Concomitant atrial fibrillation ablation in minimally invasive cardiac surgery.

Concomitant atrial fibrillation (AF) ablation in cardiac surgery effectively restores sinus rhythm and may reduce morbidity and mortality. Cardiac surgery has witnessed the transition from the historical Cox Maze procedure to more modern and less invasive approaches for concomitant AF treatment. As minimally invasive cardiac surgery gains traction, ablation methods and careful patient selection become crucial to optimize results.

Endocarditis after transcatheter aortic valve replacement; a new nightmare in cardiac surgery.

Treatment of prosthetic valve endocarditis after transcatheter aortic valve replacement (TAVR) remains challenging. An increase in TAVR endocarditis is inevitable, especially with the extension of indications and implantation in low-risk patients. We present a case of complex surgical treatment of prosthetic valve endocarditis after TAVR.

Sutureless aortic valve replacement in a calcified homograft combined with mitral valve replacement.

Background: Aortic valve replacement in a patient with an aortic homograft can be very challenging, especially when concomitant mitral valve surgery needs to be performed.

Case Presentation: We report a case of implantation of a sutureless aortic valve bioprosthesis combined with mitral valve replacement in a patient with a severely calcified aortic homograft where conventional valve replacement was technically unfeasible.

Conclusions: We believe that sutureless AVR is a viable option especially for young patients with a high surgical risk where conventional valve replacement cannot be achieved.

Aortic valve calcification as a predictor of location and severity of paravalvular regurgitation after transcatheter aortic valve implantation.

Objectives: To determine whether the location of aortic valve calcium (AVC) influences the location of paravalvular regurgitation (PR). PR is an adverse effect of transcatheter aortic valve implantation (TAVI) with a negative effect on long-term patient survival. The relationship between AVC and the occurrence of PR has been documented.

The costs and effects of contrast-enhanced magnetic resonance angiography and digital substraction angiography on quality of life in patients with peripheral arterial disease.

Background: Contrast-enhanced magnetic resonance angiography (MRA) and intra-arterial digital subtraction angiography (DSA) both have a high diagnostic performance in the imaging of peripheral arterial occlusive disease (PAOD). However, little is known about the effects of initial, preoperative imaging using MRA or DSA on quality of life (QoL) in relation to costs (cost-utility).

Purpose: To compare cost-utility of treatment strategies using either MRA or DSA as the principal imaging tool, related to QoL, in patients with PAOD.

Aluminium foil for the prevention of post-amputation pain: a randomised, double-blinded, placebo-controlled, crossover trial.

Introduction: Phantom limb pain (PLP) is a painful sensation perceived in the missing limb after amputation. The underlying pathophysiology remains unclear. Until recently, only opioid analgesics have been proven to be effective in prospective studies.

Improved microcirculation in patients with an acute ST-elevation myocardial infarction treated with the Impella LP2.5 percutaneous left ventricular assist device.

Background: Circulatory support during percutaneous coronary intervention (PCI) in patients with ST-element elevation myocardial infarction (STEMI) aims at maintaining hemodynamic stability and organ perfusion. However, continuous flow pumps may interfere with the normal pulsatile circulation and the microcirculatory function. Sidestream dark field (SDF) imaging allows the visualization of microvascular structure and function of tissue and may provide information regarding the efficacy of the circulatory support.

A combined surgical and percutaneous approach through the axillary artery to introduce the Impella LP5.0 for short-term circulatory support.

We describe a novel axillary approach for insertion and usage of the Impella LP5.0, a low cost micro-axial flow pump, in five patients requiring circulatory support after acute ST-segment elevation myocardial infarction (STEMI). This alternative approach for implantation of the Impella LP5.

Single cells isolated from human sinoatrial node: action potentials and numerical reconstruction of pacemaker current.

Pacemaker activity of the sinoatrial node has extensively been studied in laboratory animals of various species, but is virtually unexplored in man. Most experimental data have been obtained from rabbit, where the hyperpolarization-activated 'funny' current (If), also known as the 'pacemaker current', plays an important role in diastolic depolarization and thus in setting pacing rate. Recently, we isolated pacemaker cells from excised human sinoatrial node tissue, and recorded action potentials and If using the whole-cell patch-clamp technique in current clamp and voltage clamp mode, respectively.

Pacemaker current (I(f)) in the human sinoatrial node.

Aims: Animal studies revealed that the hyperpolarization-activated pacemaker current, I(f), contributes to action potential (AP) generation in sinoatrial node (SAN) and significantly determines heart rate. I(f) is becoming a novel therapy target to modulate heart rate. Yet, no studies have demonstrated that I(f) is functionally present and contributes to pacemaking in human SAN.