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1. Temporary mechanical circulatory support in infarct-related cardiogenic shock: an individual patient data meta-analysis of randomised trials with 6-month follow-up

Author

Burkhoff, Daniel, Cohen, Howard, Brunckhorst, Corinna, O'Neill, William W., Thiele, Holger Thiele, Sick, Peter, Boudriot, Enno, Diederich, Klaus-Werner, Hambrecht, Rainer, Niebauer, Josef, Schuler, Gerhard, Seyfarth, Melchior, Sibbing, Dirk, Bauer, Iris, Fröhlich, Georg, Bott-Flügel, Lorenz, Byrne, Robert, Dirschinger, Josef, Kastrati, Adnan, Schömig, Albert, Ouweneel, Dagmar M., Eriksen, Erlend, Sjauw, Krischan D., van Dongen, Ivo M., Hirsch, Alexander, Packer, Erik J.S, Vis, M. Marie, Wykrzykowska, Joanna J., Koch, Karel T., Baan, Jan, De Winter, Robbert J, Piek, Jan J., Lagrand, Wim K, de Mol, Bas A.J.M, Tijssen, Jan G.P., Henriques, José P.S., Møller, Jacob E., Engstrøm, Thomas, Jensen, Lisette Okkels, Eiskjær, Hans, Mangner, Norman, Polzin, Amin, Schulze, P. Christian, Skurk, Carsten, Nordbeck, Peter, Clemmensen, Peter, Panoulas, Vasileios, Zimmer, Sebastian, Schäfer, Andreas, Werner, Nikos, Frydland, Martin, Holmvang, Lene, Kjærgaard, Jesper, Sørensen, Rikke, Lønborg, Jacob, Greve, Matias, Christiansen, Evald H., Linke, Axel, Woitek, Felix J., Westenfeld, Ralf, Moebius-Winkler, Sven, Wachtell, Kristian, Ravn, Hanne Berg, Lassen, Jens Flensted, Boesgaard, Søren, Gerke, Oke, Hassager, Christian, Lackermair, Korbinian, Brunner, Stefan, Orban, Mathias, Peterss, Sven, Orban, Martin, Theiss, Hans D., Huber, Bruno C., Juchem, Gerd, Born, Frank, Boulesteix, Anne-Laure, Bauer, Axel, Pichlmaier, Maximilian, Hausleiter, Jörg, Massberg, Steffen, Hagl, Christian, Guenther, Sabina P.W., Ostadal, Petr, Rokyta, Richard, Karasek, Jiri, Kruger, Andreas, Vondrakova, Dagmar, Janotka, Marek, Naar, Jan, Smalcova, Jana, Hubatova, Marketa, Hromadk, Milan, Volovar, Stefan, Seyfrydova, Miroslava, Jarkovsky, Jiri, Svoboda, Michal, Linhart, Ales, Belohlavek, Jan, Banning, Amerjeet S., Sabaté, Manel, Gracey, Jay, López-Sobrino, Teresa, Bogaerts, Kris, Adriaenssens, Tom, Berry, Colin, Erglis, Andrejs, Haine, Steven, Myrmel, Truls, Patel, Sameer, Buera, Irene, Sionis, Alessandro, Vilalta, Victoria, Yusuff, Hakeem, Vrints, Christiaan, Adlam, David, Flather, Marcus, Gershlick, Anthony H., Thiele, Holger, Zeymer, Uwe, Akin, Ibrahim, Behnes, Michael, Rassaf, Tienush, Mahabadi, Amir-Abbas, Lehmann, Ralf, Eitel, Ingo, Graf, Tobias, Seidler, Tim, Schuster, Andreas, Duerschmied, Daniel, Hennersdorf, Marcus, Fichtlscherer, Stephan, Voigt, Ingo, John, Stefan, Ewen, Sebastian, Tigges, Eike, Nordbeck, Peter Steffen, Bruch, Leonhard, Jung, Christian, Franz, Jutta, Lauten, Philipp, Goslar, Tomaz, Feistritzer, Hans-Josef, Pöss, Janine, Kirchhof, Eva, Ouarrak, Taoufik, Schneider, Steffen, Desch, Steffen, Freund, Anne, Møller, Jacob E, Henriques, Jose P S, Bogerd, Margriet, Hochadel, Matthias, and Schulze, P Christian

Published
2024
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3. Aortic valved homograft degeneration: surgical or transcatheter approach for repeat aortic valve replacement?

