Midterm outcomes after transcatheter aortic valve implantation.

Objective: Transcatheter aortic valve implantation (TAVI) has become a therapeutic option for high-risk or nonoperable patients with severe symptomatic aortic valve stenosis. The best known and most frequently implanted prostheses are the CoreValve and SAPIEN prostheses. We report our experiences and analyze the results of our TAVI program.

Oxygenated shunting from right to left: a feasibility study of minimized atrio-atrial extracorporeal membrane oxygenation for mid-term lung assistance in an acute ovine model.

Objectives: Right ventricular failure is often the final phase in acute and chronic respiratory failure. We combined right ventricular unloading with extracorporeal oxygenation in a new atrio-atrial extracorporeal membrane oxygenation (ECMO).

Methods: Eleven sheep (65 kg) were cannulated by a 28-Fr inflow cannula to the right atrium and a 25-Fr outflow cannula through the lateral left atrial wall.

A new approach to the interventional therapy of tricuspid regurgitation.

Currently, there are no fully developed interventional approaches for the treatment of tricuspid regurgitation (TR). The aim of this study was to evaluate the feasibility of orthotopic interventional placement of a biological prosthetic valve in the tricuspid position by inserting, with a transvenous approach, a self-expandable valve-bearing stent into the right atrium. Based on findings of computerized tomography (CT), a model of the porcine right heart was obtained.

Low stroke rate and few thrombo-embolic events after HeartMate II implantation under mild anticoagulation.

Objectives: Bleeding and thrombo-embolism are two of the most threatening adverse events associated with the use of continuous flow left ventricular assist devices (LVADs) in the treatment of severe heart failure. We analysed our LVAD patients treated with the HeartMate II (HM II) device by following a low anticoagulation regimen.

Methods: Between 2008 and February 2011, we implanted 40 HM II LVADs in our institution.

Feasibility and efficacy of bypassing the right ventricle and pulmonary circulation to treat right ventricular failure: an experimental study.

Background: Right ventricular failure (RVF) and -support is associated with poor results. We aimed for a new approach of right - sided assistance bypassing the right ventricle and pulmonary circulation in order to better decompress the right ventricle and optimize left ventricular filling.

Methods: From a microaxial pump (Abiomed), a low resistance oxygenator (Maquet and Novalung) and two cannulas (28 and 27 Fr) a system was set up and evaluated in an ovine model (n = 7).

Inflammatory response in transapical transaortic valve replacement.

Objective: Transapical aortic valve implantation (TA-AVI) has become a fast growing alternative to conventional aortic valve replacement (cAVR) particularly for patients burdened with serious comorbidities. We investigated whether the inflammatory response triggered by TA-AVI reflects the less invasive nature of this procedure.

Method: In this prospective observational study 25 patients undergoing aortic valve replacement (AVR; 15 cAVR and 10 TA-AVI) were included.

Implantation of left ventricular epicardial leads in cardiosurgical patients with impaired cardiac function--a worthwhile procedure in concomitant surgical interventions?

Background: Cardiac resynchronization therapy (CRT) by means of multisite biventricular pacing is an effective therapeutic option for the treatment of severe heart failure. The present study estimates how many open heart-surgery patients could benefit from the implantation of permanent left ventricular (LV) pacing leads. After routine preoperative screening, epicardial electrodes were implanted in selected patients.

[The pupillary response test as a method to differentiate various types of dementia].

Aim: Pupillometry is a non-invasive measurement technique based on the pupillary response to specific sensoric, mental and emotional variables. After topical application of a cholinergic antagonist (tropicamide) an increased pupillary dilatation response in Alzheimers s disease patients was described ("receptor test"). The aim of the present study was to evaluate the usefulness of the 0.

Quetiapine versus risperidone in elderly patients with behavioural and psychological symptoms of dementia: efficacy, safety and cognitive function.

Objective: In this study we directly compared the efficacy and tolerability of the atypical antipsychotics quetiapine and risperidone in elderly patients with dementia and symptoms of disturbed perception, thought content, mood or behaviour (behavioural and psychological symptoms of dementia-BPSD).

Methods: We conducted an 8-week, rater-blinded, randomised study of 72 outpatients (55-85 years) with BPSD (assessed by NPI baseline score), who received flexibly-dosed quetiapine (50-400 mg/day) or risperidone (0.5-2 mg/day).

[State of the art management of BPSD in dementia].

Objective: To obtain a cross-sectional overview of therapeutic practice concerning non-cognitive, behavioral signs and symptoms of dementia (BPSD) in Germany, Austria, and Switzerland.

Method: We selected 24 psychiatrists (8 from each country) for a questionnaire-based survey with 28 detailed practical questions.

Results: Attitudes and preferences were in line with the state of the art as documented in the literature, with the exception of the fact that 30 % of the physicians favored a too brief therapeutic trial with selective serotonin re-uptake inhibitors (SSRIs) for agitation.

Changing aspects of psychiatric inpatient treatment. A census investigation in five European countries.

This paper presents data obtained in a one-day census investigation in five European countries (Austria, Hungary, Romania, Slovakia, Slovenia). The census forms were filled in for 4191 psychiatric inpatients. Concerning legal status, 11.

Zotepine for behavioural and psychological symptoms in dementia: an open-label study.

Objective: To provide initial information on the safety and efficacy of the atypical antipsychotic zotepine in the treatment of behavioural and psychological symptoms of dementia (BPSD).

Methods: This was an open-label, single-centre field study. Twenty-four patients with BPSD associated with Alzheimer's disease (n=12) or other forms of dementia (n=12) were included.

