Publications by authors named "Gummert J"

Background: Propensity score matching has become a popular method for estimating causal treatment effects in non-randomized studies. However, for time-to-event outcomes, the estimation of hazard ratios based on propensity scores can be challenging if omitted or unobserved covariates are present. Not accounting for such covariates could lead to treatment estimates, differing from the estimate of interest.

View Article and Find Full Text PDF

Introduction: Left ventricular assist device (LVAD) therapy may lead to an aortic regurgitation, limiting left ventricular unloading and causing adverse events. Whether concomitant aortic valve replacement may improve outcomes in patients with preoperative mild-to-moderate aortic regurgitation remains unclear.

Methods: A retrospective propensity score-matched analysis of adult patients with preoperative mild-to-moderate aortic regurgitation undergoing durable LVAD implantation between 01/01/2011 and 30/11/2021 was performed.

View Article and Find Full Text PDF

Background: Circulatory support with a catheter-based microaxial flow pump (mAFP) plays a major role in the treatment of severe cardiogenic shock. In most patients who fail to recover while on temporary mechanical circulatory support (tMCS) and who are not eligible for heart transplantation, durable left ventricular assist device (dLVAD) implantation is usually considered a reliable option. This study aimed to describe the outcome of dLVAD therapy following mAFP support and to identify predictors of mortality.

View Article and Find Full Text PDF

Aims: Timely referrals for transplantation and left ventricular assist device (LVAD) play a key role in favourable outcomes in patients with advanced heart failure (HF). Cardiovascular mortality, driven by sudden cardiac death, is the main reason for dying while waiting for heart transplantation (HTx). The purpose of the Preventive Catheter Ablation for ventricular arrhythmiaS in patients with end-sTage heart faiLure rEferred for heart transplantation eValuaTion (CASTLE-VT) trial is to test the hypothesis that prophylactic catheter ablation of arrhythmogenic ventricular scar tissue will reduce mortality, need for LVAD implantation, and urgent HTx in patients with end-stage HF related to ischaemic cardiomyopathy (ICM).

View Article and Find Full Text PDF

Background: Delirium is a frequent and serious complication of cardiac procedures that can lead to serious long-term health restrictions. As primary prevention is more effective in reducing rate of delirium than the therapy itself, this study aimed to investigate the effect of a multidisciplinary delirium prevention bundle on the postoperative delirium rate in patients undergoing cardiac procedures.

Methods: In this system-based quality improvement study, a four-component delirium prevention bundle was implemented in patients undergoing cardiac procedures at a single high-volume center.

View Article and Find Full Text PDF

Background: Acute right ventricular failure is a critical complication after left ventricular assist device (LVAD) implantation, often managed with a temporary paracorporeal right ventricular assist device (RVAD). This study examined three extracorporeal life support (ECLS) systems regarding mortality, bleeding complications, and intensive care unit (ICU) stay duration.

Methods: This monocentric, retrospective case-control study included all patients receiving LVAD with paracorporeal RVAD between 2009 and 2020.

View Article and Find Full Text PDF
Article Synopsis
  • * In a study of 194 patients, those who underwent catheter ablation showed a significant decrease in AF recurrence and improvement in their heart function, with left ventricular ejection fraction (LVEF) rising from 29.2% to 39.1% after 12 months.
  • * Overall, AF ablation not only lowered AF burden but also successfully shifted patients from persistent AF to a less severe form, benefiting those with or without left atrial cardiomyopathy.
View Article and Find Full Text PDF
Article Synopsis
  • * The study retrospectively compared outcomes of patients with coronary artery disease (CAD) and very low left ventricular function who received either CABG or LVAD, using statistical matching to analyze 168 pairs.
  • * Results indicated that while LVAD patients needed longer ventilation and ICU stays, they had lower rates of postoperative renal therapy and required less temporary mechanical support; however, CABG patients had significantly better mid-term survival rates compared to those receiving LVADs.
View Article and Find Full Text PDF
Article Synopsis
  • Coronary artery disease is a serious health issue, and the study looks at two different methods of heart surgery called CABG: off-pump and on-pump.
  • The researchers found that patients who had the off-pump technique had a much lower chance of having a stroke during or after their surgery compared to those who had the on-pump technique.
  • Overall, the study suggests that off-pump CABG is a safer choice for patients with severe carotid stenosis, while still helping them live a long time after the surgery.
View Article and Find Full Text PDF

Congenitally corrected transposition of the great arteries (ccTGA) is an infrequent and complex congenital malformation, which accounts for approximately 0.5% of all congenital heart defects. This defect is characterized by both atrioventricular and ventriculoarterial discordance, with the right atrium connected to the morphological left ventricle (LV), ejecting blood into the pulmonary artery, while the left atrium is connected to the morphological right ventricle (RV), ejecting blood into the aorta.

View Article and Find Full Text PDF

Background: The SynCardia® temporary total artificial heart (TAH) serves as a mechanical circulatory support device for patients suffering from irreversible biventricular failure.

Methods: This retrospective study analyzed 196 consecutive patients who underwent TAH implantation at our center from 2001 to 2021. We assessed survival rates and all-cause mortality during TAH support, including survival post-heart transplantation.

