Publications by authors named "Torsten Doenst"

Objectives: There is an ongoing debate whether percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) is the better choice for treatment of left main (LM) stenosis. We aimed to provide external validation for the recently reviewed guideline recommendations for invasive LM therapy by evaluating the impact of CABG or PCI on long-term survival from local reports of different regions in the world. We performed a systematic review and meta-analysis to address contemporary registry studies comparing PCI and CABG for patients with LM stenosis.

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The administration of crushed or chewed P2Y12 inhibitors (P2Y12i) allows faster platelet inhibition in patients presenting acute coronary syndrome (ACS). Whether this administration approach is safe needs further analysis. We performed a systematic review and meta-analysis of randomized controlled trials (RCTs) comparing chewed/crushed to integral P2Y12i administration in patients with ACS.

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  • The study evaluates the accuracy of the modified Duke criteria for diagnosing infective endocarditis (IE), a serious condition that needs quick diagnosis and treatment.
  • Over 11 studies were analyzed, showing an overall sensitivity of 85% and specificity of 98%, indicating the criteria are effective in confirming IE.
  • The findings highlight a strong positive likelihood ratio, suggesting that a positive result from the modified Duke criteria strongly indicates the presence of IE, which is crucial for avoiding unnecessary treatments.
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  • * It found that 269 patients (3.1%) had C. acnes endocarditis, primarily affecting younger individuals with native valves, while prosthetic valve cases were more frequent in older age groups.
  • * Although survival rates were better for native valve cases, the incidence of C. acnes endocarditis is concerning and requires specialized diagnostic methods, but surgical outcomes were generally acceptable.
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  • CCTA is a noninvasive method for diagnosing coronary artery disease (CAD) and may guide surgical decisions, particularly before valve surgery.
  • * A meta-analysis was conducted using data from 5 studies involving 6,654 patients to compare outcomes between patients receiving ICA and CCTA.
  • * The analysis found no significant differences in perioperative mortality or secondary outcomes like AKI, MI, or stroke, suggesting that CCTA is a safe alternative to ICA.
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  • Coronary artery disease (CAD) reduces life expectancy, especially in older adults, with myocardial infarctions being a leading cause of death in people over 70.
  • A study analyzed data from 4,045 elderly patients (>70 years) who underwent coronary artery bypass grafting (CABG) to assess its impact on long-term survival compared to the general age-matched population.
  • Results showed that CABG significantly lowers the risk of death in elderly patients, suggesting that the surgery effectively prolongs life by mitigating the risks associated with CAD, particularly after the first year post-surgery.
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Ageing is a major risk factor that contributes to increased mortality and morbidity rates during influenza A virus (IAV) infections. Macrophages are crucial players in the defense against viral infections and display impaired function during ageing. However, the impact of ageing on macrophage function in response to an IAV infection remains unclear and offers potential insight for underlying mechanisms.

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  • TAVI (Transcatheter Aortic Valve Implantation) generally results in lower rates of postoperative delirium compared to SAVR (Surgical Aortic Valve Replacement), as shown in a study of 12,015 patients.
  • No significant differences in secondary outcomes like 30-day mortality, stroke, or hospital stay were found between the two procedures.
  • More research is needed to evaluate the long-term effects of postoperative delirium on patient outcomes.
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  • Cardiac implantable electronic devices (CIEDs) help treat heart disease, but they can lead to serious infections.
  • The number of CIED patients and the rates of infections, including endocarditis, are on the rise due to potential contamination during implantation or secondary infections.
  • Current guidelines don't recommend preventative antibiotics for CIED patients before dental or invasive procedures unless they have specific risk factors, and any patient showing signs of infection should be treated in specialized centers.
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  • - New-onset postoperative atrial fibrillation (POAF) is common after cardiac surgery, particularly coronary artery bypass grafting (CABG), with an estimated incidence of about 30%, but it’s often temporary and under-detected.
  • - Previous studies on POAF have used intermittent monitoring techniques that may miss many cases, leading to inaccurate assessments of how often arrhythmias occur post-surgery.
  • - The CABG-AF study aims to get a clearer picture of AF incidence and patterns after CABG by using continuous monitoring with an insertable cardiac device in 196 patients, tracking episodes over a planned follow-up of three years.
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Background: Liver dysfunction is a known risk factor in the cardiovascular field. It specifically increases perioperative risk in patients undergoing coronary bypass surgery. Since percutaneous coronary intervention (PCI) is the much less invasive procedure for the treatment of coronary artery disease, we aimed to assess the relationship of liver dysfunction with outcomes in patients undergoing PCI.

