Transcatheter Tricuspid Valve Replacement Following Tricuspid Edge-To-Edge-Repair.

Significant tricuspid regurgitation (TR) is seen as a relevant contributor of cardiac morbidity and mortality. Transcatheter tricuspid valve replacement (TTVR) is a novel technique to treat this condition. We present the case of an 82-year-old lady who was admitted for recurrent right heart decompensation despite having undergone treatment with tricuspid edge-to-edge repair (TEER).

Dynamics of Thrombogenicity and Platelet Function and Correlation with Bleeding Risk in Patients Undergoing M-TEER Using the PASCAL System.

Background:  Transcatheter mitral valve repair is performed in a patient population at risk for thrombotic and bleeding events. The effects on platelet function and reactivity and their association with bleeding events after mitral transcatheter edge-to-edge therapy (M-TEER) have not been systematically examined.

Objectives:  We sought to investigate the association of different parameters of platelet function and thrombogenicity with bleeding events post M-TEER.

Machine learning predicts emergency physician specialties from treatment strategies for patients suspected of myocardial infarction.

Background: Our investigation aimed to determine how the diverse backgrounds and medical specialties of emergency physicians (Eps) influence the accuracy of diagnoses and the subsequent treatment pathways for patients presenting preclinically with MI symptoms. By scrutinizing the relationships between EPs' specialties and their approaches to patient care, we aimed to unveil potential variances in diagnostic accuracy and treatment choices.

Methods: In this retrospective, monocenter cohort study, we leveraged machine learning techniques to analyze a comprehensive dataset of 2328 patients with suspected MI, encompassing preclinical diagnoses, electrocardiogram (ECG) interpretations, and subsequent treatment strategies by attending EPs.

Preclinical identification of acute coronary syndrome without high sensitivity troponin assays using machine learning algorithms.

Preclinical management of patients with acute chest pain and their identification as candidates for urgent coronary revascularization without the use of high sensitivity troponin essays remains a critical challenge in emergency medicine. We enrolled 2760 patients (average age 70 years, 58.6% male) with chest pain and suspected ACS, who were admitted to the Emergency Department of the University Hospital Tübingen, Germany, between August 2016 and October 2020.

Pacemaker Lead Entanglement during Interventional PFO Occlusion: Salvage Using a Sizing Balloon.

We present a case of a patient with a transient ischaemic attack (TIA) likely due to paradoxical embolism through a patent foramen ovale (PFO). Her medical history included 2-degree heart block Mobitz II, which manifested with recurrent syncopes and was treated with a dual chamber pacemaker. During the interventional PFO closure procedure, we noted entrapment of the atrial pacemaker lead between the right-sided occluder disc and the interatrial septum.

Outcomes of patients undergoing edge-to-edge mitral valve repair with the Edwards PASCAL transcatheter valve repair system under conscious sedation.

Background: The development of the PASCAL transcatheter valve repair system for treating mitral regurgitation (MR) greatly extends therapeutic options.

Aims: To assess the safety, efficacy, and time efficiency of the PASCAL system in transcatheter edge-to-edge repair (TEER) under conscious sedation (CS).

Methods: This is a retrospective, two-center, German registry study consisting of 211 patients who underwent TEER using the PASCAL system under CS.

[Thromboembolic diseases from a cardiological point of view].

Thromboembolic disease is associated with a high mortality. It can be divided into two groups: embolism from a venous and embolism from an arterial side. This article gives an overview on thromboembolic disease (with a focus on pulmonary embolism and ischemic stroke) from a cardiologist's perspective.

Platelet miRNAs: differential expression in coronary artery disease and associations with course of left ventricular systolic function.

Background: MicroRNAs are paramount in post transcriptional gene regulation. We investigated platelet miRNAs in patients with CAD and examined potential associations with course of left ventricular ejection fraction (LVEF%).

Materials And Methods: In a first cohort, 62 MiRNAs were measured in platelets of 100 patients suffering from CAD.

Statin Treatment Is Associated with Alterations in the Platelet Lipidome.

Background:  Platelets are key players in the pathophysiology of coronary artery disease (CAD) and platelet hyperreactivity leads to increased risk of developing adverse cardiovascular events. Further, significant changes in the platelet lipidome occur in patients with acute coronary syndrome (ACS) and critically regulated lipids lead to platelet hyperresponsiveness. Statin treatment is crucial in the treatment and prevention of patients with CAD by remodeling lipid metabolism.

Acute coronary syndrome is associated with a substantial change in the platelet lipidome.

Aims: Platelets play a key role in the pathophysiology of coronary artery disease (CAD) and patients with enhanced platelet activation are at increased risk to develop adverse cardiovascular events. Beyond reliable cardiovascular risk factors such as dyslipoproteinaemia, significant changes of platelet lipids occur in patients with CAD. In this study, we investigate the platelet lipidome by untargeted liquid chromatography-mass spectrometry, highlighting significant changes between acute coronary syndrome (ACS) and chronic coronary syndrome (CCS) patients.

[New aspects of therapeutic plasma exchange in critical care medicine].

Unlabelled: Therapeutic plasma exchange (TPE) is used to eliminate toxins, hormones or antibodies from the blood and replace the lost volume with fresh frozen plasma, albumin or crystalloids. In this article, recent advances in the usage for TPE for four different critical disease entities are explored: Septic shock, acute liver failure, catastrophic antiphospholipid syndrome (CAPS) and thyrotoxic storm.

Septic Shock: Even though randomized controlled trials have not been able to demonstrate a clear benefit of TPE in septic shock, recent data demonstrates a sufficient safety profile for usage in critically ill, highly catecholamine dependent individuals.

Range-related glycaemic response to increasing load of carbohydrates.

The glycaemic response to feeding increased loads of glucose and sucrose was investigated in man and rat. Assessed were the tolerance tests after feeding 10-100 g glucose or 10-20 g sucrose to hospitalized diabetic or non-diabetic patients and after loading 30-450 mg glucose or sucrose per 100 g body weight to alloxan-diabetic or non-diabetic rats. The maximal levels of tolerance curves, the increase in blood glucose levels and the sum of the glycaemic values reflecting the areas under the curves were chosen as criteria.

Urinary calcium excretion in relation to kidney function in the adult.

A study based on 55 hospital patients (age groups 40-59, 60-69, 70-79) demonstrated a significant correlation between the glomerular filtration rate (as expressed by endogenous creatinine clearance) and the mean urinary calcium concentration. Excluded were patients with thyroidal or hypophyseal disorders, osteoporosis, renal stones immobilizing conditions, or those treated with corticosteroids. The study patients had a normal fluid intake and did not receive any diuretics.