Author

Peterss, Sven, Fabry, Thomas G, Steffen, Julius, Orban, Martin, Buech, Joscha, Radner, Caroline, Theiss, Hans D, Pichlmaier, Maximilian, Massberg, Steffen, Hagl, Christian, and Deseive, Simon

Subjects
AORTIC valve transplantation, AORTIC valve, HOMOGRAFTS, AORTA, HEART valve prosthesis implantation, VENTILATION
Abstract

OBJECTIVES Aortic valved allografts (homografts) have been used alternatively to mechanical or biological valve prostheses in expectation of better durability; however, homograft valves do degenerate, and redo procedures have proven challenging due to heavy wall calcification. The aim of the study was to compare the outcome of open surgical (SAVR) and transcatheter aortic valve replacement (TAVR) in degenerated homografts. METHODS Between 1993 and 2022, 81 patients underwent repeat aortic valve procedures having previously received an aortic homograft. The redo had become necessary due to regurgitation in 85% and stenosis in 15%. Sixty-five percent underwent open surgery, 35% TAVR. RESULTS Isolated SAVR was possible in 79%, and root procedures were necessary in 21%. TAVR was performed in 79% via transfemoral and 21% via transapical access. Median prosthetic valve size was 23 (22.3–23.2) mm in the SAVR and 26 (25.2–26.9) in the TAVR group. Thirty-day mortality was 0% in the TAVR and 7% in the SAVR group (P  = n.s.). TAVR showed a significantly better outcome concerning prolonged ventilation (0 vs 21%, P  = 0.013) as well as ICU (1 vs 2 days; P  < 0.001) and in-hospital stay (10.5 vs 13 days; P  = 0.028). Five-year survival was statistically comparable between groups, and no severe leakage was observed. CONCLUSIONS SAVR following structural homograft degeneration shows acceptable results, but the perioperative risk remains substantial and poorly predictable. TAVR presents a reasonable and more easily accessible alternative and is associated with good short- and mid-term results. In the absence of relevant contraindications, TAVR is presently the preferred treatment option for these patients at our center. [ABSTRACT FROM AUTHOR]

Published
2024
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5. Outcome of patients treated with extracorporeal life support in cardiogenic shock complicating acute myocardial infarction: 1-year result from the ECLS-Shock study

Author

Lackermair, Korbinian, Brunner, Stefan, Orban, Mathias, Peterss, Sven, Orban, Martin, Theiss, Hans D., Huber, Bruno C., Juchem, Gerd, Born, Frank, Boulesteix, Anne-Laure, Bauer, Axel, Pichlmaier, Maximilian, Hausleiter, Jörg, Massberg, Steffen, Hagl, Christian, and Guenther, Sabina P. W.

Published
2021
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6. Temporary mechanical circulatory support in infarct-related cardiogenic shock: an individual patient data meta-analysis of randomised trials with 6-month follow-up

