Posterior annulus shortening increases leaflet coaptation in ischemic mitral incompetence: a new and valid technique.

Background: We introduce a technique of posterior annulus shortening to augment leaflet coaptation which addresses the restrictive mitral leaflet mobility in ischemic mitral incompetence (IMI), and report its long-term outcome.

Methods: Between 1992 and 2012, 75 patients (mean age, 64.6±10.

Hemodynamic and energetic aspects of the left ventricle in patients with mitral regurgitation before and after mitral valve surgery.

Background: The role of intracardiac blood flow behavior within the context of manifestation and interventional success in patients with mitral regurgitation is unknown to date. The present study aims to assess left ventricular blood flow behavior characterized by kinetic energy (KE) in patients with mitral regurgitation before and after mitral valve surgery.

Methods: Patients with mitral regurgitation (mean age 56 ± 9 years) and the necessity for mitral valve repair (n = 6) or biological valve replacement (n = 4) received cardiac magnetic resonance before and after surgery and were compared with a group of healthy volunteers (n = 7; mean age 27 ± 7 years).

Further experience with the "no-react" bioprosthesis in patients with active infective endocarditis: 11-year single center results in 402 patients.

Objectives: We investigated early, midterm, and long-term results following valve replacement with the "No-React" bioprosthesis in patients with active infective endocarditis (AIE).Patients and Methods Between February 2000 and February 2011, a total of 402 patients (median 61 years, 17 to 91 years) received "No-React" bioprostheses due to single valve AIE in 315 (aortic valve replacement n = 158, aortic conduit n = 30, mitral valve replacement n = 116, tricuspid valve replacement n = 11) and double valve AIE in 87 cases. Prosthetic AIE was found in 105 patients (26.

Temporary right ventricular mechanical support in high-risk left ventricular assist device recipients versus permanent biventricular or total artificial heart support.

Early planned institution of temporary right ventricular assist device (RVAD) support with the CentriMag (Levitronix LLC, Waltham, MA, USA) in left ventricular assist device (LVAD) recipients was compared with permanent biventricular assist device (BVAD) or total artificial heart (TAH) support. Between 2007 and 2011, 77 patients (age range: 25-70 years) with preoperative evidence of biventricular dysfunction (University of Pennsylvania score >50; University of Michigan score >5) were included. Forty-six patients (38 men; median age 54.

Clinical, haemodynamic and echocardiographic features of early cardiac graft dysfunction.

Background: The main cause of early death after heart transplantation (HTx) is so-called early primary or secondary graft failure (GF). The risk of profound GF has not declined in the past decade, as the consequence of the liberalisation of donor acceptance criteria because of the scarcity of donors. It is therefore important to try to diagnose graft failure and recognise the mechanisms of early graft dysfunction.

Pre-explant stability of unloading-promoted cardiac improvement predicts outcome after weaning from ventricular assist devices.

Background: Detection of cardiac recovery that allows long-term cardiac stability after ventricular assist device (VAD) explantation is a major goal. After normalization of ventricular diameters during unloading, the pre-explant left ventricular ejection fraction (LVEF) allows the detection of patients with the potential to remain stable after VAD explantation. However, some patients with LVEF >45 before VAD explantation show early recurrence of heart failure (HF).

Long-term surgical outcome of mitral valve repair in infants and children with Shone's anomaly.

Objectives: Having assembled information on a large series of patients with Shone's anomaly with the longest follow-up, we studied the operative results and long-term outcome of mitral valve (MV) repair techniques performed to correct the left ventricular inflow tract lesions of this congenital anomaly.

Methods: Between 1986 and 2011, 45 infants and children [mean age 5.16 ± 5.

Simultaneous aortic valve replacement in left ventricular assist device recipients: single-center experience.

Introduction: Aortic valve regurgitation or the presence of a mechanical aortic valve prosthesis is a relative contraindication for implantation of left ventricular assist devices (LVAD). However, concomitant aortic valve replacement by a biological prosthesis is one of the options in this situation. We analyzed our recent experience with left ventricular assist device implantation and concomitant aortic valve replacement.

