Accuracy of VO estimation according to the widely used Krakau formula for the prediction of cardiac output.

Background: Invasive cardiac output (CO) is measured with the thermodilution (TD) or the indirect Fick method (iFM) in right heart catheterization (RHC). The iFM estimates CO using approximation formulas for oxygen consumption ([Formula: see text]O), but there are significant discrepancies (> 20%) between both methods. Although regularly applied, the formula proposed by Krakau has not been validated.

CMR detects extensive intracavitary thrombi as solitary clinical presentation of Antiphospholipid Syndrome: A case report.

Intracavitary thrombi are an important differential diagnosis of cardiac masses. Cardiac magnetic resonance imaging (CMR) allows their non-invasive characterization. This case highlights extensive cardiac thrombi detected by CMR as solitary presentation of antiphospholipid syndrome.

A Skill Trainer for Balloon/Stent Exchange in Percutaneous Coronary Intervention-Concept and Evaluation.

Background: To prevent complications, uncontrolled movement of the guidewire during a coronary intervention should be avoided. Unintentional withdrawal of the wire can result in the inability to recross a lesion with the risk of myocardial infarction. On the other hand, unintended forward pushing can lead to a coronary perforation.

Interventional closure of aortomitral perforation after TAVR: A case report.

Despite TAVR emerging as the gold standard for a broad spectrum of patients, it is associated with serious complications. In this report we present a case, where a TAVR procedure led to a perforation at the aortomitral continuity, discuss the risk factors for the occurrence of perforations and how we decided to treat the patient.

Myocardial Fibrosis Predicts 10-Year Survival in Patients Undergoing Aortic Valve Replacement.

Background Long-term data on evolution and clinical impact of myocardial fibrosis in valvular heart disease are scarce. Methods and Results In this 10 years' extension of a prospective study in patients undergoing conventional aortic valve replacement because of symptomatic severe aortic valve stenosis, the impact of myocardial replacement fibrosis (MRF) on long-term outcome was assessed. Endomyocardial biopsies were acquired during aortic valve replacement in 58 consecutive patients.

"Blind" pericardiocentesis: A comparison of different puncture directions.

Background: "Blind" pericardiocentesis is the standard procedure for emergency pericardial drainage when ultrasound guidance is unavailable. Under these circumstances, puncture site and needle direction are exclusively oriented according to certain anatomic landmarks. In the literature, different techniques for this "blind" method have been described.

Influence of cardiac motion on stent lumen visualization in third generation dual-source CT employing a pulsatile heart model.

Objective: To detect an in-stent restenosis, an invasive coronary angiography is commonly performed. Owing to the risk associated with this procedure, a non-invasive method to detect or exclude an in-stent restenosis is desirable. The purpose of this study was to evaluate the influence of cardiac motion on stent lumen visibility in a third-generation dual-source CT scanner (SOMATOM Force; Siemens Healthcare, Forchheim, Germany), employing a pulsatile heart model (CoroSim; Mecora, Aachen, Germany).

Echocardiographic Determinants of One-Year All-Cause Mortality in Patients With Chronic Heart Failure Complicated by Significant Functional Tricuspid Regurgitation.

Background: Right ventricular (RV) dysfunction plays an important role in chronic heart failure (CHF). We evaluated the echocardiographic determinants of 1-year all-cause mortality in CHF patients with clinically relevant functional tricuspid regurgitation (TR).

Methods And Results: A total of 101 consecutive CHF patients (mean age 74 ± 10 years, 53% male) with moderate or severe functional TR were enrolled.

Systematic Echocardiographic Evaluation of Mitral Valve Regurgitation for Transcatheter Edge-to-Edge Repair.

In patients with relevant mitral regurgitation (MR), transcatheter edge-to-edge repair (also called MitraClip) provides an alternative treatment option especially for inoperable or high-risk patients. In preparation for the procedure, echocardiography is the method of choice for assessment of mitral valve (MV) morphology and function and thus provides important information if successful treatment of MR can be accomplished by MitraClip. This review article provides structured and detailed guidance how to systematically assess functional and degenerative MR and MV pathology by echocardiography in order to select eligible patients for this procedure.

In Vitro Comparison of Second- and Third-generation Dual-source CT for Coronary Stent Visualization at Different Tube Potentials.

Rationale And Objectives: The study aimed to evaluate in vitro stent lumen visibility of coronary stents in a second- and third-generation dual-source computed tomography (CT) system at 100 and 120 kVp tube potential.

Materials And Methods: Twenty-six coronary stents ranging from 2.25 to 4.

Prevalence of severe mitral regurgitation eligible for edge-to-edge mitral valve repair (MitraClip).

Objectives: We assessed the prevalence of moderately severe or severe mitral regurgitation (MR) justifying edge-to-edge mitral valve (MV) repair (MitraClip(®)) in patients attending the University Hospital Wuerzburg, a tertiary care centre located in Wuerzburg, Germany.

Background: Transcatheter edge-to-edge MV repair of advanced MR is a non-surgical treatment option in inoperable and high-risk patients. It is unknown how many patients are potentially eligible for MitraClip(®) since several anatomical prerequisites of the MV apparatus have to be met for optimal treatment results.

Thrombus-in-Transit Following Watchman Device Implantation.

Thrombus-in-transit crossing an interatrial communication is a rare but potentially serious clinical condition, which has so far not been described after implantation of left atrial appendage (LAA) closure devices. Here, we describe the case of a 76-year-old woman with permanent atrial fibrillation and contraindication for oral anticoagulation therapy, who developed pericardial tamponade and acute pulmonary embolism with visible thrombus-in-transit formation following LAA closure. Most likely manipulation of the Watchman device in the LAA during two failed attempts in device positioning led to pericardial tamponade and venous puncture, manual compression after completion of the procedure and further immobilization resulted in deep vein thrombosis with consecutive pulmonary embolism and thrombus-in-transit formation.