Author

Thiele, Holger, Møller, Jacob E, Henriques, Jose P S, Bogerd, Margriet, Seyfarth, Melchior, Burkhoff, Daniel, Ostadal, Petr, Rokyta, Richard, Belohlavek, Jan, Massberg, Steffen, Flather, Marcus, Hochadel, Matthias, Schneider, Steffen, Desch, Steffen, Freund, Anne, Eiskjær, Hans, Mangner, Norman, Pöss, Janine, Polzin, Amin, Schulze, P Christian, Skurk, Carsten, Zeymer, Uwe, Hassager, Christian, Burkhoff, Daniel, Cohen, Howard, Brunckhorst, Corinna, O'Neill, William W., Thiele, Holger Thiele, Sick, Peter, Boudriot, Enno, Diederich, Klaus-Werner, Hambrecht, Rainer, Niebauer, Josef, Schuler, Gerhard, Seyfarth, Melchior, Sibbing, Dirk, Bauer, Iris, Fröhlich, Georg, Bott-Flügel, Lorenz, Byrne, Robert, Dirschinger, Josef, Kastrati, Adnan, Schömig, Albert, Ouweneel, Dagmar M., Eriksen, Erlend, Sjauw, Krischan D., van Dongen, Ivo M., Hirsch, Alexander, Packer, Erik J.S, Vis, M. Marie, Wykrzykowska, Joanna J., Koch, Karel T., Baan, Jan, De Winter, Robbert J, Piek, Jan J., Lagrand, Wim K, de Mol, Bas A.J.M, Tijssen, Jan G.P., Henriques, José P.S., Møller, Jacob E., Engstrøm, Thomas, Jensen, Lisette Okkels, Eiskjær, Hans, Mangner, Norman, Polzin, Amin, Schulze, P. Christian, Skurk, Carsten, Nordbeck, Peter, Clemmensen, Peter, Panoulas, Vasileios, Zimmer, Sebastian, Schäfer, Andreas, Werner, Nikos, Frydland, Martin, Holmvang, Lene, Kjærgaard, Jesper, Sørensen, Rikke, Lønborg, Jacob, Greve, Matias, Christiansen, Evald H., Linke, Axel, Woitek, Felix J., Westenfeld, Ralf, Moebius-Winkler, Sven, Wachtell, Kristian, Ravn, Hanne Berg, Lassen, Jens Flensted, Boesgaard, Søren, Gerke, Oke, Hassager, Christian, Lackermair, Korbinian, Brunner, Stefan, Orban, Mathias, Peterss, Sven, Orban, Martin, Theiss, Hans D., Huber, Bruno C., Juchem, Gerd, Born, Frank, Boulesteix, Anne-Laure, Bauer, Axel, Pichlmaier, Maximilian, Hausleiter, Jörg, Massberg, Steffen, Hagl, Christian, Guenther, Sabina P.W., Ostadal, Petr, Rokyta, Richard, Karasek, Jiri, Kruger, Andreas, Vondrakova, Dagmar, Janotka, Marek, Naar, Jan, Smalcova, Jana, Hubatova, Marketa, Hromadk, Milan, Volovar, Stefan, Seyfrydova, Miroslava, Jarkovsky, Jiri, Svoboda, Michal, Linhart, Ales, Belohlavek, Jan, Banning, Amerjeet S., Sabaté, Manel, Orban, Martin, Gracey, Jay, López-Sobrino, Teresa, Massberg, Steffen, Kastrati, Adnan, Bogaerts, Kris, Adriaenssens, Tom, Berry, Colin, Erglis, Andrejs, Haine, Steven, Myrmel, Truls, Patel, Sameer, Buera, Irene, Sionis, Alessandro, Vilalta, Victoria, Yusuff, Hakeem, Vrints, Christiaan, Adlam, David, Flather, Marcus, Gershlick, Anthony H., Thiele, Holger, Zeymer, Uwe, Akin, Ibrahim, Behnes, Michael, Rassaf, Tienush, Mahabadi, Amir-Abbas, Lehmann, Ralf, Eitel, Ingo, Graf, Tobias, Seidler, Tim, Schuster, Andreas, Skurk, Carsten, Duerschmied, Daniel, Clemmensen, Peter, Hennersdorf, Marcus, Fichtlscherer, Stephan, Voigt, Ingo, Seyfarth, Melchior, John, Stefan, Ewen, Sebastian, Linke, Axel, Tigges, Eike, Nordbeck, Peter Steffen, Bruch, Leonhard, Jung, Christian, Franz, Jutta, Lauten, Philipp, Goslar, Tomaz, Feistritzer, Hans-Josef, Pöss, Janine, Kirchhof, Eva, Ouarrak, Taoufik, Schneider, Steffen, Desch, Steffen, and Freund, Anne

