Durability Testing With Calcification of Surgical Aortic Valves and Transcatheter Heart Valves: An In Vitro Study.

Objectives: Structural valve deterioration, mainly caused by calcification, is the Achilles heel of the bioprosthetic heart valves. While clinical long-term experience of surgical aortic valve (SAV) bioprostheses exists, transcatheter heart valve (THV) requires further investigations into biological degeneration. Therefore, this in vitro study aimed to analyse the calcification pattern of different SAV and THV models under standardized conditions.

Short- and Long-Term Outcomes After Transcatheter or Surgical Aortic Valve Replacement in Patients With Chronic Lung Disease: An Analysis From the German Aortic Valve Registry.

Objectives: Data from the German Aortic Valve Registry (GARY) were analysed to determine whether there are differences between patients with and without chronic lung disease (CLD) undergoing transcatheter aortic valve implantation (TAVI) and surgical aortic valve replacement (SAVR) and whether TAVI or SAVR is more beneficial in patients with preexisting CLD.

Methods: Follow-up data from GARY registry patients treated from 2014 to 2015 and from 2018 to 2019 were incorporated in the analysis. Demographic results for each of the 2 treatment modalities were evaluated, and patients with and without CLD were compared.

Intravascular Lipoleiomyoma With Expansion Into the Right Atrium and Subsequent Debulking Surgery.

Backround: Lipoleiomyomas are rare, benign tumors combining smooth muscle and adipose tissue, most commonly found in the uterus.

Case Summary: A 61-year-old woman with a history of surgical treatment of uterine leiomyoma presented with syncopal episodes. Echocardiography revealed masses in the right atrium that led to urgent partial resection of a 10-cm tumor originating from the iliac veins.

Summary of the International Society for Heart and Lung Transplantation consensus conference on emerging understanding of antibodies and antibody-mediated rejection in heart transplantation.

The understanding of circulating antibodies and their relationship to antibody-mediated rejection (AMR) has yet to be fully elucidated in heart transplantation. Circulating antibodies are important in both pretransplant and post-transplant. In the pretransplant period, the more antibodies detected in a patient awaiting heart transplantation often significantly reduces the chance of obtaining a compatible donor heart.

[Surgical closure of the left atrial appendage for thromboembolism prophylaxis].

Background: The left atrial appendage (LAA) is the origin of thrombi in patients with atrial fibrillation (AF). Various techniques are available for surgical LAA occlusion. Current guidelines recommend surgical LAA closure as concomitant procedure in patients undergoing cardiac surgery or endoscopic or hybrid ablation for AF.

[Implantable cardioverter-defibrillators in patients with left ventricular assist devices : Current controversies].

Background: Left ventricular assist devices (LVAD) are used to treat patients with advanced heart failure. A significant fraction of these patients simultaneously fulfill the indication for an implantable cardioverter-defibrillator (ICD).

Objectives: It is currently unclear whether patients require an ICD after LVAD implantation.

Valve-sparing aortic root replacement: Strategies to avoid residual aortic regurgitation.

Objective: The study objective was to identify quantitative criteria to avoid residual aortic valve regurgitation after valve-sparing aortic root replacement.

Methods: Between 2016 and 2023, 738 adult patients were recruited into the German Aortic Root Repair Registry. A total of 562 patients with datasets on aortic root measurements and tricuspid valve treated with reimplantation valve-sparing aortic root replacement were selected.

Comprehensive assessment of aortic flow before and after aortic valve replacement in an ex vivo porcine model with four-dimensional flow magnetic resonance imaging.

Objectives: Aortic valve replacement (AVR) has shown to induce secondary flow patterns deviating from main flow. It is impossible to analyse the impact of surgical access and different AVR techniques under standardized conditions in patients or silicone models. Therefore, we developed an ex vivo swine model to analyse the impact of surgical access and to compare flow patterns after different AVR techniques within the ascending aorta.

Valve-sparing aortic root replacement for valves with paracommissural fenestrations: which valve will fail?

Objectives: To define morphologic risk constellations during valve-sparing aortic root replacement (VSARR) for aortic valves with paracommissural fenestrations.

Methods: Patients from the multicentre prospective intention-to-treat VSARR-registry German Aortic Root Repair Registry (GEARR) were screened for paracommissural cusp fenestrations. We studied a combined end-point of residual aortic regurgitation (rAR) on post-cardiopulmonary bypass (CPB) transesophageal echocardiography (TEE), mid-term progress of rAR (transthoracic echocardiography) and aortic valve replacement for AR.

Engineered heart muscle allografts for heart repair in primates and humans.

Cardiomyocytes can be implanted to remuscularize the failing heart. Challenges include sufficient cardiomyocyte retention for a sustainable therapeutic impact without intolerable side effects, such as arrhythmia and tumour growth. We investigated the hypothesis that epicardial engineered heart muscle (EHM) allografts from induced pluripotent stem cell-derived cardiomyocytes and stromal cells structurally and functionally remuscularize the chronically failing heart without limiting side effects in rhesus macaques.

