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Objective: Stented biological prostheses show different performance related to their design and ultrastructure. Therefore, we compared the Carpentier-Edwards Perimount (Edwards Lifesciences, Irvine, CA, USA) and the St. Jude Medical Epic (SJM Epic; St. Jude Medical Inc., St. Paul, MN, USA) prostheses with respect to their hemodynamic features. Methods: Eighty-six patients underwent aortic valve replacement for severe aortic stenosis (50 patients), aortic regurgitation (seven patients), or mixed lesion (29 patients) with these randomly assigned bioprostheses (Perimount: 39 patients; SJM Epic: 47 patients). Following informed consent, patients were examined postoperatively (mean 9.7 +/- 4 months after surgery) with a detailed echocardiographic study, quality of life was determined by a standardized questionnaire. Results: Comparing the indexed effective orifice area (0.77 cm(2)/m(2) vs. 0.64 cm(2)/m(2); p = 0.019), the mean pressure gradient (11.15 mmHg vs. 14.80 mmHg; p = 0.004) and the stroke-work loss (6.95% vs. 8.49%; p = 0.025), the Carpentier-Edwards Perimount demonstrated significantly better hemodynamic features than the SJM Epic prosthesis. These effects were more pronounced in the smaller prosthetic sizes. Conclusion: The Carpentier-Edwards Perimount prosthesis was less obstructive than the SJM Epic in echocardiographic controls. Patient-prosthesis mismatch as determined by indexed effective orifice area showed no impact on functional recovery. [ABSTRACT FROM AUTHOR]

We report a technique of multidimensional modeling and 3D printing in preplanning of Type A acute aortic dissection (TAAD) repair. doi: 10.1111/jocs.12772 (J Card Surg 2016;31:441-445)., (© 2016 Wiley Periodicals, Inc.)

The growing number of heart failure patients and the scarcity of donor organs give rise to the development of mechanical circulatory support devices for a long-term support. After approximately 15 years of experience, these devices should be critically evaluated. The presented article gives an overview on the currently most often used mechanical circulatory support systems, describes the indications for implantation (bridge to cardiac transplantation, destination therapy, and bridge to recovery), the complications like bleeding, thromboembolic events, infections, and technical failures, and analyzes the costs of this therapy. Furthermore, alternative treatment options like cardiac transplantation, coronary artery bypass grafting, cardiac valve surgery, defibrillator implantation, multisite pacing, dynamic and passive cardiomyoplasty, partial left ventriculectomy (PLV), Myosplint implantation (Myocor, Maple Grove, MN, USA), stem cell therapy, and xenotransplantation are shortly presented, and the future of mechanical support devices is discussed. Despite a great number of patients benefitting from mechanical support devices, the treatment with these devices will only compete with other therapeutic strategies if the rates of complications and technical failures as well as the costs are significantly reduced. Furthermore, innovative therapies like biochemical influencing of the cardiac metabolism have a high potential and may play an important role in the future.