Abstract

Percutaneous active mechanical circulatory support (MCS) devices are being increasingly used in the treatment of acute myocardial infarction-related cardiogenic shock (AMICS) despite conflicting evidence regarding their effect on mortality. We aimed to ascertain the effect of early routine active percutaneous MCS versus control treatment on 6-month all-cause mortality in patients with AMICS.

Published
2024
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7. Endovascular Repair With Triple Inner-Branch Endograft for Aberrant Subclavian Artery Aneurysm: A Case Report.

Author

Spath, Paolo, Marazzi, Giulia, Stana, Jan, Peterss, Sven, Fernandez-Prendes, Carlota, Rantner, Barbara, Pichlmaier, Maximilian A., and Tsilimparis, Nikolaos

Abstract

Background: Endovascular repair of the thoracic aorta (TEVAR) is the preferred option for the treatment of the distal arch and descending thoracic aorta. Fenestrated and branched TEVAR have become an option to treat pathologies of the aortic arch, avoiding sternotomy and cardiopulmonary arrest as well as total surgical debranching. We describe here the case of a symptomatic patient with an arteria lusoria aneurysm associated with Kommerel diverticulum who underwent total endovascular repair with a triple-branched TEVAR. Case Report: A 66-year-old male patient was treated for a symptomatic arteria lusoria artery associated with a Kommerel diverticulum, resulting in difficulty swallowing and choking. We used a custom-made triple inner-branch endograft (Cook Medical, Bloomington, Indiana) following implantation of a right-sided carotid-subclavian (C-S) bypass. The C-S bypass occluded in the interval time between the 2 procedures and required recanalization and stent-graft placement during the aortic arch procedure. The arteria lusoria was embolized with a vascular plug. No complications occurred and postoperative tomography showed exclusion and thrombosis of the Kommerel diverticulum and perfusion of the supra-aortic vessels. Conclusions: Treatment of arteria lusoria aneurysms can be performed with total endovascular arch inner-branch repair, avoiding increased risk of morbidity and mortality caused by open or hybrid procedures. [ABSTRACT FROM AUTHOR]

Published
2024
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13. Secondary Endovascular Conversions for Failed Open Repair

Author

Melo, Ryan Gouveia e, additional, Spath, Paolo, additional, Stana, Jan, additional, Prendes, Carlota F., additional, Stavroulakis, Konstantinous, additional, Rantner, Barbara, additional, Pichlmaier, Maximilian, additional, and Tsilimparis, Nikolaos, additional

Published
2023
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18. Expert opinion: How to treat type IA endoleakage

Author

Peterss, Sven, primary, Stana, Jan, additional, Rantner, Barbara, additional, Buech, Joscha, additional, Radner, Caroline, additional, Konstantinou, Nikolaos, additional, Hagl, Christian, additional, Pichlmaier, Maximilian, additional, and Tsilimparis, Nikolaos, additional

Published
2023
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20. Postoperative Outcomes and Reinterventions Following Fenestrated/Branched Endovascular Aortic Repair in Post-Dissection and Complex Degenerative Abdominal and Thoraco-Abdominal Aortic Aneurysms

Author

Benfor, Bright, primary, Högl, Julia, additional, Gouveia e Melo, Ryan, additional, Stana, Jan, additional, Prendes, Carlota Fernandez, additional, Pichlmaier, Maximilian, additional, Rantner, Barbara, additional, and Tsilimparis, Nikolaos, additional

Published
2022
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22. A Single-Center Experience With Total Percutaneous Implantation of a Low-Profile Thoracic Aortic Stent-Graft.