European Society of Organ Transplantation (ESOT) Consensus Statement on Machine Perfusion in Cardiothoracic Transplant.

The machine perfusion (MP) of transplantable grafts has emerged as an upcoming field in Cardiothoracic (CT) transplantation during the last decade. This technology carries the potential to assess, preserve, and even recondition thoracic grafts before transplantation, so it is a possible game-changer in the field. This technology field has reached a critical turning point, with a growing number of publications coming predominantly from a few leading institutions, but still need solid scientific evidence.

Comparison of Two Generations of Self-Expandable Transcatheter Heart Valves in Nine Surgical Valves: An In Vitro Study.

(1) Background: This study aimed to analyse the hydrodynamic performance of two generations of self-expanding transcatheter heart valves (THV) as a valve-in-valve (ViV) in different surgical aortic valve (SAV) models under standardised conditions. The nitinol-based Evolut R valve is frequently used in ViV procedures. It is unclear whether its successor, the Evolut PRO, is superior in ViV procedures, particularly considering the previously implanted SAV model.

Characteristic calcification behavior of five surgical aortic valve bioprostheses models: An in vitro study.

Background And Aims: The durability of surgical aortic valve bioprostheses (SAV) is limited by the calcification of the leaflets, which results in degeneration. In clinical routine, there seems to be substantial variability in the degeneration of specific SAV models. Our study aims to establish an in vitro calcification model for prosthetic valves, characterizing the calcification behavior of different SAVs.

International Society for Heart and Lung Transplantation Guidelines for the Evaluation and Care of Cardiac Transplant Candidates-2024.

The "International Society for Heart and Lung Transplantation Guidelines for the Evaluation and Care of Cardiac Transplant Candidates-2024" updates and replaces the "Listing Criteria for Heart Transplantation: International Society for Heart and Lung Transplantation Guidelines for the Care of Cardiac Transplant Candidates-2006" and the "2016 International Society for Heart Lung Transplantation Listing Criteria for Heart Transplantation: A 10-year Update." The document aims to provide tools to help integrate the numerous variables involved in evaluating patients for transplantation, emphasizing updating the collaborative treatment while waiting for a transplant. There have been significant practice-changing developments in the care of heart transplant recipients since the publication of the International Society for Heart and Lung Transplantation (ISHLT) guidelines in 2006 and the 10-year update in 2016.

European Society for Organ Transplantation (ESOT) Consensus Statement on the Use of Non-invasive Biomarkers for Cardiothoracic Transplant Rejection Surveillance.

While allograft rejection (AR) continues to threaten the success of cardiothoracic transplantation, lack of accurate and repeatable surveillance tools to diagnose AR is a major unmet need in the clinical management of cardiothoracic transplant recipients. Endomyocardial biopsy (EMB) and transbronchial biopsy (TBBx) have been the cornerstone of rejection monitoring since the field's incipience, but both suffer from significant limitations, including poor concordance of biopsy interpretation among pathologists. In recent years, novel molecular tools for AR monitoring have emerged and their performance characteristics have been evaluated in multiple studies.

Impact of Different Valve-in-Valve Positions on Functional Results of the New Generation of Balloon-Expandable Transcatheter Heart Valve.

Objectives: Very precise positioning of the transcatheter heart valve (THV) inside the degenerated SAV is a crucial factor for valve-in-valve (ViV) procedure to achieve optimal hemodynamic results. Therefore, our study aimed to investigate the impact of implantation depth on functional results after ViV procedures in a standardized in vitro setting.

Methods: THV (SAPIEN 3 Ultra 23-mm size) and three SAV models (Magna Ease, Trifecta, and Hancock II-all 21-mm size) were tested at different circulatory conditions in five different positions of the THV (2-6 mm) inside the SAV.

Identification of a functional missense variant in the matrix metallopeptidase 10 (MMP10) gene in two families with premature myocardial infarction.

A positive family history is a major independent risk factor for atherosclerosis, and genetic variation is an important aspect of cardiovascular disease research. We identified a heterozygous missense variant p.L245P in the MMP10 gene in two families with premature myocardial infarction using whole-exome sequencing.

Ex vivo evaluation of 3 different right ventricular outflow tract substitutes.

Objectives: The Ross procedure represents an excellent treatment option in younger patients with aortic stenosis but is limited by poor availability of homografts. In this study, we investigated the hydrodynamic performance of 3 different types of right ventricular outflow tract replacement with pericardium or synthetic material.

Methods: Three different types of valved conduits were constructed using pericardium and/or synthetic material (Group PEPE: pericardial cusps and pericardial conduit, Group PEPR: pericardial cusps and Dacron conduit, Group PRPR: expanded polytetrafluoroethylene cusps and Dacron conduit).

Non-femoral focused transaxillary access in TAVI: GARY data analysis and future trends.

Background: In patients not suitable for transfemoral transcatheter aortic valve implantation (TAVI), several access strategies can be chosen.

Aim: To evaluate the use and patient outcomes of transaxillary (TAx), transapical (TA), and transaortic (TAo) as alternative access for TAVI in Germany; to further evaluate surgical cutdown vs. percutaneous TAx access.