An unusual case of pacemaker failure: complete disconnection of connector block and battery of a subpectorally implanted dual chamber pacemaker.

Local trauma to patients with implanted pacemaker devices may result in lead fracture or breakage of the lead socket with leakage of fluid into the connector system. This report describes an unusual case of complete entrance and exit block in a subpectorally implanted dual chamber pacemaker due to total disconnection and dislodgement of header block and battery part. Damage may be caused by an interaction of machine fatigue/manufacturing defective and fixation of the header with unusual movability of the battery, leading to breakage with intermittent malfunction and consecutive bradycardia and syncope.

[Family caregivers of patients with dementia: impact of factors of burden].

Objectives: The enclosed paper tries to encompass the relatives of patients of three different geriatric groups diagnosed. It tries to establish the difference in care and which special factor influences each group concerning the burden of care.

Patients: Comparison of three groups: 1.

Subendocardial steal effect seen with real-time perfusion imaging at low emission power during adenosine stress: replenishment M-mode processing allows visualization of vertical steal.

We present a patient in whom power pulse inversion imaging clearly demonstrated a subendocardial myocardial perfusion defect during contrast vasodilator stress using adenosine. The defect was best appreciated with M-mode postprocessing of power pulse inversion imaging data.

Effect of risperidone on behavioral and psychological symptoms and cognitive function in dementia.

Aims: This open-label study examined the efficacy and tolerability of risperidone in the treatment of aggression, agitation, and psychotic symptoms in dementia. The influence of risperidone on cognitive function was also assessed under conditions reflecting normal, daily clinical care.

Method: A total of 34 hospital inpatients and outpatients (mean age = 76 years) with DSM-IV dementia disorders were treated with flexible doses of risperidone (0.

Cognitive relapse after discontinuation of drug therapy in Alzheimer's disease: cholinesterase inhibitors versus nootropics.

In a cross-sectional study of outpatients diagnosed with dementia of the Alzheimer type who had been treated with a broad variety of drugs supposed to improve cognition or to delay cognitive decline, we have investigated the effects of abruptly discontinuing therapy on cognition. Termination of therapy with any cholinesterase inhibitor was associated with a cognitive decline during the following 6-7 weeks which was significantly more pronounced than that experienced by patients who had received nootropic drugs or calcium channel blockers (3.41 vs.

Surgical management of complications caused by transcatheter ASD closure.

Background: Transcatheter occlusion of uncomplicated atrial septum defects (ASD) is recognized as an effective and minimally invasive method. Sometimes, serious early and late complications require surgical intervention. We therefore investigated reasons and outcomes of the secondary surgical approach.

No evidence for cognitive improvement from oral nicotinamide adenine dinucleotide (NADH) in dementia.

Reduced nicotinamide adenine dinucleotide (NADH) is advertised as an over-the-counter product or dietary supplement to treat Alzheimer's disease. We performed a 3-month open-label study with oral 10 mg/day NADH with 25 patients with mild to moderate dementia of the Alzheimer, vascular, and fronto-temporal types in addition to their current cholinomimetic drug medication. In 19 patients who completed the study, we found no evidence for any cognitive effect as defined by established psychometric tests.

Zotepine in the treatment of acute hospitalized schizophrenic episodes.

The atypical antipsychotic zotepine was studied in an open, multicentre uncontrolled, post-marketing surveillance study in 108 schizophrenic patients hospitalized in 12 trial centres in Austria. Within the dosage range of 50-450 mg (mean at the end of the study, 207 +/- 125 mg/day), a significant reduction of positive as well as negative symptoms was noted. There was no increase in extrapyramidal side-effects during the study and a significant decrease in akathisia scores.

A long-term, multicenter, open-label study of risperidone in elderly patients with psychosis. On behalf of the Risperidone Working Group.

Rationale: Studies have shown that risperidone is safe and efficacious in young and middle-aged adults with chronic schizophrenia, but considerably fewer data are available on the treatment of elderly patients with schizophrenia or other psychotic disorders, particularly long-term outcomes.

Objective: A 12-month, open-label study was conducted to assess the effects of risperidone in elderly, chronically ill, psychotic patients.

Methods: This study enrolled 180 elderly, chronically ill, psychotic patients (median age, 72 years [range 54-89]), 97 of whom completed the 12-month study.

[Homografts for mitral valve replacement in florid endocarditis--an alternative to prosthetic replacement].

Introduction: Homografts for valve replacement are indicated in acute valve endocarditis. It is assumed that they possess anti-infective properties. Homografts are an established indication in aortic valve replacement.

[Non-cognitive symptom profiles in dementia--experience from psychiatric services and memory clinics].

Objective: To assess the non-cognitive symptoms in 153 consecutive dementia patients admitted to our psychiatric ward or seen at the gerontopsychiatric ambulance and Memory Clinic.

Methods: We used the Global Deterioration Scale, the Hachinski Ischaemia Score, the Hamilton Psychiatric Rating Scale for Depression, and the Mini-Mental State Exam as staging tools in a cross-sectional design. A semi-quantitative 34-item questionnaire based on the Columbia University Scale for Psychopathology was employed to assess non-cognitive symptoms as reported by caregivers.

The effect of factor XIII on bleeding in coronary surgery.

Background: One cause of diffuse bleeding after cardiac operations may be a low plasma concentration of Factor XIII, which is essential for coagulation, but is not covered by standard coagulation monitoring.

Methods: In a prospective pilot study, Factor XIII levels before and after extracorporeal circulation were investigated, and drain volumes and blood transfusions of a control group of 11 patients were compared with a group of 11 patients who received 2500 units Factor XIII postoperatively.

Results: Factor XIII fell significantly from preoperative values of 96.