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OBJECTIVES With the expansion of transcatheter aortic valve replacement (TAVR) into intermediate and low risk, the number of TAVR procedures is bound to rise and along with it the number of cases of infective endocarditis following TAVR (TIE). The aim of this study was to review a multicentre experience of patients undergoing surgical intervention for TIE and to analyse the underlying indications and operative results. METHODS We retrospectively identified and analysed 69 patients who underwent cardiac surgery due to TIE at 9 cardiac surgical departments across Germany. The primary outcome was operative mortality, 6-month and 1-year survival. RESULTS Median age was 78 years (72-81) and 48(69.6%) were male. The median time to surgical aortic valve replacement was 14 months (5-24) after TAVR, with 32 patients (46.4%) being diagnosed with early TIE. Cardiac reoperations were performed in 17% of patients and 33% underwent concomitant mitral valve surgery. The main causative organisms were: Enterococcus faecalis (31.9%), coagulase-negative Staphylococcus spp. (26.1%), Methicillin-sensitive Staphylococcus aureus (15.9%) and viridians group streptococci (14.5%). Extracorporeal life support was required in 2 patients (2.9%) for a median duration of 3 days. Postoperative adverse cerebrovascular events were observed in 13 patients (18.9%). Postoperatively, 9 patients (13.0%) required a pacemaker and 33 patients (47.8%) needed temporary renal replacement therapy. Survival to discharge was 88.4% and survival at 6 months and 1 year was found to be 68% and 53%, respectively. CONCLUSIONS Our results suggest that TIE can be treated according to the guidelines for prosthetic valve endocarditis, namely with early surgery. Surgery for TIE is associated with acceptable morbidity and mortality rates. Surgery should be discussed liberally as a treatment option in patients with TIE by the 'endocarditis team' in referral centres.

The implementation of new surgical techniques offers chances but carries risks. Usually, several years pass before a critical appraisal and a balanced opinion of a new treatment method are available and rely on the evidence from the literature and expert's opinion. The frozen elephant trunk (FET) technique has been increasingly used to treat complex pathologies of the aortic arch and the descending aorta, but there still is an ongoing discussion within the surgical community about the optimal indications. This paper represents a common effort of the Vascular Domain of EACTS together with several surgeons with particular expertise in aortic surgery, and summarizes the current knowledge and the state of the art about the FET technique. The majority of the information about the FET technique has been extracted from 97 focused publications already available in the PubMed database (cohort studies, case reports, reviews, small series, meta-analyses and best evidence topics) published in English

Opinion paper - no abstract included

The implementation of new surgical techniques offers chances but carries risks. Usually, several years pass before a critical appraisal and a balanced opinion of a new treatment method are available and rely on the evidence from the literature and expert's opinion. The frozen elephant trunk (FET) technique has been increasingly used to treat complex pathologies of the aortic arch and the descending aorta, but there still is an ongoing discussion within the surgical community about the optimal indications. This paper represents a common effort of the Vascular Domain of EACTS together with several surgeons with particular expertise in aortic surgery, and summarizes the current knowledge and the state of the art about the FET technique. The majority of the information about the FET technique has been extracted from 97 focused publications already available in the PubMed database (cohort studies, case reports, reviews, small series, meta-analyses and best evidence topics) published in English

Dragonflies from the Cape Verde Islands, collected between 1960 and 1989 and kept in institutes in Portugal and Cape Verde, were studied. The Cape Verde collection at the Centro de Zoologia, Instituto de Investigação Científica Tropical, Lisbon, Portugal, includes eight species of dragonflies represented by 279 specimens collected in 1960-61 and 1969-72. The entomological collection at the Instituto Nacional de Investigação e Desenvolvimento Agrário (INIDA), São Jorge dos Orgãos, Republic of Cape Verde, includes four odonate species, represented by 27 specimens, collected in the years 1987 and 1989. Anax tristis Hagen and A. rutherfordi McLachlan, single male specimens of which were collected in Santo Antão, 27 October 1972, are new taxa for the archipelago. Both are tropical migrants of which the nearest known occurrence in continental Africa is more than 1,000 and 1,500 km, respectively, from the Cape Verde Islands. The two collections contain several specimens from new localities within the archipelago, particularly from the islands of Maio and Fogo. Current knowledge of flight season and island distribution are summarized and updated., Neste artigo apresenta-se um estudo de libélulas capturadas nas ilhas de Cabo Verde entre 1960 e 1989, e conservadas em institutos em Portugal e Cabo Verde. A colecção de Cabo Verde existente no Centro de Zoologia, Instituto de Investigação Científica Tropical, Lisboa, Portugal, abarca oito espécies, representadas por 279 exemplares, capturados em 1960 e 1961, e entre 1969 e 1972. A colecção entomológica do Instituto Nacional de Investigação e Desenvolvimento Agrário, São Jorge dos Orgãos, República de Cabo Verde, contém quatro espécies de libélulas, representadas por 27 exemplares, capturados em 1987 e 1989. Dois exemplares, ambos machos, de Anax tristis Hagen e A. rutherfordi McLachlan foram capturados na ilha de Santo Antão a 27 de Outubro de 1972 e constituem novos taxa para o arquipélago. Ambas são tropicais, manifestam comportamentos migratórios conhecidos, e as ocorrências mais próximas, no continente africano, localizam-se respectivamente a mais de 1000 e 1500 km das ilhas caboverdianas. As duas colecções contribuem com novas localizações no arquipélago de Cabo Verde, especialmente nas ilhas do Maio e Fogo. Por fim, é revisto o actual estado de conhecimento sobre a época de voo e a distribuição inter-insular das diversas espécies de Odonata.

