Clinically atypical abdominal manifestation of the lipoma localized in the right atrium: "Invagination hypothesis" revisited.

Cardiac lipomas are the second most common cardiac tumors. They are usually asymptomatic and diagnosed as incidental findings. We describe a 71-year-old patient with a tumor in the right atrium.

The HeartWare Ventricular Assist Device (HVAD): A Single Institutional 10-Year Experience.

Objectives: The aim of this study was to analyze our 10-year experience with the HVAD in a real-world scenario in a high-volume German heart center.

Methods: We retrospectively analyzed outcomes of adults (≥18 years) with terminal heart failure (HF), who underwent HVAD implantation for durable LVAD therapy in our center between October 2009 and March 2020. Primary and secondary end points were all-cause death after implantation and LVAD-associated complications, respectively.

High-sensitivity cardiac troponin I after coronary artery bypass grafting for post-operative decision-making.

Aims: Current troponin cut-offs suggested for the post-operative workup of patients following coronary artery bypass graft (CABG) surgery are based on studies using non-high-sensitive troponin assays or are arbitrarily chosen. We aimed to identify an optimal cut-off and timing for a proprietary high-sensitivity cardiac troponin I (hs-cTnI) assay to facilitate post-operative clinical decision-making.

Methods And Results: We performed a retrospective analysis of all patients undergoing elective isolated CABG at our centre between January 2013 and May 2019.

Donor-recipient risk assessment tools in heart transplant recipients: the Bad Oeynhausen experience.

Aims: Some risk assessment tools have been developed to categorize mortality risk in heart transplant recipients, but it is unclear whether these tools can be used interchangeable in different transplant regions.

Methods And Results: We performed a retrospective single-centre study in 1049 adult German heart transplant recipients under jurisdiction of Eurotransplant. Univariable and multivariable Cox regression analysis was used to generate a risk scoring system.

Risk-adjusted analysis of long-term outcomes after on- versus off-pump coronary artery bypass grafting.

Objectives: Recent data suggested that off-pump coronary artery bypass (OPCAB) may carry a higher risk for mortality in the long term when compared to on-pump coronary artery bypass (ONCAB). We, therefore, compared long-term survival and morbidity in patients undergoing ONCAB versus OPCAB in a large single-centre cohort.

Methods: A total of 8981 patients undergoing isolated elective/urgent coronary artery bypass grafting between January 2009 and December 2019 were analysed.

Prevalence of Sleep Disordered Breathing in Patients with Primary Mitral Regurgitation Undergoing Mitral Valve Surgery.

Background: Sleep disordered breathing (SDB) is a frequent comorbidity in cardiac disease patients. Nevertheless, the prevalence and relationship between SDB and severe primary mitral regurgitation (PMR) has not been well investigated to date.

Methods: A cohort of 121 patients with significant PMR undergoing mitral valve surgery were prospectively enrolled and received a cardiorespiratory single night polygraphy screening using ApneaLink before surgery.

Midterm outcomes with a sutureless aortic bioprosthesis in a prospective multicenter cohort study.

Objective: The objective of this study was to report midterm clinical outcomes with a self-expandable sutureless aortic valve.

Methods: Between 2010 and 2013, 658 patients at 25 European institutions received the Perceval sutureless valve (LivaNova Plc, London, United Kingdom). Mean follow-up was 3.

Secondary aortic valve replacement in continuous flow left ventricular assist device therapy.

The purpose of the study was to investigate the outcome of secondary surgical aortic valve replacement (sSAVR) in patients with severe aortic regurgitation (AR) in the context of ventricular assist device (VAD) therapy. From 2009 to 2020, 792 patients underwent cf-LVAD implantation [HVAD (Medtronic, USA), n = 585, and HM 3 (Abbott, USA), n = 207]. All cf-LVAD patients with severe AR requiring secondary AVR were enrolled in this study.

Mechanical circulatory support as a bridge to candidacy in adults with transposition of the great arteries and a systemic right ventricle.

