Exotic Superfluid Phases in Spin-Polarized Fermi Gases in Optical Lattices.

Leveraging cutting-edge numerical methodologies, we study the ground state of the two-dimensional spin-polarized Fermi gas in an optical lattice. We focus on systems at high density and small spin polarization, corresponding to the parameter regime believed to be most favorable to the formation of the elusive Fulde-Ferrell-Larkin-Ovchinnikov (FFLO) superfluid phase. Our systematic study of large lattice sizes, hosting nearly 500 atoms, provides strong evidence of the stability of the FFLO state in this regime, as well as a high-accuracy characterization of its properties.

[CircuLite Synergy ventricular assist device: a new approach to end-stage congestive heart failure].

Background: The Synergy system, a miniature partial circulatory support device, is implanted by an off-pump, minimally invasive surgical approach. The system has been optimized to improve performance in an EU clinical trial for chronic ambulatory heart failure. This therefore offers the possibility of treating elderly chronic heart failure patients who might not usually be considered for long-term circulatory support.

Circulatory support in elderly chronic heart failure patients using the CircuLite® Synergy® system.

Objective: The Synergy(®) system, a miniature partial circulatory support device, is implanted with an off-pump, minimally invasive surgical approach. In our experience, implantation of this system is associated with fewer perioperative adverse events than current full support devices. This approach therefore offers the possibility of treating elderly chronic heart-failure patients who might not ordinarily be considered for long-term circulatory support.

Mitral and aortic valve prosthetic endocarditis after percutaneous closure of mitral paravalvular leak.

A 67-year-old man presented to our hospital with massive mitral and aortic valve prosthetic endocarditis 2 months after transcatheter percutaneous closure of a mitral paravalvular leak with an Amplatzer duct occluder device (AGA Medical Corp, Plymouth MN). He underwent successful reoperation for valve prosthesis replacement and reconstruction of the anterior fibrous trigone. Although transcatheter treatment of periprosthetic valve defects has been shown to be feasible, follow-up data are still limited.

Valvulopathies in sub-Saharan African children: patterns, humanitarian interventions and cardiac surgical problems.

Despite the high burden of rheumatic fever in sub-Saharan African, there is currently no sustained and comprehensive strategy to control the disease. Consequently in this area the number of patients affected by rheumatic valve disease (RVD), most with a surgical indication, is 10-20 fold higher than in industrialised countries and estimates indicate that more than 50% of African RVD patients will die before age 25. In this paper, we review clinical and management issues of RVD in children in sub-Saharan Africa.

6 months of "temporary" support by Levitronix left ventricular assist device.

An otherwise healthy 47-year-old man presented to the emergency department in cardiogenic shock after suffering a massive myocardial infarction due to left main occlusion. He was initially supported by extracorporeal membrane oxygenation and subsequently was converted to paracorporeal support with a Levitronix left ventricular assist device. He experienced multiple postoperative complications including renal failure, respiratory failure, retroperitoneal hematoma requiring suspension of anticoagulation, and fungal bloodstream infection precluding transition to an implantable device.

Colchicine reduces postoperative atrial fibrillation: results of the Colchicine for the Prevention of the Postpericardiotomy Syndrome (COPPS) atrial fibrillation substudy.

Background: Inflammation and pericarditis may be contributing factors for postoperative atrial fibrillation (POAF), and both are potentially affected by antiinflammatory drugs and colchicine, which has been shown to be safe and efficacious for the prevention of pericarditis and the postpericardiotomy syndrome (PPS). The aim of the Colchicine for the Prevention of the Post-Pericardiotomy Syndrome (COPPS) POAF substudy was to test the efficacy and safety of colchicine for the prevention of POAF after cardiac surgery.

Methods And Results: The COPPS POAF substudy included 336 patients (mean age, 65.

Colchicine prevents early postoperative pericardial and pleural effusions.

Background: No preventive pharmacologic strategies have been proven efficacious for the prevention of postoperative effusions after cardiac surgery. Colchicine is safe and efficacious for the prevention of pericarditis. On this basis, we realized a substudy of the COPPS trial to assess the efficacy and safety of colchicine for the prevention of postoperative pericardial and pleural effusions.

Clinical and hemodynamic outcomes of "all-comers" undergoing transapical aortic valve implantation: results from the Italian Registry of Trans-Apical Aortic Valve Implantation (I-TA).

Objective: The aim of this study was to assess clinical and hemodynamic outcomes of transapical aortic valve implantation (TA-TAVI) in patients enrolled in the Italian Registry of Trans-Apical Aortic Valve Implantation (I-TA).

Methods: From April 2008 until November 2010, 504 patients from 20 Italian centers were enrolled in the I-TA registry. Mean logistic EuroSCORE and Society of Thoracic Surgeons score were 24% ± 16% and 11% ± 4%, respectively.

A case of inefficient defibrillation during thoracotomy.

