Developmental endothelial locus-1 protects from hypertension-induced cardiovascular remodeling via immunomodulation.

The causative role of inflammation in hypertension-related cardiovascular diseases is evident and calls for development of specific immunomodulatory therapies. We tested the therapeutic efficacy and mechanisms of action of developmental endothelial locus-1 (DEL-1), an endogenous antiinflammatory factor, in angiotensin II- (ANGII-) and deoxycorticosterone acetate-salt-induced (DOCA-salt-induced) cardiovascular organ damage and hypertension. By using mice with endothelial overexpression of DEL-1 (EC-Del1 mice) and performing preventive and interventional studies by injecting recombinant DEL-1 in mice, we showed that DEL-1 improved endothelial function and abrogated aortic adventitial fibrosis, medial thickening, and loss of elastin.

Brillouin confocal microscopy to determine biomechanical properties of SULEEI-treated bovine pericardium for application in cardiac surgery.

Background: Heart valves are exposed to a highly dynamic environment and underlie high tensile and shear forces during opening and closing. Therefore, analysis of mechanical performance of novel heart valve bioprostheses materials, like SULEEI-treated bovine pericardium, is essential and usually carried out by uniaxial tensile tests. Nevertheless, major drawbacks are the unidirectional strain, which does not reflect the in vivo condition and the deformation of the sample material.

Diminished PLK2 Induces Cardiac Fibrosis and Promotes Atrial Fibrillation.

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Optical coherence tomography and multiphoton microscopy offer new options for the quantification of fibrotic aortic valve disease in ApoE mice.

Aortic valve sclerosis is characterized as the thickening of the aortic valve without obstruction of the left ventricular outflow. It has a prevalence of 30% in people over 65 years old. Aortic valve sclerosis represents a cardiovascular risk marker because it may progress to moderate or severe aortic valve stenosis.

Treatment with XAV-939 prevents in vitro calcification of human valvular interstitial cells.

The development of a substance or inhibitor-based treatment strategy for the prevention of aortic valve stenosis is a challenge and a main focus of medical research in this area. One strategy may be to use the tankyrase inhibitor XAV-939, which leads to Axin stabilisation and subsequent destruction of the β-catenin complex and dephosphorylation of β-catenin. The dephosphorylated active form of β-catenin (non-phospho-β-catenin) then promotes nuclear transcription that leads to osteogenesis.

Pushing the limits-further evolutions of transcatheter valve procedures in the mitral position, including valve-in-valve, valve-in-ring, and valve-in-native-ring.

Objective: Transcatheter heart valve (THV) procedures are constantly evolving. We report our experience with valve-in-valve, valve-in-ring, and direct-view valve-in-native-ring implantation in the mitral position.

Methods: Fourteen patients undergoing THV implantation in the mitral position were included.

Heparinized blood better preserves cellular energy charge and vascular functions of intraoperatively stored saphenous vein grafts in comparison to isotonic sodium-chloride-solution.

Objective: Several studies have addressed the optimal storage conditions for vascular grafts during surgery. The results remain contradictionary. This may be attributed to the fact, that the various vascular beds have a different sensitivity to storage.

Protective effect of previous cardiac operation: survival of contained right ventricular rupture.

Although cardiac contusions are common, cardiac rupture is an uncommon sequela of blunt chest trauma. The mortality rate associated with cardiac rupture is very high, and patients usually do not survive long enough to reach the hospital. We report a 66-year-old man with a history of coronary artery bypass grafting 15 years previously, who was involved in a traffic accident and experienced multiple trauma, including a small contained rupture of the right ventricular outflow tract.

Surgery for fulminant prosthetic valve endocarditis after transapical transcatheter aortic valve-in-valve implantation.

We report the clinical course of a patient with a history of transapical aortic "valve-in-valve" transcatheter aortic valve implantation (TAVI), actually suffering from prosthetic valve endocarditis. The patient now underwent cardiac surgery as a salvage procedure. The procedure itself was uneventful, but the patient died several days postoperative due to persisting sepsis.

Isolated aortic valve replacement in patients with small aortic annulus-a high-risk group on long-term follow-up.

Background: Patients with small aortic annulus undergoing isolated aortic valve replacement face an often underestimated surgical risk. We describe initial clinical results and long-term follow-up of this particular high-risk group.

Methods: Between January 1998 and December 2004, 148 consecutive patients with small aortic annulus underwent isolated aortic valve replacement by implantation of a Mitroflow Aortic Pericardial Heart Valve (Sorin S.

Transapical transcatheter valve-in-valve implantation for deteriorated mitral valve bioprostheses.

Background: The transcatheter valve-in-valve concept has been described for patients requiring redo valve surgery. We report our experience with transapical mitral valve-in-valve implantation.

Methods: Since 2008, 301 patients were treated with transapical transcatheter valve implantation.

Composite aortic root replacement for complex prosthetic valve endocarditis: initial clinical results and long-term follow-up of high-risk patients.

Background: Little information is available regarding the clinical and long-term results of patients with complex prosthetic valve endocarditis (PVE) involving the aortic root who undergo root replacement based on the Cabrol or Bentall procedures.

Methods: Between January 2007 and December 2011, 148 patients underwent cardiac operations for PVE. The analysis included 31 patients with complex PVE and concomitant destruction of the aortic root.