View Article and Find Full Text PDF

Objectives: Bridging from a temporary microaxial left ventricular assist device (tLVAD) to a durable left ventricular assist device (dLVAD) is playing an increasing role in the treatment of terminally ill patients with heart failure. Scant data exist about the best implant strategy. The goal of this study was to analyse differences in the dLVAD implant technique and effects on patient outcomes.

View Article and Find Full Text PDF

Background: Left atrial appendage (LAA) amputation performed alongside cardiac surgery has become an increasingly established procedure to reduce stroke risk in patients with atrial fibrillation. As the recommendation levels for LAA amputation continue to rise, ample evidence assessing its perioperative safety and risk factors is of utmost interest.

Methods: All patients who underwent isolated coronary artery bypass grafting (CABG) between 2018 and 2021 at two high-volume centers were retrospectively included in the study.

View Article and Find Full Text PDF
Article Synopsis
  • A study in Germany compared two treatments for heart failure patients with secondary mitral regurgitation: transcatheter edge-to-edge repair and surgical mitral-valve repair or replacement.
  • The trial involved 210 patients and assessed outcomes like death, hospitalizations, and major adverse events, finding that transcatheter repair had similar efficacy but significantly fewer safety issues than surgery.
  • Results showed that transcatheter edge-to-edge repair was noninferior to the surgical approach, indicating it might be a safer alternative for this patient group.
View Article and Find Full Text PDF
Article Synopsis
  • The study investigates outcomes of extracorporeal life support in patients with low-output syndrome following cardiac surgery, revealing high initial mortality rates and identifying significant risk factors for both short- and long-term survival.
  • Over 570 patients were analyzed, with findings that severe aortic valve issues and previous surgeries increased in-hospital mortality, while older age and severe mitral regurgitation predicted long-term mortality, particularly for those on insulin.
  • Despite poor overall outcomes, peripheral cannulation improved survival chances, and only about 32% of patients survived beyond ten years post-discharge, highlighting the need for targeted monitoring of high-risk patients.
View Article and Find Full Text PDF
Article Synopsis
  • The EUROMACS study aimed to explore how the annual number of LVAD implantations at a medical center affects postoperative outcomes and patient survival.
  • It analyzed data from 4,802 patients across 35 centers, categorizing them based on whether the center performed 30 or fewer vs. more than 30 implants per year, focusing on 1-year survival rates and device-related complications.
  • Findings indicated that while higher volume centers had patients with more severe conditions, there was no significant difference in 1-year survival; however, higher volume centers had more device-related adverse events, highlighting the need for consistent quality improvement across all centers.
View Article and Find Full Text PDF
Article Synopsis
  • Dextro-transposition of the great arteries (D-TGA) is a serious congenital heart defect where the heart’s two main arteries are switched, leading to separation of pulmonary and systemic blood flow.
  • The condition can occur on its own or alongside other heart issues and is influenced by a mix of genetic and environmental factors.
  • Surgical intervention during infancy, including necessary procedures like balloon atrial septostomy and various corrective surgeries, is crucial for improving outcomes, as early diagnosis and treatment significantly enhance the chances of survival into adulthood.
View Article and Find Full Text PDF

Based on a voluntary registry, founded by the German Society for Thoracic and Cardiovascular Surgery (DGTHG) in 1980, a well-defined but limited dataset of all cardiac and vascular surgery procedures performed in 77 German heart surgery departments is reported annually. For the year 2023, a total of 168,841 procedures were submitted to the registry. Of these operations, 100,606 are defined as heart surgery procedures in a classical sense.

View Article and Find Full Text PDF

Background: Mitochondria play a crucial role in adapting to fluctuating energy demands, particularly in various heart diseases. This study investigates mitochondrial morphology near intercalated discs in left ventricular (LV) heart tissues, comparing samples from patients with sinus rhythm (SR), atrial fibrillation (AF), dilated cardiomyopathy (DCM), and ischemic cardiomyopathy (ICM).

Methods: Transmission electron microscopy was used to analyze mitochondria within 0-3.

View Article and Find Full Text PDF

The traditional description of cardiac development involves progression from a cardiac crescent to a linear heart tube, which in the phase of transformation into a mature heart forms a cardiac loop and is divided with the septa into individual cavities. Cardiac morphogenesis involves numerous types of cells originating outside the initial cardiac crescent, including neural crest cells, cells of the second heart field origin, and epicardial progenitor cells. The development of the fetal heart and circulatory system is subject to regulatation by both genetic and environmental processes.

View Article and Find Full Text PDF

: Postoperative Atrial Fibrillation (POAF) is a common complication in cardiac surgery. Despite its multifactorial origin, the left atrial (LA) size is closely linked to POAF, raising the question of a valid cut-off value and its impact on the long-term outcome. : Patients without a history of AF who underwent coronary artery bypass grafting between 2014 and 2016 were selected for this retrospective study.

View Article and Find Full Text PDF

Objective: We tested the feasibility of a randomized controlled trial for comparing primary nursing with standard care.

Research Methodology: Elective cardiac surgical patients were eligible for inclusion. Patients with an intensive care unit stay of ≥ 3 days were followed up until intensive care unit discharge.

View Article and Find Full Text PDF