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2. Heart Transplantation With Donation After Circulatory Death.

Author

Niederberger, P, Farine, E, Raillard, M, Dornbierer, M, Freed, DH, Large, SR, Chew, HC, MacDonald, PS, Messer, SJ, White, CW, Carrel, TP, Tevaearai Stahel, HT, Longnus, SL, Niederberger, P, Farine, E, Raillard, M, Dornbierer, M, Freed, DH, Large, SR, Chew, HC, MacDonald, PS, Messer, SJ, White, CW, Carrel, TP, Tevaearai Stahel, HT, and Longnus, SL

Abstract

Heart transplantation remains the preferred option for improving quality of life and survival for patients suffering from end-stage heart failure. Unfortunately, insufficient supply of cardiac grafts has become an obstacle. Increasing organ availability with donation after circulatory death (DCD) may be a promising option to overcome the organ shortage. Unlike conventional donation after brain death, DCD organs undergo a period of warm, global ischemia between circulatory arrest and graft procurement, which raises concerns for graft quality. Nonetheless, the potential of DCD heart transplantation is being reconsidered, after reports of more than 70 cases in Australia and the United Kingdom over the past 3 years. Ensuring optimal patient outcomes and generalized adoption of DCD in heart transplantation, however, requires further development of clinical protocols, which in turn require a better understanding of cardiac ischemia-reperfusion injury and the various possibilities to limit its adverse effects. Thus, we aim to provide an overview of the knowledge obtained with preclinical studies in animal models of DCD heart transplantation, to facilitate and promote the most effective and efficient advancement in preclinical research. A literature search of the PubMed database was performed to identify all relevant preclinical studies in DCD heart transplantation. Specific aspects relevant for DCD heart transplantation were analyzed, including animal models, graft procurement and storage conditions, cardioprotective approaches, and graft evaluation strategies. Several potential therapeutic strategies for optimizing graft quality are identified, and recommendations for further preclinical research are provided.

Published
2019

3. [Guidelines on the management of valvular heart disease (version 2012). The Joint Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS)]. FT Linee guida per il trattamento delle valvulopatie (versione 2012). Task Force congiunta per il Trattamento delle Valvulopatie della Societa Europea di Cardiologia (ESC) e dell'Associazione Europea di Chirurgia Cardiotoracica (EACTS)

Author

Vahanian, A, ALFIERI, OTTAVIO, Andreotti, F, Antunes, Mj, Baron esquivias, G, Baumgartner, H, Nulla, Nullborger Michael, Carrel, Tp, DE BONIS , MICHELE, Evangelista, A, Falk, V, Iung, B, Lancellotti, P, Pierard, L, Price, S, Schafers, Hj, Schuler, G, Stepinska, J, Swedberg, K, Takkenberg, J, Von Oppell Uo, Windecker, S, Zamorano, Jl, Zembala, M., Vahanian, A, Alfieri, Ottavio, Andreotti, F, Antunes, Mj, Baron esquivias, G, Baumgartner, H, Nulla, Nullborger Michael, Carrel, Tp, DE BONIS, Michele, Evangelista, A, Falk, V, Iung, B, Lancellotti, P, Pierard, L, Price, S, Schafers, Hj, Schuler, G, Stepinska, J, Swedberg, K, Takkenberg, J, Von Oppell, Uo, Windecker, S, Zamorano, Jl, and Zembala, M.

Published
2013

4. Guidelines on the management of valvular heart disease (version 2012): The Joint Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS)

