Thoracic Endovascular Aortic Repair For The Management of Aorto-Esophageal Fistulae: A Systematic Review.

Objective: Aorto-esophageal fistula (AEF) is a rare condition consisting in a fistula between the aorta and the esophagus. The thoracic endovascular aortic repair (TEVAR) has become an accepted treatment for initial AEF management, but large series are not available and outcomes are questionable. This study aims at evaluating the current evidence of TEVAR in AEF.

Management of left subclavian artery in type B aortic dissection treated with thoracic endovascular aorta repair.

Objective: Thoracic endovascular aortic repair (TEVAR) has been the favored approach for the treatment of type B aortic dissection (TBAD). To obtain an adequate proximal landing zone, coverage of the left subclavian artery (LSA) will often be necessary. The occurrence of possible neurologic complications has continued to be debated.

Apical closure device for full-percutaneous transapical structural and valve procedures with large-sized introducer sheaths: The final preclinical study.

Background: Closed-chest transapical valve implantations (aortic, mitral, and tricuspid) and cardiac structural procedures requiring large-sized introducer sheaths cannot be safely performed with the available technology. We tested a self-expanding apical closure device in a closed-chest animal model, using large-sized introducer sheaths and human-sized animals to establish the technique for future tests in humans.

Methods: Six human-sized pigs (mean weight: 89.

Outcome of right ventricular assist device implantation following left ventricular assist device implantation: Systematic review and meta-analysis.

Objectives: The main aim was a systematic evaluation of the current evidence on outcomes for patients undergoing right ventricular assist device (RVAD) implantation following left ventricular assist device (LVAD) implantation.

Methods: This systematic review was registered on PROSPERO (CRD42019130131). Reports evaluating in-hospital as well as follow-up outcome in LVAD and LVAD/RVAD implantation were identified through Ovid Medline, Web of Science and EMBASE.

Endovascular treatment of the dissected proximal aortic arch: a systematic review.

Objectives: Surgical repair of aortic dissection involving the proximal aortic arch is associated with higher morbidity and mortality, in particular when elderly high-risk patients are concerned. Endovascular treatments for this disease are under evaluation and some reports exist. We investigated the current use of catheter-based treatments for the dissected proximal aortic arch repair.

Catheter-based treatment of the dissected ascending aorta: a systematic review.

Objectives: Type A aortic dissection requires immediate surgical repair. Despite improvements in surgery and anaesthesia, there is still a considerable risk when high-risk patients are concerned. Less invasive endovascular treatments are under evaluation.

Performance characteristics of the new Eurosets magnetically suspended centrifugal pump.

Objective: The aim was to evaluate the performance of a newly developed magnetically suspended centrifugal pump head intended for use as a ventricular assistance device with a newly developed extracorporeal membrane oxygenator setup.

Methods: In an experimental setup, an extracorporeal membrane oxygenator circuit was established in three calves with a mean weight of 68.2 ± 2.

Chimney grafts in renal arteries: a clinical model for coronary perfusion in future transcatheter aortic root repair techniques.

Objectives: Given the similarities between coronary ostia and renal arteries, chimney grafts (CG) for kidney perfusion during abdominal endovascular aneurysm repair (EVAR) can be considered for coronary perfusion in future transcatheter aortic root repair (TARR) techniques. We analysed the results of renal CG and compared anatomic and technical details with root and coronary anthropometric data.

Methods: Current status of kidney perfusion with CG was reviewed from literature.

Transcatheter aortic root replacement with chimney grafts for coronary perfusion: a preliminary test in a three-dimensional-printed root model.

Objectives: Transcatheter aortic root repair is still not available because of the technical challenge of coronary perfusion. The use of chimney grafts for coronary ostia can be an option and we tested the flow-through coronary chimney grafts deployed in a 3-dimensional-printed root model as part of a transcatheter aortic root repair system.

Methods: A 3-dimensional-printed root was used to test the coronary flow after the deployment of 1 root endograft (28 mm diameter) and two 6-mm diameter 10-cm long coronary chimney grafts.

Effect of blood viscosity on the performance of virtually wall-less venous cannulas.

Aim: This study was designed to quantify the influence of blood as test medium compared to water in cannula bench performance assessment.

Methods: An in vitro circuit was set-up with silicone tubing between two reservoirs. The test medium was pumped from the lower reservoir by centrifugal pump to the upper reservoir.

Three-dimensional printing in adult cardiovascular medicine for surgical and transcatheter procedural planning, teaching and technological innovation.

Three-dimensional (3D)-printing technologies in cardiovascular surgery have provided a new way to tailor surgical and percutaneous treatments. Digital information from standard cardiac imaging is integrated into physical 3D models for an accurate spatial visualization of anatomical details. We reviewed the available literature and analysed the different printing technologies, the required procedural steps for 3D prototyping, the used cardiac imaging, the available materials and the clinical implications.

Self-expanding apical closure device for full-percutaneous closed-chest transapical valve procedures with large-sized introducer sheaths: first study in an animal model.

Objectives: Available apical occluders do not fulfil requirements for full-percutaneous transapical valve procedures with large-sized introducer sheaths. A self-expanding closure device designed for closed-chest transapical valve procedures was tested in an animal model to verify safety, efficacy and thrombogenicity.

Methods: Large-sized 21-Fr introducer sheaths (Certitude™ system for Sapien™ valves) were percutaneously placed in the ventricles of nine 3-month old minipigs.