Prediction of true circulatory decompensation in chronic heart failure for optimal timing of mechanical circulatory support: non-invasive arterial-ventricular coupling.

Background: Prospective comparative studies to predict the risk of hemodynamic deterioration in patients referred for transplantation were performed on the basis of standard invasive and non-invasive data and new wave intensity (WI) parameters.

Methods And Results: Study Group 1 consisted of 151 consecutive outpatients (age 48.7 ± 12 years; 110 men) with end-stage dilative cardiomyopathy.

Surgical reconstruction techniques for mitral valve insufficiency from lesions with restricted leaflet motion in infants and children.

Objectives: We report our 23-year experience with leaflet and annular remodeling techniques in infants and children with congenital mitral valve insufficiency from lesions with restricted leaflet motion (type III).

Methods: A review of the medical records, including follow-up echocardiographic studies of 49 children, aged 20 days to 14 years, was performed. These children were divided into age groups of 0 to <1 year (n = 4; mean age, 3.

Rheumatic mitral valve repair: 22-year clinical results.

Background And Aim Of The Study: Rheumatic mitral valve disease presents a surgical and a medical challenge to surgeons in the developing and developed world. Comprehensive reproducible repair techniques of the anatomic units in individual patients are required to restore the normal mitral valve anatomy and function.

Methods: Between April 1986 and December 2009, a total of 2,211 patients underwent mitral valve repair at the authors' institution.

Combined anterior mitral valve leaflet retention plasty and septal myectomy in patients with hypertrophic obstructive cardiomyopathy.

Objectives: Septal myectomy is the treatment of choice for patients with hypertrophic obstructive cardiomyopathy (HOCM) with significant left-ventricular outflow tract (LVOT) obstruction. In some HOCM patients, however, systolic anterior motion (SAM) of the anterior mitral leaflet significantly contributes to LVOT obstruction, resulting in mitral regurgitation and insufficient release of the obstruction after myectomy. We, therefore, developed a strategy of combined myectomy and anterior leaflet retention plasty (ALRP), and investigated its results in adult HOCM patients with manifest SAM.

Mitral valve growth after posterior annular stabilization with untreated autologous pericardial strip in children with mitral valve insufficiency.

Background: Mitral valve (MV) reconstruction is the technique of choice for MV disease in infants and children. We evaluated whether our technique of posterior annulus stabilization with untreated autologous pericardial strip allows growth of anterior MV leaflet and its annulus.

Methods: Seventeen children (mean age, 9.

Heart failure reversal by ventricular unloading in patients with chronic cardiomyopathy: criteria for weaning from ventricular assist devices.

Aims: Unloading-promoted reversal of heart failure (HF) allows long-term transplant-free outcome after ventricular assist device (VAD) removal. However, because few patients with chronic cardiomyopathy (CCM) were weaned from VADs (the majority only recently), the reliability of criteria used for weaning decisions to predict long-term post-weaning success is barely known. After 15 years of weaning experience, we assessed this issue.

Surgery for active infective mitral valve endocarditis: a 20-year, single-center experience.

Background And Aim Of The Study: A retrospective analysis was conducted of the early and long-term results of mitral valve repair (MVRep) and mitral valve replacement (MVR) in patients with isolated infective mitral valve endocarditis.

Methods: Between May 1986 and December 2007, a total of 1,163 patients with active infective endocarditis (AIE) were operated on. Of these patients, 497 showed an endocarditic involvement of the mitral valve.

Outcomes of elective versus emergent permanent mechanical circulatory support in the elderly: a single-center experience.

Background: Advanced age is considered a relative contraindication to heart transplantation, but there is no published consensus on critical age in the case of mechanical circulatory support (MCS). This single-center study investigated outcomes of elective versus emergent implementation of permanent MCS in the elderly.

