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JCTCV:21(3), Aim: Long-term mechanical circulatory support is increasingly being used to deal with end-stage heart failure. The objective of this retrospective monocentric study was to evaluate the short- and mid-term evolution of patients receiving left ventricular assist device (LVAD) implanted by left thoracotomy without cardiopulmonary bypass at our center. Methods and results: Eighteen patients (17 males) aged 63.3 ± 7.3 years received LVAD between November 2012 and August 2016 (15 [83%] as destination therapy and 3 [17%] as a bridge to transplant). Aetiology was ischemic cardiopathy for 13 (72%) cases and dilated cardiomyopathy for 5 (28%) cases. The follow-up time was 17 months and survival at 12 months was 66% (73% in the subgroup of patients implanted as destination therapy), with acceptable postoperative complications. Conclusion: This approach is technically feasible without cardiopulmonary bypass and is a potential alternative to conventional medial sternotomy, especially for redo patients. However, its place has yet to be defined, in particular in patients who require a subsequent heart transplant.

JCTCV:21(2), Objective: To assess hospital morbi-mortality of isolated aortic valve replacement (AVR) in a monocentric cohort of octogenarians. Methods: Between 2002 and 2014, 769 octogenarian patients, male in 46.4% (n=357), with a mean age of 82.7±2.4 years [range: 80–94.4], underwent isolated AVR with implantation of a biological valvular prosthesis in our center. The main surgical indication was aortic stenosis in 79.3% of patients. Patients who underwent redo surgeries were excluded from the study. Results: The hospital mortality rate was 1.95% (n=15) with a Euroscore 2 average of 2.7±3 [range: 0.9–41.2]. Mean intensive care unit stay was 3.1 ±4.5 days with a total hospital stay of 13.5±7.9 days. The main postoperative complications included blood transfusion (62.5%), renal failure (15.6%) requiring dialysis in 2.7 % of the cases, para-prosthesis aortic insufficiency (1 to 2/4) (3.4%), prolonged artificial ventilation (>48h) (2.9%), pace-maker implantation (1.4%), stroke (1.2%) and mediastinitis (0.5%). Multivariate predictors of hospital mortality were cardiogenic shock (OR=34.8 [4.2–215.9]), and a BMI greater than 30 (OR 4.5 [1.3–16.2]). Conclusion: Currently, aortic valve replacement in octogenarians is a reliable surgery with a low hospital morbi-mortality rate. It also provides effective identification of patients at risk.