The aim of the study is to characterize the signal transduction leading to interstitial fibrosis in the pathogenesis of atrial fibrillation (AF) and atrial remodeling. Samples of the left atrial appendage (LA) from patients with AF showed higher collagen content (73 ± 5 vs. 38 ± 2 μg/mg protein) and 2.
View Article and Find Full Text PDFBackground: Reconstruction of the regurgitant bicuspid aortic valve has been performed for >10 years, but there is limited information on long-term results. We analyzed our results to determine the predictors of suboptimal outcome.
Methods And Results: Between November 1995 and December 2008, 316 patients (age, 49±14 years; male, 268) underwent reconstruction of a regurgitant bicuspid aortic valve.
Objective: Bicuspid aortic valve anatomy is associated with aortic root aneurysm in a relevant proportion of patients. These patients require root replacement for prognostic reasons, and the valve may be preserved. The objective of this analysis is to analyze the early and late outcomes of root remodeling for bicuspid aortic valve.
View Article and Find Full Text PDFWe report the case of a 51-year-old woman who underwent pulmonary endarterectomy for chronic thromboembolic pulmonary hypertension. On postoperative day 1 she developed bilateral pulmonary thrombosis due to preoperatively undiagnosed heparin-induced thrombocytopenia. Systemic thrombolytic therapy with alteplase on postoperative days 5 and 6 resulted in marked clinical improvement.
View Article and Find Full Text PDFBackground: Postoperative outcome after pulmonary endarterectomy (PEA) for CTEPH (chronic thromboembolic pulmonary hypertension) is difficult to predict. We analyzed specific angiographic findings to predict the success of PEA.
Methods: Pulmonary angiograms were reviewed retrospectively in 90 patients with CTEPH who underwent PEA.
Background: This study was aimed to assess the pleiotropic effects of non-hematopoietic doses of erythropoietin (Epo) on post-ischemic microcirculatory dysfunction and inflammation in murine cardiac allografts.
Methods: Epo was given intraperitoneally 2 hours prior to explantation (Epo-donor) or 2 hours prior to the onset of reperfusion (Epo-recipient). Controls were not treated.
Background: Chronic thromboembolic pulmonary hypertension (CTEPH), subsequent to pulmonary embolism is a relatively frequent cause of pulmonary hypertension. Similar to patients with pulmonary arterial hypertension (PAH), CTEPH carries a poor prognosis. There is no hard evidence for any other therapy except pulmonary endarterectomy and none for those patients that are not eligible for this procedure.
View Article and Find Full Text PDFEur J Cardiothorac Surg
October 2010
Objective: Normalisation of aortic root and cusp configuration is a prerequisite for successful aortic valve repair (AVR). Using transthoracic echocardiography, we studied aortic root dimensions relative to body size in normal subjects and AVR patients.
Methods: Aortic roots of healthy volunteers (n=130, age 27.
Liver transplantation (LT) is the only curative option for patients with familial amyloid polyneuropathy (FAP) at present. Twenty patients with FAP underwent LT between May 1998 and June 2007. Transthyretin mutations included predominantly the Val30Met mutation but also 10 other mutations.
View Article and Find Full Text PDFPurpose: (18)F-fluorodeoxyglucose (FDG) PET is the most accurate imaging modality in characterizing a solitary pulmonary nodule (SPN). Besides visual image interpretation, semiquantitative analysis using standardized uptake values (SUV) is performed to improve diagnostic accuracy. Mostly, an SUV threshold of 2.
View Article and Find Full Text PDFObjectives: We studied the signal transduction of atrial structural remodeling that contributes to the pathogenesis of atrial fibrillation (AF).
Background: Fibrosis is a hallmark of arrhythmogenic structural remodeling, but the underlying molecular mechanisms are incompletely understood.
Methods: We performed transcriptional profiling of left atrial myocardium from patients with AF and sinus rhythm and applied cultured primary cardiac cells and transgenic mice with overexpression of constitutively active V12Rac1 (RacET) in which AF develops at old age to characterize mediators of the signal transduction of atrial remodeling.
Chordal replacement has been a tool in mitral repair for two decades and is a particularly suitable option for the treatment of anterior mitral leaflet (AML) prolapse. Chordal replacement has also become an alternative to more conventional techniques in posterior leaflet prolapse. It has proven to be safe and durable, and the mid- to long-term results in AML repair are approaching those achieved by conventional repair of the posterior leaflet.