The island of São Vicente, Cape Verde Islands, has no natural and permanent surface fresh water habitats. Surprisingly, with records of 10 species of dragonflies, the island is the most species-rich in the archipelago so far (cf. Aistleitner et al. 2008, this study). Knowledge of Odonata from São Vicente is based on a small number of reports, mostly including single records only (Calvert 1893, Kirby 1897, Lobin 1982, Aistleitner et al. 2008). During a visit to the island in August 2009, AM recorded four species as single adults. Two species were recorded on 26 August 2009, after two days of heavy rainfall which caused extensive temporary waterflows and pools in the main courses of river beds, on the plains, as well as on roads and sports grounds in and around the town of Mindelo.

Dragonflies have been proposed as indicators for the ecosystem health of freshwater wetlands. For their useful functioning as indicators it is, however, necessary to identify species compositions in specific habitats and species-habitat associations, particularly in the tropics, where such knowledge is still weak. We examined the dragonfly species composition of 133 localities in the arid environment of western Namibia. An analysis of nestedness indicated that distinct, and predictable patterns of species associations can be expected. Discriminant analyses revealed that most of the nine habitat types separated by structural and hydrological parameters are well discriminated by their dragonfly assemblages. Spring brooks in particular host a specific assemblage, which is threatened due to the habitat restriction of several species, as well as by recent habitat loss and degradation. Using a hierarchical method of several criteria we demonstrated the selection of a set of potential indicator species from the species set, most of these being useful indicators for spring brook assemblages. The conservation status of certain habitats and species is discussed. We propose that dragonflies will have a high indicator potential for threatened freshwater wetlands in such areas and may also serve as an indication of the sustainable use of water resources including evaluating measures to rehabilitate environments.

Aims Several cardiac resident progenitor cell types have been reported for the adult mammalian heart. Here we characterize their frequencies and distribution pattern in non-ischaemic human myocardial tissue and after ischaemic events. Methods and results We obtained 55 biopsy samples from human atria and ventricles and used immunohistological analysis to investigate two cardiac cell types, characterized by the expression of breast cancer resistance protein (BCRP)/ABCG2 [for side population (SP) cells] or c-kit. Highest frequencies of BCRP+ cells were detected in the ischaemic right atria with a median of 5.40% (range: 2.48-11.1%) vs. 4.40% (1.79-7.75%) in the non-ischaemic right atria (P = 0.47). Significantly higher amounts were identified in ischaemic compared with non-ischaemic ventricles, viz. 5.44% (3.24-9.30%) vs. 0.74% (0-5.23%) (P = 0.016). Few numbers of BCRP+ cells co-expressed the cardiac markers titin, sarcomeric α-actinin, or Nkx2.5; no co-expression of BCRP and progenitor cell marker Sca-1 or pluripotency markers Oct-3/4, SSEA-3, and SSEA-4 was detected. C-kit+ cells displayed higher frequencies in ischaemic (ratio: 1:25 000 ± 2500 of cell counts) vs. non-ischaemic myocardium (1:105 000 ± 43 000). Breast cancer resistance protein+/c-kit+ cells were not identified. Following in vitro differentiation, BCRP+ cells isolated from human heart biopsy samples (n = 6) showed expression of cardiac troponin T and α-myosin heavy-chain, but no full differentiation into functional beating cardiomyocytes was observed. Conclusion We were able to demonstrate that BCRP+/CD31− cells are more abundant in the heart than their c-kit+ counterparts. In the non-ischaemic hearts, they are preferentially located in the atria. Following ischaemia, their numbers are elevated significantly. Our data might provide a valuable snapshot at potential progenitor cells after acute ischaemia in vivo, and mapping of these easily accessible cells may influence future cell therapeutic strateg

The implementation of new surgical techniques offers chances but carries risks. Usually, several years pass before a critical appraisal and a balanced opinion of a new treatment method are available and rely on the evidence from the literature and expert's opinion. The frozen elephant trunk (FET) technique has been increasingly used to treat complex pathologies of the aortic arch and the descending aorta, but there still is an ongoing discussion within the surgical community about the optimal indications. This paper represents a common effort of the Vascular Domain of EACTS together with several surgeons with particular expertise in aortic surgery, and summarizes the current knowledge and the state of the art about the FET technique. The majority of the information about the FET technique has been extracted from 97 focused publications already available in the PubMed database (cohort studies, case reports, reviews, small series, meta-analyses and best evidence topics) published in English