[TAVI in Germany. What have we learned from current studies?].

Transcatheter aortic valve implantation (TAVI) has become an established treatment for symptomatic aortic valve stenosis in inoperable patients and high-risk patients. In Germany the TAVI procedure has now surpassed the annual numbers of isolated surgical aortic valve replacement with a recent trend towards treatment of intermediate-risk patients; however, before TAVI can also be used in patients with lower surgical risk, studies are required to demonstrate the safety and efficacy of this method for this patient population.

Successful in situ repair of a symptomatic left main coronary artery aneurysm by a saphenous vein graft.

In a male patient, presenting with progressive angina refractory to medical treatment, a solitary aneurysm of the left main coronary artery without fistula, a 2 cm large atrial septal defect (ASD) and a persisting left superior caval vein were diagnosed. Successful resection with subsequent in situ repair by vein grafting of the left anterior descending artery and the circumflex coronary artery system and direct closure of the ASD are described.

[Surgical treatment of pulmonary hypertension].

There are two important options in the surgical treatment of chronic pulmonary hypertension, namely thrombendarterectomy or, if there are no other alternatives, transplantation, which nowadays is almost always double-lung transplantation. Pulmonary thrombendarterectomy is indicated in patients who have a mean pulmonary artery pressure (PAPm) of 40 mm Hg or more, have proximal changes (types I - II) and are in NYHA functional class III - IV. An initial estimate of whether surgical intervention is reasonable can be obtained with spiral computed tomography and pulmonary angiography.

Right ventricular assist device implantation--a new transcutaneous approach.

The necessity for a secondary right heart assist device (RVAD) is a disastrous complication in left ventricular assist device (LVAD) support with respect to both complications and outcome. We have developed a new technique for inflow and outflow cannulation via a transcutaneous cannula in the femoral vein and a prosthesis-supported arterial cannula into the pulmonary artery, which does not necessitate rethoracotomy for device explantation. In addition to the simplified RVAD removal this transcutaneous approach may reduce the complications in patients requiring RVAD support.

Tissue engineering of ovine aortic blood vessel substitutes using applied shear stress and enzymatically derived vascular smooth muscle cells.

Compared to native blood vessels, all clinically available blood vessel substitutes perform suboptimally. Numerous approaches to tissue engineer (TE) blood vessels have been pursued using different scaffold materials, cell types, and culture conditions. Several limitations however remain to be overcome prior to the potential application in the arterial system.

Lung retrieval from non-heart-beating donors: first experience with an innovative preservation strategy in a pig lung transplantation model.

Objective: Lung transplantation is limited by the scarcity of donor organs. Lung retrieval from non-heart-beating donors (NHBD) might extend the donor pool and has been reported recently. However, no studies in NHBD exist using the novel approach of retrograde preservation with Perfadex solution.

Complete dynamic repopulation of decellularized heart valves by application of defined physical signals-an in vitro study.

Objective: Cardiovascular tissue engineering is a novel concept to develop ideal heart valve substitutes. The objective of this study was to use decellularized porcine pulmonary valves, ovine cells and dynamic tissue culture to obtain viable and biomechanically stable constructs, resembling native aortic heart valves.

Methods: Endothelial cells and myofibroblasts were obtained from ovine carotid arteries.

Impact of decellularization of xenogeneic tissue on extracellular matrix integrity for tissue engineering of heart valves.

The multidisciplinary research of tissue engineering utilizes biodegradable or decellularized scaffolds with autologous cell seeding. Objective of this study was to investigate the impact of different decellularization protocols on extracellular matrix integrity of xenogeneic tissue by means of multiphoton femtosecond laser scanning microscopy, biochemical and histological analysis. Pulmonary valves were dissected from porcine hearts and placed in a solution of trypsin-EDTA and incubated at 37 degrees C for either 5, 8, or 24 h, followed by a 24 h PBS washing.

The impact of early postoperative cyclosporine serum levels on the incidence of cardiac allograft rejection.

The introduction of cyclosporine A (CyA) into the immunosuppressive therapy has significantly improved the results of heart transplantation (HTX). Its nephrotoxicity and hepatotoxicity, however, often limit the perioperative and postoperative use of this drug. The purpose of this retrospective study was to evaluate the effect of early postoperative CyA blood levels on the incidence of early as well as late cardiac rejection and patients' survival.