Understanding the use of observational and randomized data in cardiovascular medicine.

The availability of large datasets from multiple sources [e.g. registries, biobanks, electronic health records (EHRs), claims or billing databases, implantable devices, wearable sensors, and mobile apps], coupled with advances in computing and analytic technologies, have provided new opportunities for conducting innovative health research.

CNB-001 reduces paraplegia in rabbits following spinal cord ischemia.

Spinal cord ischemia associated with trauma and surgical procedures including thoraco-abdominal aortic aneurysm repair and thoracic endovascular aortic repair results in devastating clinical deficits in patients. Because spinal cord ischemia is inadequately treated, we studied the effects of [4-((1E)-2-(5-(4-hydroxy-3-methoxystyryl-)-1-phenyl-1H-pyrazoyl-3-yl) vinyl)-2-methoxy-phenol)] (CNB-001), a novel curcumin-based compound, in a rabbit SCI model. CNB-001 is known to inhibit human 5-lipoxygenase and 15-lipoxygenase and reduce the ischemia-induced inflammatory response.

Evaluation of Hybrid Surgical Access Approaches for Pulmonary Valve Implantation in an Acute Swine Model.

Percutaneous implantation of the pulmonary valve through peripheral vascular access can be limited due to poor venous access, low patient weight, hemodynamic or rhythmic instability, and size constraints related to the valve. In such cases, hybrid procedures may provide alternatives. Because the most commonly used median sternotomy is unsuitable for chronic trials in large animals, we evaluated several hybrid approaches for pulmonary valve replacement in a swine model.

CNB-001, a pleiotropic drug is efficacious in embolized agyrencephalic New Zealand white rabbits and ischemic gyrencephalic cynomolgus monkeys.

Ischemic stroke is an acute neurodegenerative disease that is extremely devastating to patients, their families and society. Stroke is inadequately treated even with endovascular procedures and reperfusion therapy. Using an extensive translational screening process, we have developed a pleiotropic cytoprotective agent with the potential to positively impact a large population of brain ischemia patients and revolutionize the process used for the development of new drugs to treat complex brain disorders.

Type A aortic dissection model to improve endovascular research and technologies.

Objective: Type A aortic dissection is a life-threatening disease requiring immediate surgical treatment. With emerging catheter-based technologies, endovascular stent-graft implantation to treat aneurysms and dissections has become a standardized procedure. However, endovascular treatment of the ascending aorta remains challenging.

Left Subclavian Arterial Coverage and Stroke During Thoracic Aortic Endografting: A Systematic Review.

Stroke is a devastating complication of thoracic endovascular aortic repair (TEVAR). Whether left subclavian artery (LSA) coverage and LSA revascularization affect stroke rate is debated. Whether patients with aneurysms or dissections undergoing TEVAR have higher stroke rates is also debated.

Methodology of motor evoked potentials in a rabbit model.

Spinal cord ischemia (SCI) is a devastating complication of aortic operations. Neuromonitoring using motor evoked potentials (MEPs) is a sensitive modality to detect SCI in humans. We describe a leporine SCI model using MEPs to test pharmaceutical therapeutics and other neuroprotective adjuncts.

Thoracic endovascular aortic repair: are we approaching total endovascular solutions for thoracic aortic disease?

Thoracic endovascular aortic repair (TEVAR) has become an attractive alternative treatment option for thoracic aortic disease. New devices and advanced image-guided procedures are continuously expanding the indications. This article focuses on currently available endovascular solutions for thoracic aortic disease and future 'all endovascular' directions of TEVAR.

An update on endovascular management of acute thoracic aortic disease and future directions.

Thoracic endovascular aortic repair (TEVAR) has become an alternative treatment option for acute thoracic aortic disease. This review focuses on current endovascular treatment of acute thoracic aortic disease and future directions of TEVAR. TEVAR is a promising alternative approach to open surgery, with lower early mortality and morbidity rates, especially in high-risk cohorts.

J-147 a Novel Hydrazide Lead Compound to Treat Neurodegeneration: CeeTox Safety and Genotoxicity Analysis.

J-147 is a broad spectrum neuroprotective phenyl hydrazide compound with significant neurotrophic properties related to the induction of brain-derived neurotrophic factor (BDNF). Because this molecule is pleiotropic, it may have substantial utility in the treatment of a wide range of neurodegenerative diseases including acute ischemic stroke (AIS), traumatic brain injury(TBI), and Alzheimer's disease(AD) where both neuroprotection and neurotrophism would be beneficial. Because of the pleiotropic actions of J-147, we sought to determine the safety profile of the drug using multiple assay analysis.

