Non-immune factors cause prolonged myofibroblast phenotype in implanted synthetic heart valve scaffolds.

The clinical application of heart valve scaffolds is hindered by complications associated with the activation of valvular interstitial cell-like (VIC-like) cells and their transdifferentiation into myofibroblasts. This study aimed to examine several molecular pathway(s) that may trigger the overactive myofibroblast phenotypes in the implanted scaffolds. So, we investigated the influence of three molecular pathways - macrophage-induced inflammation, the TGF-β1-SMAD2, and WNT/β-catenin β on VIC-like cells during tissue engineering of heart valve scaffolds.

ADAR1 Non-Editing Function in Macrophage Activation and Abdominal Aortic Aneurysm.

Background: Macrophage activation plays a critical role in abdominal aortic aneurysm (AAA) development. However, molecular mechanisms controlling macrophage activation and vascular inflammation in AAA remain largely unknown. The objective of the study was to identify novel mechanisms underlying adenosine deaminase acting on RNA (ADAR1) function in macrophage activation and AAA formation.

Minimally Invasive Bicuspid Aortic Valve Repair Using Geometric Ring Annuloplasty.

A 51-year-old man with congestive heart failure, Sievers type 1 bicuspid aortic valve, and severe aortic insufficiency had an upper mini-sternotomy. The annulus was sized to 27 mm, and the nonfused cusp to a 21-mm bicuspid ring. Using the geometric annuloplasty ring, two 180° subcommissural ring post sutures, 3 nonfused looping annular sutures, and 4 fused annular sutures were placed.

Robotic mitral valve operations by experienced surgeons are cost-neutral and durable at 1 year.

Background: Robotic mitral valve surgery has potential advantages in patient satisfaction and 30-day outcome. Cost concerns and repair durability limit wider adoption of robotic technology. This study examined detailed cost differences between robotic and sternotomy techniques in relation to outcomes and durability following robotic mitral program initiation.

Oral anticoagulation may not be necessary for patients discharged in sinus rhythm after the Cox Maze IV procedure.

Objectives: Oral anticoagulants have inherent risks. In the absence of clear evidence, anticoagulant use after surgical ablation for atrial fibrillation remains variable. This study examined patient outcomes with and without oral anticoagulants after successful surgical ablation.

Experience With Pericardiectomy for Constrictive Pericarditis Over Eight Decades.

Background: The purpose of this study was to review the surgical outcomes of pericardiectomy for constrictive pericarditis and to examine risk factors for overall mortality in a contemporary period.

Methods: We reviewed all patients who underwent pericardiectomy for constriction from 1936 through 2013. The investigation included constrictive pericarditis cases confirmed intraoperatively, all other types of pericarditis were excluded; 1,071 pericardiectomies were performed in 1,066 individual patients.

Concomitant Valve-in-Valve Transcatheter Aortic Valve Replacement and Left Ventricular Assist Device Implantation.

Redo aortic valve replacement (AVR) performed simultaneously with left ventricular assist device (LVAD) implantation carries potential for increased mortality rates. Although transcatheter AVR has been used for patients with previous LVAD placement, no literature reports concomitant valve-in-valve transcatheter AVR and LVAD implantation. Our patient had severe aortic prosthetic valve deterioration and advanced heart failure.

Robotic mitral repair with sliding leaflet valvuloplasty and remodelling partial annuloplasty.

Complex pathoanatomy that requires posterior leaflet height reduction can be accomplished robotically with excellent surgical outcomes. We report the technique of robotic sliding leaflet valvuloplasty in cases of severe myxomatous degenerative disease with elevated predictive risk of systolic anterior motion.

Impact of Left Ventricular Systolic Function on Outcome of Correction of Chronic Severe Aortic Valve Regurgitation: Implications for Timing of Surgical Intervention.

Background: The timing of valve repair or replacement in patients with severe aortic valve regurgitation (AR) is controversial. We investigated the effect of left ventricular (LV) function on survival and recovery of LV performance and dimensions after correction of chronic severe AR.

Methods: We reviewed 530 consecutive patients who underwent aortic valve repair or replacement for severe AR between January 1, 2004, and June 30, 2014.

Clinical Outcomes After Transapical and Transfemoral Transcatheter Aortic Valve Insertion: An Evolving Experience.

Background: Prior publications note increased adverse events after transapical compared with transfemoral access transcatheter aortic valve insertion (TAVI). We reviewed our TAVI experience to understand the differences in baseline patient characteristics and outcomes associated with the two access methods.

Methods: The records were reviewed of 567 patients who underwent transfemoral (n = 351, 61.

Intraoperative Electroencephalogram-Guided Deep Hypothermia Plus Antegrade and/or Retrograde Cerebral Perfusion During Aortic Arch Surgery.

Background: A number of intraoperative tools are used for brain monitoring in aortic arch surgery. We rely on intraoperative electroencephalogram (EEG) to guide deep hypothermic circulatory arrest.

Methods: Between July 2012 and June 2014, 157 patients underwent aortic arch surgery with deep hypothermic circulatory arrest performed by a single surgeon.

Sapien XT Transcatheter Mitral Valve Replacement Under Direct Vision in the Setting of Significant Mitral Annular Calcification.

Mitral valve replacement carries a high risk in patients with extensive mitral annular calcification. We report the case of a 71-year-old woman with severely calcified mitral valve stenosis and extensive annular calcification. We approached the mitral valve through a left atriotomy using cardiopulmonary bypass and cardiac arrest.

Mitral valve gradient after valve repair of degenerative regurgitation with restrictive annuloplasty.

Backgrounds: Outcomes of mitral valve repair have been well described for patients with degenerative regurgitation. The hemodynamic effects of repair have not been as well studied, however. We report hemodynamic outcomes in these patients.

Does the number of redo mitral valve replacements for structural valve deterioration affect early and late outcomes?: experience from 114 reoperative cases.

Background And Aim Of The Study: Whether the number of reoperative mitral valve replacements (MVRs) for structural valve deterioration (SVD) affects early or late survival is unclear. Hence, the aim of the present study was to investigate this issue.

Methods: A total of 114 consecutive patients (84 females, 30 males; mean age 63.

Late outcome of tricuspid annuloplasty using a flexible band/ring for functional tricuspid regurgitation.

Background: We assessed late outcome after tricuspid annuloplasty (TAP) using a flexible band or ring for functional tricuspid regurgitation (FTR).

Methods And Results: We reviewed 220 consecutive patients (mean age, 65.4±11.

Technical modifications in the repair of acute ischemic posterior ventricular septal defect without ventriculotomy.

Objective: Transventricular repair for acute ischemic posterior ventricular septal defect is challenging and is associated with high operative morbidity and mortality. We have adopted the alternative technique of transatrial repair and recently have added technical modifications that result in less residual or recurrent septal shunt. This study reports those modifications and the related outcomes.

The number of valves requiring surgery does not affect early and late survival in redo valvular surgery.

Objectives: The purpose of this study was to determine whether the number of operated valves affects early and late outcomes in redo valvular surgery.

Methods: We analysed 328 consecutive patients who underwent a total of 431 redo valvular surgeries from January 1990 to December 2010. The mean age was 61.

Persistent tricuspid regurgitation after tricuspid annuloplasty during redo valve surgery affects late survival and valve-related events.

Background: Long-term survival and incidence of late tricuspid regurgitation (TR) were studied in patients who underwent tricuspid annuloplasty (TAP) during redo valve surgery. METHODS AND RESULTS: We retrospectively analyzed 125 patients (mean age, 64.5±10.