Effects of PDE-5 Inhibition on the Cardiopulmonary System After 2 or 4 Weeks of Chronic Hypoxia.

Purpose: In pulmonary hypertension (PH), hypoxia represents both an outcome and a cause of exacerbation. We addressed the question whether hypoxia adaptation might affect the mechanisms underlying PH alleviation through phosphodiesterase-5 (PDE5) inhibition.

Methods: Eight-week-old male Sprague-Dawley rats were divided into two groups depending on treatment (placebo or sildenafil, a drug inhibiting PDE5) and were exposed to hypoxia (10% O) for 0 (t0, n = 9/10), 2 (t2, n = 5/5) or 4 (t4, n = 5/5) weeks.

Outcome of inter-hospital transfer of patients on extracorporeal membrane oxygenation in Switzerland.

Aims Of The Study: An extracorporeal membrane oxygenation system (ECMO), as a bridge to either recovery, a ventricular assist device (VAD), or heart or lung transplantation, may be the only lifesaving option for critically ill patients suffering from refractory cardiac, respiratory or combined cardiopulmonary failure. As peripheral hospitals may not offer ECMO treatment, tertiary care centres provide specialised ECMO teams for on-site implantation and subsequent patient transfer on ECMO to the tertiary hospital. This study reports the results of the largest ECMO transportation programme in Switzerland and describes its feasibility and safety.

Suitability of 3D-Printed Root Models for the Development of Transcatheter Aortic Root Repair Technologies.

Transcatheter aortic root repair (TARR) is still not available because of the complex anatomy. In order to develop future TARR technologies, a human-derived bench test model is required before performing animal tests. For this purpose, we aimed to validate computed tomography (CT)-derived 3D-printed root models for TARR technologies.

New, optimized, dual-lumen cannula for veno-venous ECMO.

Objective: The present study was designed to assess in vivo a new, optimized, virtually wall-less, dual-lumen, bi-caval cannula for veno-venous ECMO in comparison to a commercially available cannula.

Methods: Veno-venous extracorporeal membrane oxygenation (ECMO) was carried out in a bovine study (n=5, bodyweight 75±5kg). Following systemic heparinization, ECMO was established in a trans-jugular fashion through a calibrated 23F orifice, using a new, optimized, virtually wall-less, dual-lumen, bi-caval 24F cannula (Smartcanula LLC, Lausanne, Switzerland) versus a commercially available 23F bi-caval, dual-lumen control cannula (Avalon Elite, Maquet, Rastatt, Germany) in a veno-venous ECMO setup.

Clinical Experience in Minimally Invasive Cardiac Surgery With Virtually Wall-Less Venous Cannulas.

Objective: Inadequate peripheral venous drainage during minimally invasive cardiac surgery (MICS) is a challenge and cannot always be solved with increased vacuum or increased centrifugal pump speed. The present study was designed to assess the benefit of virtually wall-less transfemoral venous cannulas during MICS.

Methods: Transfemoral venous cannulation with virtually wall-less cannulas (3/8″ 24F 530-630-mm ST) was performed in 10 consecutive patients (59 ± 10 years, 8 males, 2 females) undergoing MICS for mitral (6), aortic (3), and other (4) procedures (combinations possible).

Phosphodiesterase-5 Inhibition Alleviates Pulmonary Hypertension and Basal Lamina Thickening in Rats Challenged by Chronic Hypoxia.

Hypoxia represents both an outcome of cardiopulmonary diseases and a trigger for severe pulmonary complications as pulmonary hypertension. Because nitric oxide (NO) is a critical mediator in the development of pulmonary hypertension, the modulators of its downstream function may become target of pharmacological interventions aimed at alleviating the impact of this condition. Here, we investigate the effects of an early administration of phosphodiesterase-5 inhibitor in rats where pulmonary artery hypertension was induced by chronic exposure to hypoxia.

Impact of aortic root annuloplasty on 3D aortic root geometry.

Background: The aim was to evaluate the impact of aortic root (AoR) annuloplasty on 3D AoR deformation.

Methods: In experimental setup, Yacoub procedure and Yacoub with annuloplasty were performed. Results were compared to native AoR.

Impact of the bicuspid aortic valve on aortic root haemodynamics: three-dimensional computed fluid dynamics simulation.

Objectives: The aim was to evaluate the impact of a bicuspid aortic valve (BAV) on local shear stress and on the pressure profile on the elements of the aortic root (AoR).

Methods: The experiment setup included a BAV with aortic valve stenosis (n = 5 pigs, 67 ± 3.5 kg) and insufficiency (n = 5 pigs, 66.

Suitability of the porcine aortic model for transcatheter aortic root repair.

Objectives: To treat aortic valve disease and concomitant root disease with transcatheter techniques, 'composite graft' implants are required. Our goal was to assess the suitability of the porcine aortic root for transcatheter root repair tests.

Methods: Eight pig hearts explanted from domestic pigs used in experimental surgery were compared to data from the literature on human hearts.

Endovascular treatment of non-dissected ascending aorta disease: a systematic review.

Severe ascending aorta disease includes aneurysms, pseudoaneurysms (ascending aorta pseudoaneurysms), penetrating aortic ulcers and Type A aortic dissections. Surgical replacement of the aortic root, ascending aorta or aortic arch is the common treatment for severe ascending aortic disease involving the root, the ascending aorta and/or the arch. Despite good surgical results, there is still a risk for morbidity and mortality following surgery for ascending aorta replacement when elderly patients or patients at high risk for surgery are concerned.