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Introduction: Indications for transcatheter aortic valve implantation (TAVI) are constantly expanding, including younger patients. Bicuspid aortic valves (BAV) often occur in this group. In order to achieve optimal treatment results in younger patients, it is necessary to develop an effective method for selecting the size of implanted valves. Aim: To compare the results of TAVI with use of a self-expanding prosthesis in patients with a BAV and a tricuspid aortic valve (TAV) with valve selection based on annular sizing. Material and methods: The diagnosis of BAV and TAV and measurements (annular sizing) were based on multi-slice computed tomography scans. Eighty-three patients received a self-expanding CoreValve or Evolut R prosthesis. In group I (BAV) there were 21 (25.3%) patients and in group II (TAV) there were 62 (74.7%) patients. Results: The groups did not differ in terms of baseline clinical characteristics. Device success was achieved in 16 (76.2%) and 55 (88.7%) (p = NS) in group I and II respectively. Composite endpoints: early safety occurred in 5 (23.8%) and 11 (17.7%) patients (p =NS) in group I and II respectively; clinical efficacy occurred in 10 (47.6%) and 28 (45.2%) patients (p = NS) in group I and II respectively. 30-day mortality was 4.8% vs 9.7%, 1-year mortality was 28.6% vs 17.7% (p = NS) in group I and II respectively. Conclusions: TAVI in patients with severe aortic stenosis and BAV is as effective as in patients with TAV using self-expanding prostheses if the valve selection is based on annular sizing. [ABSTRACT FROM AUTHOR]

Introduction: Before the operation each cardiosurgery geriatric patient is assessed by the Vulnerable Elders-13 Survey (VES-13) and European System for Cardiac Operative Risk Evaluation (EuroSCORE) scales. Aim: To compare the applicability of the VES-13 and EuroSCORE scale in the assessment of postoperative risk among operated patients > 60 years old qualified most often for coronary artery bypass grafting. Material and methods: VES-13 is a questionnaire containing 13 questions, including patient's age and a health self-assessment. The EuroSCORE includes age, sex and cardiological assessment and vascular changes, respiratory diseases, neurological and nephrological disorders. In both scales the risk of death is high when the patient has > 6 points. The study included 100 patients = 60 (60.83 ±6.18) years old who were divided into subgroups with < 6 points and = 6 points. Results: The number of VES-13 points = 3.06 ±2.25, EuroSCORE = 5.50 ±3.19. In patients > 75 years old VES score was 4.32 ±2.6 vs. 2.707 ±2.02 and EuroSCORE 8.09 ±3.02 vs. 4.77 ±2.83. The most frequent postoperative complication was atrial fibrillation. The most frequent complications were the following: death (5%), delirium (3.64%), bleeding (3.54%), stroke (3.54%), renal failure (3.32%), pacemaker implantation (3.28%), difficult healing of the wound (2.64%), intestinal ischemia (2.56%). The correlation between the VES-13 and EuroSCORE was moderate. Conclusions: In cardiosurgery patients who obtained before the operation = 6 points on the VES-13 or EuroSCORE the risk of postoperative complications is high. VES-13 and EuroSCORE cannot be used interchangeably because the correlation is at a medium level. [ABSTRACT FROM AUTHOR]

Introduction: Off-pump coronary artery bypass grafting is considered potentially more effective than on-pump surgery in elderly patients. Aim: To compare the early and long-term results of these techniques in patients = 80 years of age with left main coronary artery disease. Material and methods: All patients = 80 years of age (N = 3648) who were reported to the Polish National Registry of Cardiac Surgery Procedures between 2006 and 2016 and underwent primary, isolated coronary artery bypass surgery were included in the study. The patients were divided into 2 groups: group A - without significant left main stenosis (LMS) (n = 2094) and B group - with LMS = 50% (n = 1524). The groups were compared according to the type of surgery: on-pump (A = 1107 vs. B = 891), off-pump (A = 908 vs. B = 616) and MIDCAB (A = 79 vs. B = 17). Results: There were significant differences in preoperative status between the groups in the whole cohort, which were not observable after propensity score matching. The in-hospital mortality was significantly higher in the LMS group operated on-pump (10.5% vs. 7.0%; p = 0.01) and non-significant in the off-pump group (5.1% vs. 5.7%; p = 0.78), as well as in the MIDCAB subgroup (5.9% vs. 5.1%; p = 0.64). 10-year survival in all subgroups was comparable and remained at a level of 50-60%. The mean entire cohort follow-up was 3.4 ±2.7 vs. 3.7 ±2.8 years (p = 0.2). Conclusions: Off-pump coronary bypass grafting may optimize the outcomes in elderly patients with significant left main stenosis. Octogenarians surgically treated for coronary artery disease, despite increased post-operative risks, present encouraging long-term survival. [ABSTRACT FROM AUTHOR]

Introduction: The presence of coronary artery disease (CAD) in patients who underwent transcatheter aortic valve implantation (TAVI) may increase in-hospital and long-term mortality. Aim: To evaluate the impact of CAD in patients who underwent TAVI. Material and methods: The study group consisted of the first 142 patients treated with TAVI between 26 November 2008 and 31 December 2015. The patients were divided into two groups: group I comprised 103 (72.5%) patients with CAD, and group II comprised 39 (27.5%) patients without CAD. Results: Group I was characterized by a significantly higher risk according to EuroSCORE - 11.2 ±2.5 vs. 9 ±2.3 in group II (p < 0.001) and Logistic EuroSCORE - 25.4 ±13.4 vs. 16.3 ±8.7 (p < 0.001). 30-day mortality was 8 (7.8%) vs. 2 (5.1%) (p = NS) and 1-year mortality was 22 (21.4%) vs. 6 (15.4%) (p = NS) in group I and II respectively. The composite endpoint evaluating the efficacy of TAVI was achieved in 82 (79.6%) vs. 31 (79.5%) (p = NS) in group I and II respectively. The composite endpoint, which involved 30-day observation, occurred in 39 (37.86%) vs. 12 (30.77%) (p = NS) and the composite endpoint, which involved 1-year evaluation of the clinical efficacy of TAVI, occurred in 48 (57.8%) vs. 13 (48.1%) (p = NS) in patients with and without CAD respectively. Conclusions: The short- and mid-term outcomes of TAVI patients with CAD, despite higher risk profile, did not differ from the outcomes of treatment in patients without CAD. [ABSTRACT FROM AUTHOR]

Cardiogenic shock (CS) remains the main cause of death in patients with myocardial infarction. Conservative treatment alone does not sufficiently improve prognosis. Mortality in CS can only be significantly reduced with revascularization, both surgical and percutaneous. However some patients present with haemodynamic instability despite optimal medical treatment and complete revascularization, resulting in very high mortality rates. These patients require the implementation of mechanical circulatory support in order to increase systemic blood flow, protect against organ hypoperfusion and protect the myocardium through a decrease in oxygen consumption. In contemporary interventional cardiology it seems that every operator should be aware of all available mechanical circulatory support methods for their patients. This article aims to present the current state of knowledge and technical possibilities in this area. [ABSTRACT FROM AUTHOR]

Copyright of Advances in Interventional Cardiology / Postępy w Kardiologii Interwencyjnej is the property of Termedia Publishing House and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Advances in Interventional Cardiology / Postępy w Kardiologii Interwencyjnej is the property of Termedia Publishing House and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The following paper presents a patient with severe aortic stenosis and severely reduced left ventricular ejection fraction with intra-aortic balloon pump counterpulsation support, who underwent transfemoral aortic valve implantation of a CoreValve prosthesis. [ABSTRACT FROM AUTHOR]