Author

Vahanian, A, Alfieri, O, Andreotti, F, Antunes, Mj, Barón Esquivias, G, Baumgartner, H, Borger, Ma, Carrel, Tp, De Bonis, M, Evangelista, A, Falk, V, Iung, B, Lancellotti, P, Pierard, L, Price, S, Schäfers, Hj, Schuler, G, Stepinska, J, Swedberg, K, Takkenberg, J, Von Oppell UO, Windecker, S, Zamorano, Jl, Zembala, M, ESC Committee for Practice Guidelines, Bax, Jj, Ceconi, Claudio, Dean, V, Deaton, C, Fagard, R, Funck Brentano, C, Hasdai, D, Hoes, A, Kirchhof, P, Knuuti, J, Kolh, P, Mcdonagh, T, Moulin, C, Popescu, Ba, Reiner, Z, Sechtem, U, Sirnes, Pa, Tendera, M, Torbicki, A, Document, Reviewers, Von Segesser, L, Badano, Lp, Bunc, M, Claeys, Mj, Drinkovic, N, Filippatos, G, Habib, G, Kappetein, Ap, Kassab, R, Lip, Gy, Moat, N, Nickenig, G, Otto, Cm, Pepper, J, Piazza, N, Pieper, Pg, Rosenhek, R, Shuka, N, Schwammenthal, E, Schwitter, J, Mas, Pt, Trindade, Pt, and Walther, T.

Subjects
NO
Published
2012

6. Prolonged survival of patients with primary sarcoma of the pulmonary artery after extended pneumonectomy and vascular reconstruction on extracorporal circulation

Author

Stammberger, U, Eckstein, FS, Minder, S, Krause, TM, Nicod, LP, Carrel, TP, and Schmid, RA

Subjects
ddc: 610, 610 Medical sciences, Medicine
Abstract

Objectives: Primary pulmonary artery sarcomas (PPAS) present rare mesenchymal tumors which are frequently misdiagnosed as unilateral pulmonary embolism. Mean survival without surgical intervention is only 1.5 months. Methods: Three patients with PPAS who underwent extended pneumonectomy with reconstruction[for full text, please go to the a.m. URL], 16. Jahrestagung der Deutschen Gesellschaft für Thoraxchirurgie

Published
2010
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7. Das Poplitealaneurysma

Author

Widmer, MK, Schmidli, J, and Carrel, TP

Abstract

Das Poplitealaneurisma (PA) ist eine typische Erkrankung von Männern über 65 Jahren, bei denen häufig Aneurysmen der Aorta, der iliacalen, femoralen und kontralateralen Poplitealarterie vorkommen. Als Ursache des Poplitealaneurysmas (PA) werden prioritär die Degradation durch Matrixmetalloproteinasen, eine entzündliche Reaktion mit Bildung von reaktiven Sauerstoffradikalen sowie der oxidative Stress in der Arterienwand postuliert. Zwei Drittel der Patienten kommen wegen Symptomen zum Chirurgen, die übrigen wegen eines Zufallsbefundes oder weil bereits die Gegenseite operiert wurde. Die akute und chronische Ischämie mit ihrer hohen Morbidität stehen im Vordergrund. Asymptomatische PA sollten ab einem Durchmesser von 2 cm therapeutisch angegangen werden, besonders wenn sie partiell thrombosiert sind. Zur Diagnostik reicht eine Duplexuntersuchung. Die digitale Subtraktionsangiographie ist die wichtigste Untersuchung für die Operationsplanung. Lokalisierte Befunde, die auf die Kniekehle begrenzt sind, können von dorsal, langstreckige PA müssen durch einen Zugang von medial mit einem Interponat überbrückt werden. Dabei ist eine autologe Vene dem Kunststoffinterponat vorzuziehen. Im Fall eines Veneninterponates oder -bypasses kann mit einer Offenheitsrate von 85% nach 5 Jahren gerechnet werden. Endografts sollen nur ausnahmsweise oder im Rahmen von Studien eingesetzt werden.

Published
2006
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8. Popliteal aneurysm