Author

Benfor, Bright, Stana, Jan, Fernandez Prendes, Carlota, Pichlmaier, Maximilian, Mehmedovic, Aldin, Banafsche, Ramin, Rantner, Barbara, and Tsilimparis, Nikolaos

Abstract

Purpose: To evaluate the safety and effectiveness of total percutaneous implantation of the Zenith Alpha Thoracic (ZTA) endograft in the treatment of diseases of the descending thoracic aorta. Materials and Methods: A retrospective cohort study of 56 consecutive patients undergoing total percutaneous ZTA implantation between 2018 and 2020 was performed in a single center. Patients' demographics, clinical characteristics, anatomical parameters, operative details, device features, and postoperative outcomes were assessed. The primary endpoint was ongoing clinical success. A Cox regression model was used to determine the predictive factors of worse postoperative outcomes. Results: Eighty-three ZTA endografts were implanted in 35 men and 21 women with a mean age of 69±11 years for the treatment of 26 degenerative aneurysms, 15 type B dissections, and 8 penetrating ulcers, among others. Primary technical success was 100%, with a 30-day ongoing clinical success rate of 94.6%. The 1-year ongoing clinical success rate was 91.1% (51 patients), and freedoms from all-cause mortality, type 1 and 3 endoleaks, and any unplanned reintervention were, respectively, 95.3%, 91.4%, and 88.2% at 1 year. During follow-up, there was one case of surgical conversion for an aorto-esophageal fistula. On the contrary, neither aneurysmal rupture nor significant aneurysmal expansion was recorded. Repair of ruptured thoracic aorta and a high ratio of sheath outer diameter to external iliac artery diameter were found to be independently associated with worse outcomes, with adjusted odds ratios of 4.4 [1.5-15.3] and 4.9 [1.1-23.9], respectively. Conclusion: The outcomes of total percutaneous implantation of ZTA endograft show excellent primary technical success and favorable midterm ongoing clinical success. Factors associated with worse outcomes include the repair of ruptured aorta and a high sheath to access vessel ratio. [ABSTRACT FROM AUTHOR]

Published
2023
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31. Early Use of Methylene Blue in Vasoplegic Syndrome: A 10-Year Propensity Score-Matched Cohort Study

Author

Kofler, Othmar, primary, Simbeck, Maximilian, additional, Tomasi, Roland, additional, Hinske, Ludwig Christian, additional, Klotz, Laura Valentina, additional, Uhle, Florian, additional, Born, Frank, additional, Pichlmaier, Maximilian, additional, Hagl, Christian, additional, Weigand, Markus Alexander, additional, Zwißler, Bernhard, additional, and von Dossow, Vera, additional

Published
2022
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32. German Aortic Root Repair Registry—Insights From the First 400 Consecutive Patients

Author

Kari, Fabian A., primary, Misfeld, Martin, additional, Borger, Michael, additional, Rylski, Bartosz, additional, Zimmer, Emmanuel, additional, Siepe, Matthias, additional, Hagl, Christian, additional, Detter, Christian, additional, Petersen, Johannes, additional, Tsvelodub, Stanislav, additional, Richardt, Doreen, additional, Werner, Paul, additional, Andreas, Martin, additional, Pichlmaier, Maximilian, additional, and Mueller, Christoph S., additional

Published
2022
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35. Thrombotic microangiopathy following aortic surgery with hypothermic circulatory arrest: a single-centre experience of an underestimated cause of acute renal failure

Author

Kamla, Christine E, primary, Grigorescu-Vlass, Melissa, additional, Wassilowsky, Dietmar, additional, Fischereder, Michael, additional, Hagl, Christian, additional, Schönermarck, Ulf, additional, Pichlmaier, Maximilian A, additional, Peterss, Sven, additional, and Jóskowiak, Dominik, additional

Published
2021
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41. Clinical Results and Quality of Life after Nonelective Cardiac Surgery in Octogenarians.