Two-dimensional transesophageal echocardiography for aortic annular sizing in patients undergoing transcatheter aortic valve implantation.

Background: Accurate preoperative assessment of the aortic annulus dimension is crucial for successful transcatheter aortic valve implantation (TAVI). In this study we examined the accuracy of a novel method using two-dimensional transesophageal echocardiography (2D-TEE) for measurement of the aortic annulus.

Methods: We evaluated the theoretical impact of the measurement of the annulus diameter and area using the circumcircle of a triangle method on the decision to perform the procedure and choice of the prosthesis size.

Does Simulation-Based Training Improve Procedural Skills of Beginners in Interventional Cardiology?--A Stratified Randomized Study.

Objective: To assess whether mentored simulation-based-training can improve the procedural skills of beginners in coronary interventional procedures.

Background: Simulation based-catheter training is a valuable tool to practice interventional procedures. Whether this type of training enhances the procedural skills of fellows learning percutaneous coronary interventions has never been studied.

Differences in natural history of low- and high-gradient aortic stenosis from nonsevere to severe stage of the disease.

Background: The aim of the present study was to assess and compare the disease progression of aortic stenosis (AS) subtypes from nonsevere to severe disease on the basis of measures of gradient and flow.

Methods: Seventy-seven patients with AS (mean aortic valve area, 1.3 ± 0.

Feasibility of a new method using two-dimensional transesophageal echocardiography for aortic annular sizing in patients undergoing transcatheter aortic valve implantation; a case-control study.

Background: Accurate preoperative assessment of the aortic annulus dimension is crucial for successful transcatheter aortic valve implantation (TAVI). In this study we validated a new method using two-dimensional transesophageal echocardiography (2D-TEE) for measurement of the aortic annulus prior to TAVI.

Methods: We analysed 124 patients who underwent successful TAVI using a self-expandable prosthesis, divided equally into two groups; in the study group we used the cross sectional short axis 2D-TEE for measurement of the aortic annulus and in the control group we used the long axis 2D-TEE.

Next generation coronary CT angiography: in vitro evaluation of 27 coronary stents.

Objectives: To evaluate in-stent lumen visibility of 27 modern and commonly used coronary stents (16 individual stent types, two stents at six different sizes each) utilising a third-generation dual-source CT system.

Methods: Stents were implanted in a plastic tube filled with contrast. Examinations were performed parallel to the system's z-axis for all stents (i.

Using simple imaging markers to predict prognosis in patients with aortic valve stenosis and unacceptable high risk for operation.

Aortic valve stenosis (AS) in patients >75 years of age is a challenge for diagnosis and management of every day clinical routine. Therefore, this clinical follow-up study aims to investigate predictors of death in patients with advanced stages of AS. In a single-center study, all patients (n = 157) with primary conservatively treated severe AS (mean age 78 ± 6 years) were included.

Clinical implication of mitral annular plane systolic excursion for patients with cardiovascular disease.

Mitral annular plane systolic excursion (MAPSE) has been suggested as a parameter for left ventricular (LV) function. This review describes the current clinical application and potential implications of routinely using MAPSE in patients with various cardiovascular diseases. Reduced MAPSE reflects impaired longitudinal function and thus provides complementary information to ejection fraction (EF), which represents the global result of both longitudinal and circumferential contraction.

Five-year results of the Multicenter Randomized Controlled Open-Label Study of the CYPHER Sirolimus-Eluting Stent in the Treatment of Diabetic Patients with De Novo Native Coronary Artery Lesions (SCORPIUS) study: a German multicenter investigation on the effectiveness of sirolimus-eluting stents in diabetic patients.

Background: Because a delayed arterial healing response after drug-eluting stent implantation has raised concerns about safety in diabetic patients, long-term effects of treatment with sirolimus-eluting stent (SES), as compared with bare-metal stent (BMS), have to be established. The aim of the 5-year follow-up of the randomized, controlled, open-label multicenter SCORPIUS study was to assess long-term safety and efficacy of the CYPHER (Cordis, Johnson & Johnson, Bridgewater, NJ) SES in percutaneous coronary intervention of diabetic patients.

Methods: A total of 190 patients with type 2 diabetes mellitus were randomized to receive either a SES (n = 95) or a BMS (n = 95).

Echocardiographic quantification of regional deformation helps to distinguish isolated left ventricular non-compaction from dilated cardiomyopathy.

Aims: Pronounced trabeculation is presented in both left ventricular non-compaction (LVNC) and dilated cardiomyopathy (DCM), which sometimes makes the differentiation difficult. We hypothesized that echocardiographic deformation analysis would help to differentiate these two cardiomyopathies.

Methods And Results: We investigated 15 patients with LVNC (9 males; 42 ± 9 years), 15 age- and gender-matched DCM patients, and 15 healthy controls.

Failure to unmask pseudonormal diastolic function by a valsalva maneuver: tricuspid insufficiency is a major factor.

Background: For the clinical assessment of patients with dyspnea, the inversion of the early (E) and late (A) transmitral flow during Valsalva maneuver (VM) frequently helps to distinguish pseudonormal from normal filling pattern. However, in an important number of patients, VM fails to reveal the change from dominant early mitral flow velocity toward larger late velocity.

Methods And Results: From December 2009 to October 2010, we selected consecutive patients with abnormal filling with (n=25) and without E/A inversion (n=25) during VM.