Author

Widmer, MK, Schmidli, J, and Carrel, TP

Abstract

Das Poplitealaneurisma (PA) ist eine typische Erkrankung von Männern über 65 Jahren, bei denen häufig Aneurysmen der Aorta, der iliacalen, femoralen und kontralateralen Poplitealarterie vorkommen. Als Ursache des Poplitealaneurysmas (PA) werden prioritär die Degradation durch Matrixmetalloproteinasen, eine entzündliche Reaktion mit Bildung von reaktiven Sauerstoffradikalen sowie der oxidative Stress in der Arterienwand postuliert. Zwei Drittel der Patienten kommen wegen Symptomen zum Chirurgen, die übrigen wegen eines Zufallsbefundes oder weil bereits die Gegenseite operiert wurde. Die akute und chronische Ischämie mit ihrer hohen Morbidität stehen im Vordergrund. Asymptomatische PA sollten ab einem Durchmesser von 2 cm therapeutisch angegangen werden, besonders wenn sie partiell thrombosiert sind. Zur Diagnostik reicht eine Duplexuntersuchung. Die digitale Subtraktionsangiographie ist die wichtigste Untersuchung für die Operationsplanung. Lokalisierte Befunde, die auf die Kniekehle begrenzt sind, können von dorsal, langstreckige PA müssen durch einen Zugang von medial mit einem Interponat überbrückt werden. Dabei ist eine autologe Vene dem Kunststoffinterponat vorzuziehen. Im Fall eines Veneninterponates oder -bypasses kann mit einer Offenheitsrate von 85% nach 5 Jahren gerechnet werden. Endografts sollen nur ausnahmsweise oder im Rahmen von Studien eingesetzt werden.

Published
2006

9. Long-term results after proximal thoracic aortic redo surgery

Author

Czerny, M, primary, Barchichat, I, additional, Meszaros, K, additional, Sodeck, G, additional, Weber, A, additional, Reineke, D, additional, Englberger, L, additional, Schönhoff, F, additional, Kadner, A, additional, Jenni, H, additional, Schmidli, J, additional, and Carrel, TP, additional

Published
2013
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17. Management of patients with type-A aortic dissection: lessons learned from the registry

Author

Weigang, E, primary, Beyer, M, additional, Matschke, K, additional, Carrel, TP, additional, Reichenspurner, H, additional, Krian, A, additional, Klövekorn, WP, additional, Schäfers, HJ, additional, Vahl, CF, additional, Reichart, B, additional, Jakob, H, additional, Sievers, HH, additional, Posival, H, additional, Sons, H, additional, Diegeler, A, additional, Leyh, RG, additional, Warnecke, H, additional, Harringer, W, additional, Cremer, J, additional, Franke, UF, additional, Ziemer, G, additional, Dörge, H, additional, Autschbach, R, additional, Scheld, HH, additional, Eigel, P, additional, Weinhold, C, additional, Fischlein, T, additional, Ennker, JC, additional, Beyersdorf, F, additional, Kuntze, T, additional, Silber, RE, additional, Rein, JG, additional, Hammel, D, additional, and Karck, M, additional

Published
2009
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46. Spontaneous dissection of common iliac artery: a case report.

Author

Savolainen H, Heller G, Fleischmann A, Widmer MK, Carrel TP, and Schmidli J

Abstract

Spontaneous dissection of the iliac artery is very rare but known as a complication of high-energy traumatic injuries and has been reported in connection with pregnancy, collagen diseases, and alpha-1-antitrypsin deficiency. The authors report a 42-year-old man with an acute dissection of the common iliac artery during exercise. Groin pain and claudication were the early symptoms. Computerized angiotomography was diagnostic. Operative iliac artery reconstruction was performed. A prerelease control computed tomography examination showed a dissection of the distal aorta and left iliac artery. To their knowledge, the combination of the 2 dissections has not been previously published. [ABSTRACT FROM AUTHOR]

Published
2004
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47. P682Preserved contractile function of unloaded cardiomyocytes despite diminished sarcomere size is associated with troponin I activation

Author

Most, H., Segiser, A., Fu, X., Zuppinger, C., Ullrich, ND, Longnus, SL, Carrel, TP, Tevaearai, HT, Most, H., Segiser, A., Fu, X., Zuppinger, C., Ullrich, ND, Longnus, SL, Carrel, TP, and Tevaearai, HT

