Protective role of Nrf2 against ischemia reperfusion injury and cardiac allograft vasculopathy.

Ischemia-reperfusion injury (IRI) and cardiac allograft vasculopathy (CAV) remain unsolved complications post-heart transplant (Tx). The antioxidant transcription factor Nuclear factor erythroid 2-related factor 2 (Nrf2) has been suggested to inhibit reactive oxygen species-mediated NF-κB activation. We hypothesized that Nrf2 inhibits NF-κB activation post-Tx and suppresses IRI and the subsequent development of CAV.

Maximum Walking Speed at Discharge Could Be a Prognostic Factor for Vascular Events in Patients With Mild Stroke: A Cohort Study.

Objective: To identify the prognostic value of physical activity-related factors as well as known vascular risk factors for vascular events in mild ischemic stroke (MIS).

Design: Single-center prospective cohort study.

Setting: University hospital.

High-risk cardiac surgery as an alternative to transplant or mechanical support in patients with end-stage heart failure.

Objective: Although the results of cardiac surgery in patients with poor left ventricular function have been widely published, the outcomes in patients with end-stage heart failure who meet criteria for advanced therapies are not well investigated. As access to transplantation and ventricular assist device therapy remains limited, we explored the possibility of conventional surgery as an alternative option for highly selected patients with end-stage heart failure.

Methods: We identified patients with left ventricular ejection fraction <20% and VO max <14 mL/min/m, who were initially referred for advanced therapies but were instead offered a conventional procedure from 2002 to 2012.

Tricuspid Valve Annular Dilation as a Predictor of Right Ventricular Failure After Implantation of a Left Ventricular Assist Device.

Background: Tricuspid annular (TA) dilation has been suggested as a more reliable marker of concomitant advanced right ventricular failure (RVF) than severity of tricuspid regurgitation (TR). Our objective was to examine the impact of TA dilation on occurrence of RVF and in-hospital mortality following left ventricular assist device (LVAD) implant.

Methods: Consecutive patients undergoing implantation of a continuous-flow LVAD implant were grouped according to the presence or absence of preoperative dilated TA.

Longitudinal assessment of inflammation in recipients of continuous-flow left ventricular assist devices.

Background: The long-term effects of continuous-flow left ventricular assist device (CF-LVAD) support on trends of inflammatory markers over time are unknown. We examined the hypothesis that the levels of inflammatory markers in CF-LVAD recipients are higher than in healthy controls and that these levels increase over time with long-term CF-LVAD support.

Methods: We examined the levels of inflammatory markers longitudinally at baseline before CF-LVAD implantation and at 3, 6, and 9 months after implantation.

Predictive impact of daily physical activity on new vascular events in patients with mild ischemic stroke.

Background: Daily physical inactivity is associated with a substantially increased risk of cardiovascular events. However, the target level of daily physical activity remains unclear.

Aim: We aimed to evaluate the impact of physical activity on long-term vascular events in patients with mild ischemic stroke.

Negative pressure therapy for post-sternotomy wound infections in young children.

Objectives: Post-sternotomy wound infection remains a significant morbidity in congenital and paediatric cardiac surgery. However, the techniques used for this complication in children are not optimal in terms of mortality, morbidity and the use of medical resources. Negative pressure therapy is an effective modality in the treatment in adults, but reports of its use in children are limited.

Novel beating heart repair for anomalous origin of right coronary artery.

Anomalous origin of the right coronary artery (ARCA) from the left coronary sinus is a rare anatomic anomaly. It may cause myocardial ischemia and sudden death. Several treatments have been tried, including coronary bypass grafting, unroofing, and reimplantation.

Modified intraatrial translocation for prosthetic mitral valve endocarditis.

Despite prompt diagnosis and aggressive surgical treatment of prosthetic mitral valve endocarditis (PVE), morbidity and mortality remain high. Surgical strategies have mostly been limited to debridement and anatomic valve reinstallation. Alternative surgical techniques have been attempted sporadically against this mortal disease, either with protection by antibiotic sewing rings or by anatomic evacuation of infectious foci.

Hybrid repair of subclavian-axillary artery aneurysms and aortic arch aneurysm in a patient with Marfan syndrome.

A patient with Marfan syndrome who had previously undergone a Cabrol procedure and thoracoabdominal aortic replacement had enlarging, symptomatic aneurysms in the subclavian-axillary artery and aortic arch. Both vessels were replaced with prosthetic grafts. A thoracic endoprosthesis was inserted bridging the aortic arch graft and the previously implanted descending aorta graft.

Time to revisit role of transcatheter balloon aortic valvuloplasty: a bridge-therapy to subsequent treatment case report.

Recently there has been a noticeable resurgence in the usage of percutaneous balloon aortic valvuloplasty (BAV) by the development of less invasive endovascular therapies including transcatheter aortic valve implantation (TAVI). We performed BAV in a 91-year-old man with end-stage severe symptomatic aortic stenosis (AS) and an impending abdominal aortic aneurysm (AAA) rupture who had been refused surgical treatment because of the comorbidities with stage V chronic kidney disease (CKD) and severe left ventricular dysfunction. Improvement in hemodynamics and kidney function was observed after BAV.

Hybrid repair of a Kommerell diverticulum associated with a right aortic arch and a left descending aorta.

This report describes the first successful case of a hybrid endovascular approach for management of aneurysmal Kommerell diverticulum arising from the left descending aorta in a right aortic arch. This patient also had dilatation of the ascending aorta and a small aortic arch aneurysm. This three-step procedure consisted of (1) ascending aorta replacement with total debranching using a handmade quarto-branched composite graft; (2) endovascular exclusion of Kommerell diverticulum and the aortic arch aneurysm by covering the whole aortic arch; and (3) coil embolization against the root of the left subclavian artery.

Novel single-stage operation and inflow source: for thoracic aortic aneurysm and limb ischemia.

Patients with thoracic aortic aneurysms sometimes also have peripheral vascular disease. In such cases, staged operations are usually performed in order to avoid additional morbidity. We have achieved good long-term outcomes in 2 patients with use of a single-stage surgical technique.

Repair of traumatic tricuspid insufficiency via minimally invasive port access.

We report on a successful tricuspid valve plasty using port-access minimally invasive cardiac surgery (MICS) for severe traumatic tricuspid insufficiency caused by blunt chest trauma suffered 15 years previously. A combination repair procedure, consisting of cleft closures, plication of the anteroseptal commissure, and ring annuloplasty, was necessary to achieve valve competence and proved possible via port access without difficulty. Port-access MICS is an alternative approach for tricuspid valve surgery.