bypass grafting.