Abstract

Objective: Myocardial unloading with ventricular assist devices in patients with severe heart failure (HF) can lead to reversal of certain aspects of pathological remodeling. However, these effects do not translate into recovery of myocardial function in the human heart, possibly due to detrimental atrophic processes also elicited through unloading. We have studied the effects of long-term unloading on sarcomeric morphology and function in a small animal model of ventricular unloading, heterotopic heart transplantation (HTX) in rats. Methods: Native rat hearts were unloaded via HTX for 30 days, CMs from control and unloaded hearts were isolated (n=8 hearts/>250 individual cells/group). CM overall size was determined, sarcomere length/contractility assessed and Calcium transients as well as E-C coupling gain analyzed in patch-clamped CMs. Additionally, phosphorylation of Troponin I, indicative of sarcomere activation, was measured with western blotting. Results: CM cross-sectional area was diminished in unloaded cells by about one third (2787±345 vs 1993±230 μm2) as was cell capacitance in patched cells. Accordingly, baseline sarcomere length was significantly reduced by ~0.2μm (Figure). However, this reduction did not diminish contractile function: fractional shortening was significantly higher in unloaded CMs (8.0 ± 3 % vs 6.6 ± 2.5 % in CTR, p = 0.01). Departure velocity of the transients was similar (-135.2 ± 48 vs -119.4 ± 40 dL/dt), and return velocity was slightly increased in unloaded cells (120.7 ± 54 vs 94.0 ± 46 dL/dt, p < 0.05), indicating preserved relaxation. Calcium transient amplitudes and current-voltage relationship under basal condition and isoproterenol stimulation was not changed. Troponin I phosphorylation was elevated and may contribute to the maintenance of sarcomeric function in long-term unloaded CMs. Conclusion: Although there are limitations regarding assessment of contractility in isolated cells, we may conclude that the considerable size

48. P682 Preserved contractile function of unloaded cardiomyocytes despite diminished sarcomere size is associated with troponin I activation.

Author

Most, H, Segiser, A, Fu, X, Zuppinger, C, Ullrich, ND, Longnus, SL, Carrel, TP, and Tevaearai, HT

Subjects
HEART cells, TROPONIN I, HEART failure, HEART transplantation, PHOSPHORYLATION, LABORATORY rats
Abstract

Objective: Myocardial unloading with ventricular assist devices in patients with severe heart failure (HF) can lead to reversal of certain aspects of pathological remodeling. However, these effects do not translate into recovery of myocardial function in the human heart, possibly due to detrimental atrophic processes also elicited through unloading. We have studied the effects of long-term unloading on sarcomeric morphology and function in a small animal model of ventricular unloading, heterotopic heart transplantation (HTX) in rats.Methods: Native rat hearts were unloaded via HTX for 30 days, CMs from control and unloaded hearts were isolated (n=8 hearts/>250 individual cells/group). CM overall size was determined, sarcomere length/contractility assessed and Calcium transients as well as E-C coupling gain analyzed in patch-clamped CMs. Additionally, phosphorylation of Troponin I, indicative of sarcomere activation, was measured with western blotting.Results: CM cross-sectional area was diminished in unloaded cells by about one third (2787±345 vs 1993±230 μm2) as was cell capacitance in patched cells. Accordingly, baseline sarcomere length was significantly reduced by ~0.2μm (Figure). However, this reduction did not diminish contractile function: fractional shortening was significantly higher in unloaded CMs (8.0 ± 3 % vs 6.6 ± 2.5 % in CTR, p = 0.01). Departure velocity of the transients was similar (-135.2 ± 48 vs -119.4 ± 40 dL/dt), and return velocity was slightly increased in unloaded cells (120.7 ± 54 vs 94.0 ± 46 dL/dt, p < 0.05), indicating preserved relaxation. Calcium transient amplitudes and current-voltage relationship under basal condition and isoproterenol stimulation was not changed. Troponin I phosphorylation was elevated and may contribute to the maintenance of sarcomeric function in long-term unloaded CMs.Conclusion: Although there are limitations regarding assessment of contractility in isolated cells, we may conclude that the considerable size reduction in CMs induced by unloading does not translate into diminished contractile function or E-C coupling. [ABSTRACT FROM PUBLISHER]

Published
2014
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50. The ARCH Projects: design and rationale (IAASSG 001)