Objectives: Clinical experience with continuous flow ventricular assist devices (VADs) in patients with transposition of the great arteries (TGA) including dextro-TGA and congenitally corrected TGA is rare, and indications as well as potential benefits or specific hurdles remain unclear. Therefore, our goal was to report on our experience regarding VAD therapy in adult patients with TGA as a bridge to candidacy.

Methods: We performed a single-centre retrospective study of all adult patients with TGA with systemic right ventricular failure who had continuous flow VAD implants between 2010 and 2018.

Myocardial adaptation as assessed by speckle tracking echocardiography after isolated mitral valve surgery for primary mitral regurgitation.

The risk of left ventricular (LV) and right ventricular (RV) maladaptation after surgery for isolated primary mitral regurgitation (PMR) is poorly defined. We aimed to evaluate LV and RV contractile function using speckle-tracking analysis alongside with quantification of exercise tolerance in patients with PMR after mitral valve surgery. All consecutive patients with symptomatic PMR undergoing mitral valve surgery between July 2015 and May 2017 were prospectively enrolled.

Long-Term Clinical Outcome in Elderly Patients Undergoing Mitral Valve Repair.

Background:  Long-term data on patients over 75 years undergoing mitral valve (MV) repair are scarce. At our high-volume institution, we, therefore, aimed to evaluate mortality, stroke risk, and reoperation rates in these patients.

Methods:  We investigated clinical outcomes in 372 patients undergoing MV repair with ( = 115) or without ( = 257) tricuspid valve repair.

Heart transplantation after SynCardia total artificial heart implantation.

Background: The SynCardia total artificial heart (TAH) is the only approved TAH device. This report summarizes our single-center experience with the SynCardia TAH with particular focus on the outcome after subsequent heart transplantation.

Methods: We retrospectively analysed the outcome of all transplanted SynCardia TAH patients at our center between 2001 and 2019 in comparison to transplanted left ventricular assist device (LVAD) and biventricular assist device (BVAD) patients and to transplanted patients without prior durable mechanical circulatory support (non-MCS).

Papillary Muscle Heads Focalization for Functional Mitral Valve Regurgitation.

Mitral valve annuloplasty has been the gold standard for treatment of functional mitral valve regurgitation. However, annuloplasty for functional mitral regurgitation may cause augmented posterior leaflet tethering, which results in functional anterior prolapse. Herein we added papillary muscle heads focalization for such patients.

Comparing short-term outcome after implantation of the HeartWare® HVAD® and the Abbott® HeartMate 3®.

Aims: Centrifugal continuous flow pumps are currently the state of the art in left ventricular assist device therapy. This study was conducted to compare the results after implantation of the HVAD® and the HeartMate 3®.

Methods And Results: We retrospectively analysed preoperative and post-operative patient data of all 106 patients, who received a HeartMate 3 (HM3) at our centre between 2014 and 2018.

Off-pump Revascularization with Bilateral versus Single Mammary Arteries-A Propensity Score-Matched Analysis.

Background: Coronary artery bypass grafting is the first-line therapy for severe multivessel coronary artery disease. We aimed to investigate the clinical outcome in patients undergoing isolated off-pump surgery with the single or bilateral internal mammary artery (SIMA or BIMA) approach.

Methods: We performed a propensity score-matched analysis in 1,852 consecutive patients, aged 50 to 70 years, who underwent myocardial revascularization at our institution between July 2009 and August 2016.

Risk factors for adverse outcomes after left ventricular assist device implantation and extracorporeal cardiopulmonary resuscitation.

Left ventricular assist device implantation following extracorporeal cardiopulmonary resuscitation has been associated with ambivalent results. In a series of patients who underwent left ventricular assist device implantation after extracorporeal cardiopulmonary resuscitation, we investigated whether the outcome can be predicted by preoperative risk factors or established risk scores. Primary endpoint was a composite of mortality and severe neurological disabling over 1 year of follow-up.

