Low-dose oral anticoagulation in patients with mechanical heart valve prostheses: final report from the early self-management anticoagulation trial II.

Aims: In mechanical heart valve recipients, low-dose international normalized ratio (INR) self-management of oral anticoagulants can reduce the risk of developing thrombo-embolic events and improve long-term survival compared with INR control by a general practitioner. Here, we present data on the safety of low-dose INR self-management.

Methods And Results: In a prospective, randomized multi-centre trial, 1346 patients with a target INR range of 2.

Implantation of CardioWest total artificial heart for irreversible acute myocardial infarction shock.

Patients who develop cardiogenic shock after acute myocardial infarction have a very high mortality rate despite early reperfusion therapy. Hemodynamic stabilization can often only be achieved by implanting a mechanical circulatory support system. When, in cases representing expansive myocardial impairment without any chance of recovery, pharmacological therapy and the use of percutaneous assist devices have failed, the implantation of a total artificial heart is indicated.

Comparison of Portapres non-invasive blood pressure measurement in the finger with intra-aortic pressure measurement during incremental bicycle exercise.

Background And Design: In order to evaluate the accuracy of continuous, non-invasive blood pressure measurements in the finger during stress, blood pressure was measured in six patients with a Portapres Model 2 during increasing levels of bicycle exercise, using simultaneously registered intra-aortic (aortic arch) pressure as a reference.

Methods: Blood pressure was measured continuously and non-invasively in the left middle finger using the Portapres Model 2 device, at the same time invasively using a pigtail catheter situated in the aortic arch at rest and during and after standardized bicycle exercise. At the end of each stress level, in accordance with the protocol of the Association for the Advancement of Medical Instrumentation, systolic and diastolic blood pressure and pulse values were determined from the non-invasive (Portapres Model 2) and invasive measurements for 15 s each, and the mean values and standard deviations were calculated.

Is myocardial Na+/Ca2+ exchanger transcription a marker for different stages of myocardial dysfunction? Quantitative polymerase chain reaction of the messenger RNA in endomyocardial biopsies of patients with heart failure.

Objectives: This study was designed to determine the stage of myocardial dysfunction at which an upregulation of the Na+/Ca2+ exchanger (EXCH) transcription takes place.

Background: Because EXCH is an important regulator of intracellular calcium homeostasis, alterations in EXCH expression may occur before the onset of end-stage heart failure (HF) to maintain normal intracellular Ca2+ concentrations. We analyzed whether the EXCH transcription level is correlated to the degree of myocardial dysfunction and whether it can be a suitable molecular marker to define the transition to myocardial decompensation early on.

Validation of the Omron F3 blood pressure measuring device for use in the finger through simultaneous invasive comparative measurements according to the German Institute for Validation (DIN) 58130 protocol.

Objectives And Design: Simultaneous invasive comparative measurements in order to validate the blood pressure measuring device Omron F3 for use in the finger, in accordance with the German Institute for Validation (DIN) 58130 protocol.

Methods: A total of five consecutive simultaneous blood pressure comparative measurements were carried out in each of 15 patients (n = 75). Blood pressure was measured in the left index finger using the blood pressure measuring device Omron F3, and at the same time invasively using a pigtail catheter situated in the aortic arch.

Improvement of coronary vasodilatation capacity through single LDL apheresis.

A concomitant phenomenon of hypercholesterolemia is reduced coronary vasodilatation capacity due to disturbed endothelial function. Endothelial function can be partially or completely normalized by reducing cholesterol levels through drug therapy, but it is still unclear how rapidly this desired effect is achieved. An interval of between weeks and months has been presumed.

Percutaneous transluminal septal myocardial ablation in hypertrophic obstructive cardiomyopathy: acute results and 3-month follow-up in 25 patients.

Objectives: We report the acute results and midterm clinical course after percutaneous transluminal septal myocardial ablation (PTSMA) in symptomatic patients with hypertrophic obstructive cardiomyopathy (HOCM).

Background: In the treatment of HOCM, surgical myectomy and DDD pacemaker therapy are considered the standard procedural extensions to drug therapy with negatively inotropic drugs. As an alternative nonsurgical procedure for reducing the left ventricular outflow tract (LVOT) gradient, PTSMA by alcohol-induced septal branch occlusion was introduced.

Validation of the OMRON R3 blood pressure self-measuring device through simultaneous comparative invasive measurements according to protocol 58130 of the German Institute for Validation.

OBJECTIVES: To perform simultaneous invasive comparative measurements in order to validate the blood pressure self-measuring device OMRON R3 for use on the wrist, in accordance with protocol 58130 of the German Institute for Validation. METHODS: Five consecutive comparative blood pressure measurements were carried out for each of 15 patients (n = 75 measurements). The blood pressure was measured simultaneously non-invasively using the blood pressure self-measuring device OMRON R3 around the left wrist and at the same time invasively using a pigtail catheter situated in the aortic arch.

Extended donor criteria: use of cardiac allografts after carbon monoxide poisoning.

Background: An increasing demand for cardiac allografts for the treatment of end-stage cardiac failure has led to a shift in the traditional views about donor criteria. The use of allografts exposed to high concentrations of carbon monoxide is still under discussion. The current literature on this topic is contradictory.

Therapy for acute vascular complications in percutaneous transluminal coronary angioplasty with the autoperfusion balloon catheter.

Prolonged dilatation with an autoperfusion balloon catheter (APBC) (High-Flow-CPC-Mainz (Schneider) in 23 cases and Stack Perfusion (ACS) in 50 cases) was carried out in 73 patients (60 men, 13 women, mean age 59.3 +/- 8.8 years) with acute vascular complications occurring during PTCA (25 occlusive dissections (34%), five thrombotic occlusions (7%), 42 non-occlusive dissections (58%) and one non-occlusive thrombus with reduction of flow (1%)) in order to avoid stent implantation or emergency bypass surgery.