Long-Term Follow-Up of Survivors of Extracorporeal Life Support Therapy for Cardiogenic Shock: Are They Really Survivors?

Cardiogenic shock (CS) is a medical emergency associated with a high mortality rate. Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) has become an accepted therapy for CS. Despite widely available data for short-term survival rates, there are only limited data available regarding long-term outcomes following successful VA-ECMO therapy.

Mechanical circulatory support for cardiovascular complications in a young COVID-19 patient.

Background: The current coronavirus (COVID-19) pandemic is associated with severe pulmonary and cardiovascular complications.

Case Presentation: This report describes a young patient with COVID-19 without any comorbidity presenting with severe cardiovascular complications, manifesting with pulmonary embolism, embolic stroke, and right heart failure.

Conclusion: Management with short-term mechanical circulatory support, including different cannulation strategies, resulted in a successful outcome despite his critical cardiovascular status.

Cardiac Myxoma and Cerebrovascular Events: A Retrospective Cohort Study.

Cardiac myxoma (CM) is the most frequent, cardiac benign tumor and is associated with enhanced risk for cerebrovascular events (CVE). Although surgical CM excision is the only curative treatment to prevent CVE recurrence, in recent reports conservative treatment with antiplatelet or anticoagulant agents in high-risk patients with CM-related CVE has been discussed. Case records at the University Hospital of Tübingen between 2005 and 2017 were screened to identify patients with CM-related CVE.

Clinical and economical impact of the presence of an extended heart team throughout the balloon-expandable transcatheter aortic valve implantation procedure.

Background: Transcatheter aortic valve implantation (TAVI) is a standard therapy for aortic valve stenosis in patients at intermediate-to-high surgical risk. Previously, TAVI at our site was performed by a minimalist heart team (MHT), comprised of two interventional cardiologists, echocardiography staff and two cardiac catheterization laboratory nurses. After revision of German Federal Joint Committee (G-BA) guidelines in September 2015, the presence of an extended heart team (EHT; including a full cardiac surgical team) became mandatory throughout the TAVI procedure.

Catheter-based tricuspid valve replacement: first experimental data of a newly designed bileaflet stent graft prosthesis.

Objectives: Moderate or severe degree tricuspid valve regurgitation (TVR) is associated with high rates of morbidity and mortality. Surgical correction as the only therapeutic option offers unsatisfactory results. Recently, several interventional procedures have been introduced clinically in a limited cohort.

Impella 5.0 as a Second-Line Mechanical Circulatory Support Strategy After Extracorporeal Life Support.

The catheter-based Impella 5.0 left ventricular assist device is a powerful and less invasive alternative for patients in cardiogenic shock. The use as second-line therapy in patients with precedent extracorporeal life support (ECLS) has not been described before now.

Preservation of the bicuspid aortic valve.

Background: Bicuspid anatomy of the aortic valve is a common reason for aortic regurgitation and is associated with aortic dilatation in more than 50% of patients. We have observed different patterns of aortic dilatation and used different approaches preserving the valve.

Methods: Between October 1995 and February 2006, a regurgitant bicuspid valve was repaired in 173 patients.

Aortic valve repair with autologous pericardial patch.

Introduction: Isolated aortic valve repair (AVR) has been gaining increasing interest in recent times. Results of isolated aortic valve repair have been reported to be variable. Various techniques have been utilized.

Valve sparing aortic replacement - root remodeling.

Aortic root remodeling restores aortic root geometry and improves valve competence. We have used this technique whenever aorto-ventricular diameter is preserved. The operative technique is detained in this presentation.

Bronchovascular versus bronchial sleeve resection for central lung tumors.

Background: Pneumonectomy has traditionally been the treatment of choice for central lung tumors. Bronchial sleeve resections are increasingly considered as a reasonable alternative. For tumor involvement of both central airways and pulmonary artery, bronchovascular sleeve resections are possible, but considered to be technically demanding and associated with a higher perioperative risk.

A bronchogenic cyst of the right ventricular endocardium.

In a 73-year-old male patient with a history of prostate cancer, a right ventricular endoluminal tumor was diagnosed by echocardiography. An endocardial papillary fibroelastoma or myxoma appeared possible; a malignant tumor could not be ruled out. The tumor was resected using extracorporeal circulation and cardioplegic arrest.

A canine model for production of severe unilateral panacinar emphysema.

The authors created a canine model of severe emphysema using whole lung lavage to deliver repeated porcine pancreatic elastase solution to the terminal airways and alveoli of the right lung. This model produces extreme unilateral panacinar emphysema closely resembling that encountered in patients with alpha1-antitrypsin deficiency. Because the contralateral lung remains functional, the animals can be maintained indefinitely.

Iloprost ameliorates post-ischemic lung reperfusion injury and maintains an appropriate pulmonary ET-1 balance.

Background: Ischemia-reperfusion (I/R) injury of the lung involves increased pulmonary vascular resistance. Prostaglandins are thought to have a beneficial effect in lung transplantation, but their mechanism in I/R injury is unknown. We investigated whether iloprost, a stable prostacyclin analogue, prevents I/R-associated pulmonary vascular dysfunction and whether it affects endothelin-1 (ET-1) balance.

Bronchial fenestration improves expiratory flow in emphysematous human lungs.

Background: The crippling effects of emphysema are due in part to dynamic hyperinflation, resulting in altered respiratory mechanics, an increased work of breathing, and a pervasive sense of dyspnea. Because of the extensive collateral ventilation present in emphysematous lungs, we hypothesize that placement of stents between pulmonary parenchyma and large airways could effectively improve expiratory flow, thus reducing dynamic hyperinflation.

Methods: Twelve human emphysematous lungs, removed at the time of lung transplantation, were placed in an airtight ventilation chamber with the bronchus attached to a tube traversing the chamber wall, and attached to a pneumotachometer.