Author

Li-Zhong Sun, Thierry Carrel, Alessandro Della Corte, Anthony L. Estrera, Axel Haverich, Himanshu J. Patel, Konstantinos G. Perreas, Santi Trimarchi, Chunsheng Wang, Thoralf M. Sundt, Hazim J. Safi, Randall B. Griepp, Tristan D. Yan, Riccardo Sinatra, Joseph S. Coselli, Friedhelm Beyersdorf, Marek Ehrlich, Joseph E. Bavaria, Scott A. LeMaire, Aung Oo, Teruhisa Kazui, Satoshi Numata, Paul G. Bannon, Marco Di Eusanio, Roberto Di Bartolomeo, Yutaka Okita, Malcolm J. Underwood, David H. Tian, Andras Hoffman, Joel S. Corvera, Alberto Pochettino, Friedrich W. Mohr, Eric E. Roselli, Minoru Tabata, Edward P. Chen, Martin Misfeld, Heinz Jakob, Malakh Shrestha, Nicholas T. Kouchoukos, George Matalanis, G. Chad Hughes, John A. Elefteriades, Yan, Td, Tian, Dh, Lemaire, Sa, Misfeld, M, Elefteriades, Ja, Chen, Ep, Hughes, Gc, Kazui, T, Griepp, Rb, Kouchoukos, Nt, Bannon, Pg, Underwood, Mj, Mohr, Fw, Oo, A, Sundt, Tm, Bavaria, Je, Di Bartolomeo, R, Di Eusanio, M, Roselli, Ee, Beyersdorf, F, Carrel, Tp, Corvera, J, DELLA CORTE, Alessandro, Ehrlich, M, Hoffman, A, Jakob, H, Matalanis, G, Numata, S, Patel, Hj, Pochettino, A, Safi, Hj, Estrera, A, Perreas, Kg, Sinatra, R, Trimarchi, S, Sun, Lz, Tabata, M, Wang, C, Haverich, A, Shrestha, M, Okita, Y, Coselli, J., Yan TD, Tian DH, LeMaire SA, Misfeld M, Elefteriades JA, Chen EP, Hughes GC, Kazui T, Griepp RB, Kouchoukos NT, Bannon PG, Underwood MJ, Mohr FW, Oo A, Sundt TM, Bavaria JE, Di Bartolomeo R, Di Eusanio M, Roselli EE, Beyersdorf F, Carrel TP, Corvera JS, Della Corte A, Ehrlich M, Hoffman A, Jakob H, Matalanis G, Numata S, Patel HJ, Pochettino A, Safi HJ, Estrera A, Perreas KG, Sinatra R, Trimarchi S, Sun LZ, Tabata M, Wang C, Haverich A, Shrestha M, Okita Y, and Coselli J

Subjects
Pulmonary and Respiratory Medicine, Clinical variables, Databases, Factual, Steering committee, Objective (goal), Medizin, Aorta, Thoracic, 610 Medicine & health, AORTA, Quality of life (healthcare), Humans, Medicine, Operations management, Registries, Arch, aortic arch surgery, cerebral protection, database, business.industry, General Medicine, Aortic arch surgery, medicine.disease, Circulatory Arrest, Deep Hypothermia Induced, Treatment Outcome, Cerebrovascular Circulation, Surgery, Medical emergency, Operative risk, Cardiology and Cardiovascular Medicine, business
Abstract

OBJECTIVE: A number of factors limit the effectiveness of current aortic arch studies in assessing optimal neuroprotection strategies, including insufficient patient numbers, heterogenous definitions of clinical variables, multiple technical strategies, inadequate reporting of surgical outcomes and a lack of collaborative effort. We have formed an international coalition of centres to provide more robust investigations into this topic. METHODS: High-volume aortic arch centres were identified from the literature and contacted for recruitment. A Research Steering Committee of expert arch surgeons was convened to oversee the direction of the research. RESULTS: The International Aortic Arch Surgery Study Group has been formed by 41 arch surgeons from 10 countries to better evaluate patient outcomes after aortic arch surgery. Several projects, including the establishment of a multi-institutional retrospective database, randomized controlled trials and a prospectively collected database, are currently underway. CONCLUSIONS: Such a collaborative effort will herald a turning point in the surgical management of aortic arch pathologies and will provide better powered analyses to assess the impact of varying surgical techniques on mortality and morbidity, identify predictors for neurological and operative risk, formulate and validate risk predictor models and review long-term survival outcomes and quality-of-life after arch surgery.

Published
2013

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