Methods: Between January 1, 2006 and April 1, 2009, 31 patients, >65 years of age, were supported with a ventricular assist device (VAD), intended for permanent support, at our institution.

Homograft aortic root replacement in native or prosthetic active infective endocarditis: twenty-year single-center experience.

Objective: We compared early and long-term results of cryopreserved homograft aortic root replacement in native valve endocarditis or prosthetic valve endocarditis associated with periannular abscess.

Methods: Between May 1986 and December 2007, 1163 patients with endocarditis were operated upon. Of these, 221 patients (n = 185 men, median age 55 years) had homograft aortic root replacement due to 99 cases of native valve endocarditis (45%) and 122 of prosthetic valve endocarditis (55%).

Sustained improvement after combined anterior mitral valve leaflet retention plasty and septal myectomy in preventing systolic anterior motion in hypertrophic obstructive cardiomyopathy in children.

Objective: Anatomic alterations of the mitral valve such as increased mitral leaflet area, length and laxity, and anterior displacement of the papillary muscles in hypertrophic obstructive cardiomyopathy predispose patients to residual systolic anterior motion and persistence of outflow obstruction and mitral regurgitation after septal myectomy. We investigate the long-term results of combined anterior mitral leaflet retention plasty and septal myectomy in children with hypertrophic obstructive cardiomyopathy.

Methods And Results: Anterior mitral leaflet retention plasty and subaortic septal myectomy were performed in 12 children (mean age 10.

Predictors of early mortality in patients with active infective native or prosthetic aortic root endocarditis undergoing homograft aortic root replacement.

Purpose: We compared early results of homograft aortic root replacement (ARR) in native (NVE) and prosthetic (PVE) aortic valve endocarditis in order to identify predictors for early mortality (<30 days).

Methods: Between 05/1986 and 12/2007, 1,163 endocarditis patients were operated upon. Of these, 221 patients (n = 185 men, median age 55 years) underwent homograft ARR due to 99 cases of NVE (45%) and 122 of PVE (55%) aortic root endocarditis.

Prediction of cardiac stability after weaning from left ventricular assist devices in patients with idiopathic dilated cardiomyopathy.

Background: During ventricular assist device (VAD) unloading, cardiac recovery is possible even in patients with chronic heart failure (HF). We sought parameters predictive of cardiac stability after VAD removal.

Methods And Results: Among 81 patients weaned since March 1995, a homogenous group of 35 with idiopathic dilated cardiomyopathy weaned from left VADs was selected.

Aortic valve replacement with the Mitroflow pericardial bioprosthesis: durability results up to 21 years.

Objective: The study aim was to analyze the performance profile of a large series of Mitroflow pericardial valves (Sorin Group Canada Inc. Mitroflow Division) in the very long term.

Methods: Data from 1513 patients with isolated aortic valve replacement who received pericardial bioprostheses between 1986 and 2007 were analyzed.

Surgical therapy in patients with active infective endocarditis: seven-year single centre experience in a subgroup of 255 patients treated with the Shelhigh stentless bioprosthesis.

Objective: We investigated outcomes after surgical therapy in patients with active infective endocarditis (AIE) with regard to survival in relation to surgical urgency, valve position, number of valves implanted and abscess formation. We aimed to identify independent risk factors for early mortality.

Methods And Results: Two hundred and fifty-five patients received Shelhigh bioprostheses between February 2000 and March 2007.

Differences in clinical manifestations in patients with bicuspid and tricuspid aortic valves undergoing surgery of the aortic valve and/or ascending aorta.

A bicuspid aortic valve is found in approximately 2 % of the population. The data in the literature concerning the incidence of clinical manifestations are inconsistent, and a detailed comparison with patients with tricuspid aortic valve is not yet available. We analyzed the clinical manifestations and demographic data of patients with bicuspid and tricuspid aortic valves who underwent an operation on the aortic valve and/or the ascending aorta over a five-year period.