Multicentre experience with valve-sparing aortic root replacement by means of combined remodelling and external aortic ring annuloplasty in patients with Marfan syndrome.

Objectives: The most recent valve-sparing root replacement technique combines the advantages of the reimplantation (David) and remodelling (Yacoub) techniques. The aortic root is reconstructed according to the remodelling technique, the aortic valve is repaired according to the principle of effective height, and an external ring provides annular support. The purpose of this study was to evaluate operative and mid-term outcomes using this technique in patients with Marfan syndrome.

Reference Values for Physical Stress Echocardiography in Asymptomatic Patients after Mitral Valve Repair.

Background: Clinical decision-making in symptomatic patients after mitral valve (MV) repair remains challenging as echocardiographic reference values are lacking. In native MV disease intervention is recommended for mean transmitral pressure gradient (TPG) >15 mmHg or systolic pulmonary artery pressure (SPAP) >60 mmHg at peak exercise. Insight into standard stress echo parameters after MV repair may therefore aid to clinical decision-making during follow-up.

The association between aortic cross clamp time and postoperative morbidity and mortality in mitral valve repair: a retrospective cohort study.

Background: The aim of this study was to estimate the association between aortic cross clamp time and postoperative morbidity and mortality in patients undergoing mitral valve repair.

Methods: A retrospective cohort study between 2006 and 2014 was performed as a single Center study in the University Medical Center Utrecht. In total 1007 patients who underwent mitral valve repair were included.

Transcollateral retrograde diagnostic coronary angiogram - important therapeutic implications for an occluded arterial coronary artery bypass graft.

This case illustrates the potential clinical usefulness of retrograde approach for selective visualization of distal vessels in a patient with multiple coronary chronic total occlusions and previous coronary artery bypass graft (CABG) surgery. By knowing in extreme detail the exact anatomy of the complex post-surgical coronary system, a successful treatment can be planned for the patient.

Giant left atrial appendage: a rare anomaly.

A giant left atrial appendage is a rare congenital anomaly that has been reported on only a few occasions. We report two symptomatic patients with atrial fibrillation combined with a cerebellar infarct in one and dyspnea in the other. Both patients were treated surgically with resection of the giant left atrial appendage and radiofrequency pulmonary vein isolation.

Reduced connexin40 protein expression in the right atrial appendage of patients bearing the minor connexin40 allele (-44 G --> A).

Aims: The occurrence of connexin40 (Cx40) minor polymorphism (-44 G → A) was increased in patients with idiopathic atrial fibrillation (AF), although its effect on atrial Cx40 protein expression is unknown. We aimed to evaluate whether alterations in Cx40 are directly linked to the development of AF, we studied the effect of this polymorphism on Cx40 expression and distribution in patients without any history of AF and in patients who developed post-operative AF.

Methods And Results: Hundred and eight patients (mean age 67 ± 9 years), without a history of AF or conditions that predispose to AF, were included.

Cognitive outcomes five years after not undergoing coronary artery bypass graft surgery.

Background: Patients with coronary artery disease who underwent coronary artery bypass graft surgery have a high risk of cognitive decline 5 years after the procedure. It is conceivable that this is not caused by the operation, but by natural aging.

Methods: Psychologists repeatedly administered a battery of seven neuropsychological tests with eight main variables to 112 subjects without known coronary artery disease, with a time interval of 5 years.