First-in-human: Leaflet laceration with balloon mediated annihilation to prevent coronary obstruction with radiofrequency needle (LLAMACORN) for valve-in-valve transcatheter aortic valve replacement.

Coronary obstruction (CO) is a potential pitfall for transcatheter aortic valve replacement (TAVR), especially in valve in valve procedures into degenerated surgical or transcatheter prostheses. Bioprosthetic leaflet modification techniques that incorporate electrosurgery are evolving as the preferred strategy to mitigate the risk of CO in high CO risk settings. The UNICORN method is proposed as a more predictable leaflet modification strategy than the earlier described BASILICA approach, but its proponents have hitherto mandated the use of a balloon-expandable valve (BEV) prosthesis.

Third-Generation Transcatheter Aortic Heart Valve with Reverse Parachute Sealing Cuff in Patients with Aortic Valve Disease.

Background: The Navitor (Abbott Inc, IL, USA) transcatheter heart valve is a novel third-generation self-expanding bioprosthesis with specific features to mitigate paravalvular regurgitation (PVR). Owing to its novelty, there is a paucity of data on its application in clinical practice.

Methods: Consecutive cohort analysis of the use of the Navitor system in an as-treated clinical setting at a quaternary heart hospital.

Del Nido cardioplegia in adult cardiac surgery: analysis of myocardial protection and post-operative high-sensitivity Troponin T.

Background: del Nido cardioplegia has been adopted for use in adult cardiac surgery, despite a lack of robust randomised evidence supporting equivalence or superiority to conventional hyperkalaemic blood cardioplegia. We investigated the clinical surrogates of myocardial protection, and performed an extensive analysis of post-operative high-sensitivity Troponin T (hs-TnT) values in a general adult cardiac surgery population receiving del Nido, in comparison to a historical hyperkalaemic blood cohort.

Method: 171 consecutive patients of a single surgeon from between November 2018 and June 2020 received del Nido, and were compared to a historical cohort of 326 patients between January 2016 and November 2018 who received hyperkalaemic blood cardioplegia.

Postoperative Pain in Thoracic Surgical Patients: An Analysis of Factors Associated With Acute and Chronic Pain.

Background: Thoracic surgery is associated with high levels of acute and chronic pain, which is associated with significant morbidity, reduced quality of life, and increased health care expenditure. This study aims to identify patient-care factors associated with higher levels of acute and chronic pain after thoracic surgery.

Methods: The acute pain component of this study retrospectively analysed 53 patients, surgical, anaesthetic, and postoperative factors against an average measure of acute pain during a patient's hospital admission, for 134 individual acute admission episodes.

Surgical management of mitral valve infective endocarditis with annular abscess and calcification in the setting of a leaking mycotic infrarenal abdominal aortic aneurysm: a case report.

We present the case of a previously well seventy-four year old male caucasian grazier who presented with mild back pain and was subsequently found to have a large posterior mitral valve leaflet perivalvular abscess associated with mitral annulus calcification and a mycotic infrarenal abdominal aortic aneurysm (AAA) of Staphylococcal origin. He underwent a right axillofemoral bypass with oversewn aorta and a right to left femoral crossover graft, and a subsequent mitral valve repair with decalcification/debridement of the annulus and extensive posterior leaflet reconstruction with pericardium patch. Despite multiple sequelae and an extended intensive care and hospital stay, the patient was discharged home after six months.