View Article and Find Full Text PDFMultimed Man Cardiothorac Surg
January 2010
Unicuspid anatomy of the aortic valve is an infrequent variant, but may require surgery early in life for regurgitation. We have developed a repair technique that converts the unicuspid into a bicuspid aortic valve and is applicable in most patients. The repair strategy focuses on the creation of a symmetric bicuspid aortic valve with two normal commissures.
View Article and Find Full Text PDFQuadricuspid aortic valve anatomy is an uncommon congenital anomaly. Patients develop relevant aortic regurgitation in the 4th and 5th decade of life. Reconstruction is possible, and we recommend conversion to a tricuspid configuration.
View Article and Find Full Text PDFBackground: Residual/recurrent mitral valve regurgitation is observed in 30% after undersized ring annuloplasty (RING) for ischemic mitral regurgitation (IMR). RING addresses primarily annular dilatation but does not correct severe leaflet tethering attributable to papillary muscle (PM) displacement. We proposed adjunctive PM repositioning under transesophageal echocardiography (TEE) guidance in the loaded beating heart using a transventricular suture (STRING).
View Article and Find Full Text PDFRationale: During reperfusion of ischemic myocardium, a burst of hydroxyl radicals (OH) induces contractile dysfunction ("myocardial stunning"), and OH in the plasma of patients after myocardial infarction predict the development of heart failure. The effects of OH on myocardial function in patients with heart failure; however, have never been assessed. Furthermore, although ATP-dependent K+ channels (K(ATP) channels) are implicated in myocardial protection during ischemia/reperfusion ("ischemic preconditioning"), their role in heart failure has hardly been elucidated.
View Article and Find Full Text PDFObjective: Aortic valve repair is a more recent approach for the treatment of aortic regurgitation. Limited data exist for reconstruction in specific pathologies with isolated cusp pathology. We analyzed the results of aortic valve repair in patients with aortic regurgitation caused by myxomatous cusp prolapse in the presence of tricuspid valve anatomy and normal root size.
View Article and Find Full Text PDFEur J Cardiothorac Surg
January 2010
Objective: Aortic valve replacement for aortic regurgitation (AR) has been established as a standard treatment but implies prosthesis-related complications. Aortic valve repair is an alternative approach, but its mid- to long-term results still need to be defined.
Methods: Over a 12-year period, 640 patients underwent aortic valve repair for regurgitation of a unicuspid (n=21), bicuspid (n=205), tricuspid (n=411) or quadricuspid (n=3) aortic valve.
Objective: Hypercholesterolemia is a risk factor for aortic stenosis (AS) and for coronary artery disease (CAD). Serum cholesterol concentrations are determined by intestinal cholesterol absorption and endogenous cholesterol synthesis. Vascular effects of differences in cholesterol metabolism in patients with AS are so far unknown.
View Article and Find Full Text PDFA 76-year-old woman underwent mitral valve repair and coronary artery bypass grafting. Intrabronchial bleeding occurred after inflation of the balloon tip of the pulmonary artery catheter in the wedge position. A Forgaty catheter was introduced into the trachea parallel to the endotracheal tube and advanced under bronchoscopic vision into the intermediate bronchus.
View Article and Find Full Text PDFBackground: Heterotopic cardiac transplantation in mice was used to determine whether complementary immunomodulation by statins prevents lymphocyte function-associated antigen (LFA)-1-dependent acute allograft rejection in vivo.
Method: Hearts from BalbC mice were transplanted to the cervical vessels of either C57BL/6, CD11a(-/-), CD28(-/-) or double-deficient animals lacking expression of both LFA-1 and CD28.
Results: Allografts were rejected at days 7.
Delayed-type hypersensitivity reactions (DTHRs) after subcutaneous application of unfractionated heparins or low-molecular-weight heparins are not uncommon. Standard allergological testing usually includes intracutaneous skin tests and patch testing of different heparins, heparinoids, and thrombin inhibitors followed by subcutaneous and/or intravenous challenge with skin test-negative drugs. We present data from a single-center case series of 15 patients with DTHR after low-molecular-weight heparin administration.
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