Preservation of endothelial vascular function of saphenous vein grafts after long-time storage with a recently developed potassium-chloride and N-acetylhistidine enriched storage solution.

Objectives: Saphenous vein grafts are still commonly used in cardiac, vessel and also in transplant surgery. In cardiac surgery, a desperate graft situation could force to keep nonutilized explanted vein segments after CABG in reserve for case of early graft failure. Historically there were no options for adequate long-time graft storage protecting the endothelial layer with its important antithrombotic and immunosuppressive functional aspects.

Metastasizing primary atrial leiomyosarcoma causing a functional high-grade mitral stenosis.

We report the case of a 43-year-old man who presented with a primary cardiac leiomyosarcoma and multiple metastases. Despite the severely poor prognosis, cardiac surgery was performed as part of a multidisciplinary palliative approach, which paved the way for further chemotherapy and radiation therapy.

Transcatheter valve-in-valve implantation for deteriorated aortic bioprosthesis: initial clinical results and follow-up in a series of high-risk patients.

Background: Transcatheter aortic valve implantation (TAVI) has become a viable alternative in maximum risk patients. For those patients requiring aortic valve re-replacement, the "valve-in-valve" concept has been described. We report our experience with transapical valve-in-valve implantation in 7 patients with deteriorated aortic bioprosthesis at 1-year follow up.

Even short-time storage in physiological saline solution impairs endothelial vascular function of saphenous vein grafts.

Objectives: A faultless endothelial layer is decisive for vascular function and therewith graft's patency. Functional impairment of the endothelium increases risk of graft thrombosis, intimal hyperplasia, and consecutive accelerated graft atherosclerosis. Storage solutions for intra-operatively harvested saphenous vein segments (SVS) might have significant impact on endothelial function.

Left main artery dissection as a clinical sign of the aortic rupture following aortic valve replacement for fulminant aortic endocarditis.

Aortic valve endocarditis with perivalvular abscess formation remains a demanding condition and the results of the surgery are not optimal. Abscess localized in the aortic basis area can weaken the aortic wall, leading to further deterioration and rupture. The presented case allows us to recommend a maximal aggressive approach in patients, in whom the aortic wall seems to be rearranged due to abscess formation.

Aortic valve replacement in noncompaction cardiomyopathy at two-year follow-up.

We report a male patient suffering left ventricular noncompaction cardiomyopathy in combination with low-gradient aortic stenosis. Preoperative echocardiography and magnetic resonance imaging revealed the diagnosis. After aortic valve replacement, the clinical course was uneventful.

Microwave ablation of permanent atrial fibrillation during isolated bypass grafting and isolated mitral valve surgery.

Background: This study was designed to compare the rate of restoration to sinus rhythm in patients with permanent atrial fibrillation (pAF) undergoing endocardial microwave ablation during isolated coronary artery bypass grafting (CABG) or isolated mitral valve surgery.

Methods: A total of 42 patients who underwent isolated CABG (age, 70.1 +/- 5.

Charles Bonnet Syndrome: successful treatment of visual hallucinations due to vision loss with selective serotonin reuptake inhibitors.

Visual hallucinations are a common and often distressing consequence of vision loss, particularly in age-related macular degeneration. Charles Bonnet Syndrome (CBS) is defined by the triad of complex visual hallucinations, ocular pathology causing visual deterioration and preserved cognitive status. So far, although this condition is frequent, no established treatment for CBS has been stated.

Asymptomatic statin-induced rhabdomyolysis after long-term therapy with the hydrophilic drug pravastatin.

Case Summary: A male patient aged 73 years, 165 cm in height, and weighing 78 kg presented to the emergency department with dsypnea. He had undergone heart transplantation 7 years earlier and been receiving daily pravastatin therapy for >3 years without complaining of any symptoms. A physical examination of the patient at admission was unremarkable, except for dyspnea.

Entrapped coronary catheter remnants and stents: must they be surgically removed?

Entrapment of catheter components during cardiologic interventions is rare but can cause life-threatening complications and the need for emergency cardiac surgery. We report our surgical series of patients who have experienced entrapped guidewires, Rotablator Systems, and stents after cardiologic interventions. Nine patients were referred for emergency surgery after entrapment of catheter remnants and ensuing acute ischemia.

Intraoperative endocardial microwave ablation for treatment of permanent atrial fibrillation during coronary artery bypass surgery: 1-year follow-up.

Aims: Operative treatment of atrial fibrillation was initially performed as a maze operation in combination with mitral valve surgery or as a stand-alone procedure. The introduction of simplified ablation procedures led to the extension of operative atrial fibrillation treatment.

Methods And Results: In 102 consecutive patients, endocardial microwave ablation was performed during coronary artery bypass surgery alone (n = 42) or in combination with valve surgery (n = 60).

Native infective endocarditis: which determinants of outcome remain after surgical treatment?

Surgical therapy of native infective endocarditis is still considered as a particular challenge, due to remaining morbidity and mortality up to 20%. Further risk analysis and characterization of clinical features is of great importance for further improvement of surgical results. The aim of this retrospective study was a risk analysis concerning clinical features of the pre-, intra- and postoperative period.