Challenges in cannulation of left ventricular apex for temporary circulatory support: a case report.

Apical cannulation of a left ventricle for temporary support is still challenging, especially in case of prolonged support due to donor organ shortage. Traditional cannulation techniques with the cannula being directly inserted into the left ventricle cavity are technically easy, but prone to hemorrhage during circulatory support, unsafe for a prolonged support (over than 30 days) and limits the possibility to ambulate patient due to risk for cannula dislocation and related life-threatening bleeding. We describe a case of temporary left ventricular assist device placement in a 59-year-old male patient being on veno-arterial extracorporeal membrane oxygenation support secondary to acute myocardial infarction.

Long-term results after reconstruction of a new annulus in heavily calcified mitral annulus.

Background And Aim Of The Study: In 2009 our group described a new surgical technique for patients with severe mitral valve calcification undergoing mitral valve surgery. This technique creates a new mitral annulus with plication of the mitral leaflet and the atrial wall. Our objective is to report the long-term results of the experience at our institution.

A three dimensional model of multicellular aggregate compression.

Multicellular aggregates are an excellent model system to explore the role of tissue biomechanics, which has been demonstrated to play a crucial role in many physiological and pathological processes. In this paper, we propose a three-dimensional mechanical model and apply it to the uniaxial compression of a multicellular aggregate in a realistic biological setting. In particular, we consider an aggregate of initially spherical shape and describe both its elastic deformations and the reorganisation of the cells forming the spheroid.

Contemporary epidemiology and outcomes in recurrent infective endocarditis.

Objective: Recurrent infective endocarditis (IE) is a major complication of patients surviving a first episode of IE. This study sought to analyse the current state of recurrent IE in a large contemporary cohort.

Methods: 1335 consecutive episodes of IE were recruited prospectively in three tertiary care centres in Spain between 1996 and 2015.

Impact of Valve Culture in the Prognosis of Active Left-sided Infective Endocarditis.

Background: The culture of removed cardiac tissues during cardiac surgery of left-sided infective endocarditis (LSIE) helps to guide antibiotic treatment. Nevertheless, the prognostic information of a positive valve culture has never been explored.

Methods: Among 1078 cases of LSIE consecutively diagnosed in 3 tertiary centers, we selected patients with positive blood cultures who underwent surgery during the active period of infection and in whom surgical biological tissues were cultured (n = 429).

Early surgery for acute-onset infective endocarditis.

Objectives: Acute onset of infective endocarditis has been previously linked to the development of septic shock and a worse prognosis. The purpose of this study was to analyse the clinical features and in-hospital evolution of patients with acute-onset endocarditis as well as the potential role of early surgery in the treatment of these patients.

Methods: From 1996 to 2014, 1053 consecutive patients with left-sided endocarditis were prospectively included.

Risk score for cardiac surgery in active left-sided infective endocarditis.

Objective: To develop and validate a calculator to predict the risk of in-hospital mortality in patients with active infective endocarditis (IE) undergoing cardiac surgery.

Methods: Thousand two hundred and ninety-nine consecutive patients with IE were prospectively recruited (1996-2014) and retrospectively analysed. Left-sided patients who underwent cardiac surgery (n=671) form our study population and were randomised into development (n=424) and validation (n=247) samples.

Therapeutic alternatives after aborted sternotomy at the time of surgical aortic valve replacement in the TAVI Era-Five centre experience and systematic review.

Background: We aimed to analyze causes, management, and outcomes of the unexpected need to abort sternotomy in aortic stenosis (AS) patients accepted for surgical aortic valve replacement (SAVR) in the transcatheter aortic valve implantation (TAVI) era.

Methods: Cases of aborted sternotomy (AbS) were gathered from 5 centers between 2009 and 2014. A systematic review of all published cases in the same period was performed.

Propensity score matched comparison of transcatheter aortic valve implantation versus conventional surgery in intermediate and low risk aortic stenosis patients: A hint of real-world.

Background: Recently, the use of transcatheter aortic valve implantation (TAVI) in inter-mediate-low risk patients has been evaluated in the PARTNER II randomized trial. However, in the last years, this therapy has been employed in this scenario with underreported results, as compared to surgical aortic valve replacement (SAVR).

Methods: We enrolled 362 consecutive patients with severe symptomatic aortic stenosis and intermediate-low surgical risk (logEuroSCORE < 20%), treated in our center with TAVI (103 patients) or single SAVR (259 patients) between 2009 and 2014.

Long-Term Hemodynamic Performance of the Aortic Valve After David I: An Echocardiographic Study.

Despite optimal hemodynamics at rest, the performance of the aortic valve under stress conditions long after David I procedure is still debated. From 2001-2014, 73 patients underwent reimplantation with David I technique. Aortic valve function of 13 patients (age 61.

Midterm follow-up of the reimplantation technique in patients with relatively normal annulus: is David I still a clinically valid option?

Objective: The aim of this study was to evaluate the midterm results of the reimplantation technique with a straight tubular graft in patients with aortic root aneurysms with or without aortic insufficiency.

Methods: From February 2002 to November 2012, 51 consecutive patients underwent the David I valve-sparing aortic procedure for aortic root aneurysm; the mean age was 59.9±12.

Neointimal hyperplasia associated with the use of u-clip.

The U-Clip (Coalescent Surgical, Sunnydale, CA USA) allows the surgeon to create an interrupted anastomosis in the same amount of time that is required for a continuous anastomosis with the elimination of knotting. Its use is indicated especially in minimally invasive surgery. We describe a case of a patient in which the proximal anastomosis was performed by interrupted suture with Coalescent U-Clip anastomotic device.

Combined surgical treatment in aortic type A dissection.

Acute Stanford type A aortic dissection is a fatal event that, for its high mortality when left untreated, requires urgent surgical intervention. The established treatment includes repair of the ascending aorta and various portions of the aortic arch, leaving the descending aorta untreated. We report the case of a 62-year-old man in whom a combined approach of the ascending aorta with surgical correction and transluminal placement of a stent in the aortic arch was performed.