The Impact of a Dedicated Chronic Total Occlusion PCI Program on Heart Team Decision Making.

Background: Guidelines endorse a heart team (HT) approach to standardize the decision-making process for patients with complex coronary artery disease (CAD). With percutaneous treatment options for complex CAD increasing, we hypothesized that practice had changed over the past decade-and that more individuals, previously deemed too high risk for intervention, would now be referred for either surgical or percutaneous revascularization.

Methods: This observational study was conducted at St Thomas' Hospital (London, United Kingdom).

Transcatheter Valve Implantation in Mitral Annular Calcification During Open Surgery: Extended Collar Technique.

We describe an improvised technique during open surgery of inserting a transcatheter heart valve in the mitral position under very challenging circumstances. This is the first described use of the "extended collar" technique, which allowed implantation of a transcatheter heart valve in severe mitral valve annular calcification, into which a surgical valve could not safely be implanted. We believe that this technique is reproducible and may be helpful to other surgeons when faced with similar difficult circumstances.

Mitral valve-in-valve and valve-in-ring for failing surgical bioprosthetic valves and rings.

The transcatheter valve-in-valve (VIV) procedure for failed aortic bioprostheses is recognized as an alternative treatment to conventional surgery in high-risk patients. This less invasive option has now been applied to failed mitral bioprostheses (VIV) or failed repairs i.e.

Day surgery unit thoracic surgery: the first UK experience.

Objective: Operating in a day surgery unit has potential benefits, including lower risk of cancellation, reduced infection rates, cost effectiveness and increased patient satisfaction. We believe that we are the first unit in the UK to regularly perform thoracic surgery in a dedicated day surgery unit, and describe our experience to date.

Methods: Data were collected prospectively from 1 September 2007 to 31 December 2009.

Identification of low circulatory transforming growth factor beta-1 in patients with degenerative heart valve disease.

Transforming growth factor β-1 (TGF-β1) is an immunosuppressive cytokine. It exerts cardioprotection during acute myocardial ischaemia, promoting healing of the injured myocytes. Lower plasma concentrations of TGF-β1 have been identified in patients with coronary artery disease (CAD) compared to those with normal coronary arteries.