We describe the case of an accidental intraoperative ventricular fibrillation that could not be interrupted by a 35-J shock fired by an implantable cardioverter defibrillator (ICD). We believe that the iatrogenic pneumothorax induced by thoracotomy during the epicardial lead implant temporarily changed the intrathoracic impedance, causing an increase in defibrillation threshold. This possible change in impedance with resulting ineffective interruption of arrhythmia should be taken in consideration when a thoracotomy is planned in a patient bearing an ICD.

Compliance of the Valsalva graft's pseudosinuses at midterm follow-up with cardiovascular magnetic resonance.

Background: In previous studies, the Valsalva graft's compliance at the level of the Dacron pseudosinuses was found similar to that of normal sinuses shortly (2±1 months) after the operation. We sought to investigate with cardiac magnetic resonance the compliance of the Valsalva graft pseudosinuses at midterm follow-up.

Methods: Seven patients (group A) and 7 age-matched controls (group B) were studied with steady-state free precession and phase-contrast cardiac magnetic resonance for aortic root and ascending aorta evaluation.

COlchicine for the Prevention of the Post-pericardiotomy Syndrome (COPPS): a multicentre, randomized, double-blind, placebo-controlled trial.

Aims: No drug has been proven efficacious to prevent the post-pericardiotomy syndrome (PPS), but colchicine seems safe and effective for the treatment and prevention of pericarditis. The aim of the COlchicine for the Prevention of the Post-pericardiotomy Syndrome (COPPS) trial is to test the efficacy and safety of colchicine for the primary prevention of the PPS.

Methods And Results: The COPPS study is a multicentre, double-blind, randomized trial.

Mitral valve repair after papillary muscle rupture through beating heart adjustment of artificial chordae length.

Acute papillary muscle rupture results in severe mitral regurgitation and hemodynamic instability, and it carries a poor prognosis with a high mortality rate. We present a case of an 86-year-old woman affected by mitral regurgitation due to an acute posterior papillary muscle rupture. The patient underwent a mitral valve repair with annuloplasty and artificial chordae implantation.

Cardiac resynchronization therapy in patients undergoing open-chest cardiac surgery.

Purpose: Few data are available on the effects of cardiac resynchronization therapy (CRT) in candidates for cardiac surgery and affected by severe heart failure (HF). The aim of our analysis is to evaluate the percentage of patients who maintain indication for CRT after surgery and the efficacy of CRT in those patients subsequently implanted.

Methods: We enrolled 124 HF patients with indication both to heart surgery and to CRT.

Initial results of clinical trial with a new left ventricular assist device (LVAD) providing synchronous pulsatile flow.

Objectives: A multicentric European Clinical Study is ongoing to evaluate safety and efficacy of a new pulsatile implantable LVAD (BestBeat), smaller and lighter than similar devices, capable of providing synchronous and counterpulsating flow with respect to the LV of end-stage heart failure patients. Preliminary clinical results are reported.

Methods: The new BestBeat LVAD was used, consisting of an implantable pulsatile blood pump, electromechanically driven by a ball screw mechanism, and a wearable electronic controller and power sources.

Technique to prevent inadvertent paramedian sternotomy.

Previous reports documented the relationship between inadvertent paramedian sternotomy and postoperative sternal instability and dehiscence.We describe a modification of the technique of median sternotomy in order to prevent inadvertent paramedian sternotomy and related wound complications.

Prevention of limb ischemia and edema during peripheral venoarterial extracorporeal membrane oxygenation in adults.

Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is a mechanical circulatory support indicated for the advanced treatment of refractory heart failure. The cannulation of the femoral vessels may be complicated by distal limb ischemia by arterial hypoperfusion and severe edema by venous obstruction. We describe a modified cannulation technique in order to prevent ischemia and edema of the inferior limb during VA-ECMO.

Is aortic wall degeneration related to bicuspid aortic valve anatomy in patients with valvular disease?

Objective: Patients with bicuspid aortic valve are at increased risk for aortic complications.

Methods: A total of 115 consecutive patients with bicuspid aortic valve disease underwent surgery of the ascending aorta. We classified the cusp configuration by 3 types: fusion of left coronary and right coronary cusps (type A), fusion of right coronary and noncoronary cusps (type B), and fusion of left coronary and noncoronary cusps (type C).

Noncardiac surgical procedures in patient supported with long-term implantable left ventricular assist device.

Background: Left ventricular assist devices (LVADs) are increasingly used as bridges to transplantation or as destination therapy. As sicker and older patients are more frequently considered for mechanical support, general surgical problems are expected to increase in these patients.

Methods: Anesthesia records and clinical charts were reviewed for 11 recipients of LVADs undergoing 12 general surgical procedures between January 1988 and March 2007.

Is fixed severe pulmonary hypertension still a contraindication to heart transplant in the modern era of mechanical circulatory support? A review.

Pulmonary vascular hypertension (PVH) is a common complication of severe, long-lasting chronic heart failure. It is nowadays well recognized that PVH, nonresponsive to pharmacological approaches, is a risk factor for early and late mortality after heart transplant. Recent evidences in literature highlighted that in these patients chronic unloading with left ventricular assist device resulted in significant reduction of pulmonary vascular resistance, thus ultimately leading them to successful heart transplant.