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This study aimed to conduct a systematic review and meta-analysis comparing video-assisted thoracoscopic surgery (VATS) and open thoracotomy (OT) in the context of pulmonary metastasectomy. Three databases were assessed. The primary outcome was overall survival.

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: Aortic valve infective endocarditis (AV-IE) and mitral valve infective endocarditis (MV-IE) are often grouped together as one entity: left-sided endocarditis. However, there are significant differences between the valves in terms of anatomy, physiology, pressure, and calcification tendency. This study aimed to compare AV-IE and MV-IE in terms of patient characteristics, pathogen profiles, postoperative outcomes, and predictors of mortality.

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  • Aortic regurgitation (AR) can develop in about one-third of LVAD patients over three years, potentially leading to heart failure.
  • The study followed 68 patients who had mild or no AR during HeartMate 3 implantation, with findings showing stable aortic root dimensions despite some patients developing AR.
  • Patient survival rates over five years were 71%, indicating that the development of AR did not significantly impact overall survival.
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The degree of both mitral (MR) and tricuspid valve regurgitation (TR) correlates with mortality. A vicious cycle has been proposed consisting of increasing regurgitation and decreasing ventricular function. Restoration of valve competence should break this vicious cycle and improve life expectancy.

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Recent randomized evidence has shown that low-dose colchicine lowers the risk of cardiovascular events in patients with chronic coronary artery disease. Colchicine has also been used in coronary artery bypass grafting (CABG), with individual studies suggesting protective effects for postoperative atrial fibrillation (POAF). We performed a meta-analysis of studies assessing the effect of colchicine on outcomes in CABG surgery.

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Background: We aimed to assess the impact of complex mitral valve disease and patient risk profile on operative outcomes in the large cohort of the Mini-Mitral International Registry.

Methods: Patients were assigned to categories of complex degenerative mitral valve regurgitation (DMR; bileaflet or anterior mitral leaflet prolapse/flail) and simple DMR (posterior mitral leaflet prolapse/flail). Subgroup analyses was performed in low-risk (EuroSCORE II <8%) and high-risk (EuroSCORE II >8%) cohorts.

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  • A study in Germany compared two treatments for heart failure patients with secondary mitral regurgitation: transcatheter edge-to-edge repair and surgical mitral-valve repair or replacement.
  • The trial involved 210 patients and assessed outcomes like death, hospitalizations, and major adverse events, finding that transcatheter repair had similar efficacy but significantly fewer safety issues than surgery.
  • Results showed that transcatheter edge-to-edge repair was noninferior to the surgical approach, indicating it might be a safer alternative for this patient group.
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The demographic shift towards an aging population necessitates a reevaluation of surgical interventions like coronary artery bypass grafting (CABG) in octogenarians. This study aims to elucidate the outcomes of CABG in octogenarians with heart failure and reduced ejection fraction (HFrEF), a group traditionally considered at high risk for such procedures. Conducted across four academic hospitals in Germany from 2017 to 2023, this retrospective multicenter study assessed 100 patients (50 octogenarians ≥80 years and 50 non-octogenarians <80 years) with HFrEF undergoing isolated CABG.

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Objectives: This study aimed to analyse the impact of preoperative septic cerebral embolism on early and late postoperative outcomes in patients with infective endocarditis undergoing valve surgery.

Methods: Retrospective multicentric study based on the Clinical Multicentric Project for Analysis of Infective Endocarditis in Germany (CAMPAIGN) registry comprising patients with infective endocarditis who underwent valve surgery between 1994 and 2018 at 6 German centres. Patients were divided into 2 groups for statistical comparison according to the presence or absence of preoperative septic cerebral embolism.

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Cardiomyocytes depend on mitochondrial oxidative phosphorylation (OXPHOS) for energy metabolism, which is facilitated by the mitochondrial electron transfer system (ETS). In a series of thermogenic redox reactions, electrons are shuttled through the ETS to oxygen as the final electron acceptor. This electron transfer is coupled to proton translocation across the inner mitochondrial membrane, which itself is the main driving force for ATP production.

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