Current perspectives on mechanical circulatory support.

Mechanical circulatory support gained a significant value in the armamentarium of heart failure therapy because of the increased awareness of the prevalence of heart failure and the tremendous advances in the field of mechanical circulatory support during the last decades. Current device technologies already complement a heart transplant as the gold standard of treatment for patients with end-stage heart failure refractory to conservative medical therapy. This article reviews important aspects of mechanical circulatory support therapy and focuses on currently debated issues.

Minimally invasive mitral valve repair or replacement for degenerative mitral regurgitation.

Objectives: This study describes our experience with minimally invasive mitral valve (MV) repair and chordal-sparing replacement in patients with degenerative MV regurgitation.

Methods: Between February 2009 and October 2015, a total of 960 patients underwent isolated minimally invasive MV repair, whereas 95 patients underwent chordal-sparing MV replacement. We performed a propensity score-matched analysis in 85 pairs to compare overall survival and major adverse cardiac and cerebrovascular event (MACCE) -free survival over an 8-year follow-up period.

Extracorporeal resuscitation as a further modifier of clinical outcome in patients with left ventricular assist device implantation and Interagency Registry for Mechanically Assisted Circulatory Support level 1.

In cardiogenic shock patients with Interagency Registry for Mechanical Circulatory Support (INTERMACS) level 1, the need for temporary circulatory support is a predictor and modifier of patient outcome. Because this group includes patients with and without cardiopulmonary resuscitation (CPR) and is thus very heterogeneous, we investigated whether a further subclassification is useful. We compared 30-day and 1-year mortality of patients who underwent left ventricular assist device implantation after extracorporeal CPR with the aid of an extracorporeal life support system (CPR+ group; n = 40) with cardiogenic shock patients in which the extracorporeal life support system was implanted under non-CPR conditions (CPR- group, n = 68).

Anaortic off-pump versus clampless off-pump using the PAS-Port device versus conventional coronary artery bypass grafting: mid-term results from a matched propensity score analysis of 5422 unselected patients.

Objectives: Meta-analyses from observational and randomized studies have demonstrated benefits of off-pump surgery for hard and surrogate endpoints. In some of them, increased re-revascularization was noted in the off-pump groups, which could impact their long-term survival. Therefore, we analyzed the course of all patients undergoing isolated coronary surgery regarding the major cardiac and cerebrovascular event (MACCE) criteria.

Management of end-stage heart failure patients with or without ventricular assist device: an observational comparison of clinical and economic outcomes.

Objectives: Heart transplantation (HT) and ventricular assist devices (VAD) for the management of end-stage heart failure have not been directly compared. We compare the outcomes and use of resources with these 2 strategies in 2 European countries with different allocation systems.

Methods: We studied 83 patients managed by VAD as the first option in Bad Oeynhausen, Germany (Group I) and 141 managed with either HT or medical therapy, as the first option, in Paris, France (Group II).

Preclinical determination of the best functional position for transcatheter heart valves implanted in rapid deployment bioprostheses.

Aims: The aim of this study was to determine the best functional position of a transcatheter heart valve (THV) implanted as a valve-in-valve (ViV) procedure in small rapid deployment valves (RDV) in an in vitro model.

Methods And Results: A 21 mm Perceval, Enable or INTUITY RDV was mounted into a pulse duplicator and a 23 mm balloon-expandable or a self-expanding THV was deployed (valve-in-valve) in two different positions. Under physiological hydrodynamic conditions, the performance of the THV was characterised by mean transvalvular pressure gradient (MPG), effective orifice area (EOA) and regurgitation volume (RV).

The sutureless aortic valve at 1 year: A large multicenter cohort study.

Objective: Sutureless aortic valve replacement (AVR) offers an alternative to standard AVR in aortic stenosis. This prospective, single-arm study aimed to demonstrate safety and effectiveness of a bovine pericardial sutureless aortic valve at 1 year.

Methods: From February 2010 to September 2013, 658 patients (mean age 78.