In vitro comparison of novel polyurethane aortic valves and homografts after seeding and conditioning.

The aim of the study was to compare the behavior of seeded cells on synthetic and natural aortic valve scaffolds during a low-flow conditioning period. Polyurethane (group A) and aortic homograft valves (group B) were consecutively seeded with human fibroblasts (FB), and endothelial cells (EC) using a rotating seeding device. Each seeding procedure was followed by an exposure to low pulsatile flow in a dynamic bioreactor for 5 days.

Transcatheter valve replacement: new concepts for microsurgery inside the heart.

Objective: Transcatheter aortic valve implantation gained clinical relevance with an impressive and peerless power; however, the procedure induces unsolved complications such as paravalvular leakage, occlusion of coronary ostia, and vascular complications. The safe removal of bulky calcified valves will improve the outcome, well known through the open surgical procedure. In this article, a new stapler-based resection and implantation device as well as a new approach for valve isolation during normal heart cycle without extracorporeal circulation will be analyzed.

Partial inferior sternotomy and deep hypothermic circulatory arrest for rescue of a failed TAVI case: what does constitute 'inoperable'?

A 65-year-old male patient was considered inoperable by conventional means for a previous triple coronary artery bypass grafting with a patent in situ right internal mammary artery graft to the left anterior descending artery crossing the thorax at midline directly behind the sternum. Transcatheter aortic valve implantation failed due to loss of the prosthetic device in the left ventricular outflow tract. Mandatory conversion was accomplished by an inferior partial T-shape sternotomy and extracorporeal circulation draining from the right atrium and feeding into the right femoral artery.

Management of thoracic aortic lesions--the future is endovascular.

Open surgical repair of lesions of the descending thoracic aorta, such as aneurysm, dissection and traumatic rupture, has been the "state-of-the-art" treatment for many decades. However, in specialized cardiovascular centers, thoracic endovascular aortic repair and hybrid aortic procedures have been implemented as novel treatment options. The current clinical results show that these procedures can be performed with low morbidity and mortality rates.

Transcatheter aortic valve implantation in aortic coarctation.

A 77-year-old male patient was scheduled for transcatheter aortic valve implantation for symptomatic and severe aortic valve stenosis. Severe multidirectional kinking of the aorta based on aortic coarctation did not allow for the transfemoral, but only for the transapical approach. The procedure was complicated because of the technically challenging retrograde passage of the transfemorally inserted pig-tail catheter required for intraoperative angiography of the aortic root.

Transapical mitral valved stent implantation: a survival series in swine.

Objective: To assess short-term survival after transcatheter mitral valve replacement using a unique mitral valved stent design and anchoring system.

Methods: The new nitinol self-expandable valved stent houses a trileaflet glutaraldehyde-preserved bioprosthesis and contains atrial and ventricular fixation systems. Eight pigs underwent transesophageal echocardiogram-guided transapical mitral valved stent implantation through a lower mini-sternotomy.

Percutaneous tissue-engineered pulmonary valved stent implantation.

Purpose: The purpose of this study was to evaluate the feasibility of percutaneously implanted tissue-engineered valved stents in the ovine pulmonary valve position.

Description: Porcine pulmonary heart valves and small intestinal submucosa were obtained from a slaughterhouse, and the intestinal submucosa used to cover the inside of the porcine pulmonary valved stents. Endothelial cells and autologous myofibroblasts were obtained from carotid artery segments of juvenile sheep.

Percutaneous aortic valve replacement: emerging tractability for sufficient intracardiac resection of the aortic valve.

Objective: : The feasibility of endovascular resection of highly calcified aortic valves has already been demonstrated by our group. Different endovascular and intracardiac tractability methods were applied. In this study, these technologies were analyzed comparing the tractability, the resection time, and the lesions in the surrounding tissue.

Percutaneous aortic valve replacement: computed tomography scan after valved stent implantation in human cadaver hearts.

Computed tomography scans were performed before and after aortic valve resection with consecutive implantation of a valved stent in human hearts with highly calcified aortic valves in situ (n=2). This demonstrates that the valved stent shows better fitting in the annulus after removal of the native valve.

Percutaneous aortic valve replacement: gross anatomy and histological findings after transapical and endoluminal resection of human aortic valves in situ.

Objective: Transluminal resection of the aortic valve was already successfully carried out by our group. The aim of this study was the analysis of the gross anatomy and the histology of the surrounding tissue after resection.

Methods: Aortic valve resection was performed in postmortem human hearts (endoluminal (EL) n=9, transapical (TA) n=4).