Author

Saha, Shekhar, Lang, Andrea, von der Linden, Julia, Wassilowsky, Dietmar, Peterss, Sven, Pichlmaier, Maximilian, Hagl, Christian, Juchem, Gerd, and Joskowiak, Dominik

Subjects
OCTOGENARIANS, CARDIAC surgery, QUALITY of life, ARTIFICIAL respiration, PROPENSITY score matching, HOSPITAL mortality
Abstract

Background We analyzed the short-term and mid-term outcomes as well as the health-related quality of life (HRQOL) of octogenarians undergoing elective and urgent cardiac surgery. Patients and Methods We retrospectively identified 688 consecutive octogenarians who underwent cardiac surgery at our center between January 2012 and December 2019. A propensity score matching was performed which resulted in the formation of 80 matched pairs. The patients were interviewed and the Short Form-36 survey was used to assess the HRQOL of survivors. Multivariable analysis incorporated binary logistic regression using a forward stepwise (conditional) model. Results The median age of the matched cohort was 82 years (p = 0.937), among whom, 38.8% of patients were female (p = 0.196). The median EuroSCORE II of the matched cohort was 19.4% (10.1–39.1%). The duration of postoperative mechanical ventilation was found to be independently associated with in-hospital mortality (odds ratio: 1.01 [95% confidence interval: 1.0–1.02], p = 0.038). The survival rates at 1, 2, and 5 years was 75.0, 72.0, and 46.0%, respectively. There was no difference in the total survival between the groups (p = 0.080). The physical health summary score was 41 (30–51) for the elective patients and 42 (35–49) for the nonelective octogenarians (p = 0.581). The median mental health summary scores were 56 (48–60) and 58 (52–60), respectively (p = 0.351). Conclusion Cardiac surgery can be performed in octogenarians with good results and survivors enjoy a good quality of life; however, the indication for surgery or especially for escalation of therapy should always be made prudently, reserved, and in consideration of patient expectations. [ABSTRACT FROM AUTHOR]

Published
2022
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45. Emergent Triple-Branched TEVAR and Redistribution of the Branches to the Supra-Aortic Target Vessels for Treatment of a Contained Ruptured Descending Aortic Aneurysm Associated With a Chronic Type A Aortic Dissection

Author

Stana, Jan, primary, Fernandes Prendes, Carlota, additional, Banafsche, Ramin, additional, Konstantinou, Nikolaos, additional, Rantner, Barbara, additional, Pichlmaier, Maximilian, additional, and Tsilimparis, Nikolaos, additional

Published
2021
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46. Bacterial infiltration in structural heart valve disease

Author

Oberbach, Andreas, Friedrich, Maik, Lehmann, Stefanie, Schlichting, Nadine, Kullnick, Yvonne, Gräber, Sandra, Buschmann, Tilo, Hagl, Christian, Bagaev, Erik, Gruhle, Miriam, Albert, Marion, Luehr, Maximilian, Pichlmaier, Maximilian, Rodloff, Arne C., Reiche, Kristin, Kraft, Theresa, Horn, Friedemann, and Publica

Subjects
calcification, bacterial infiltration, polymicrobial, structural valvular heart disease, metagenome analysis, transcatheter aortic valve implantation
Abstract

Objectives: The pathology of structural valvular heart disease (sVHD) ranges from basic diseases of rheumatologic origin to chronic degenerative remodeling processes after acute bacterial infections. Molecular genetic methods allow detection of the complete microbial spectrum in heart valve tissues independent of microbiological cultivation. In particular, whole-metagenome analysis is a sensitive and highly specific analytical method that allows a deeper insight into the pathogenicity of the diseases. In the present study we assessed the pathogen spectrum in heart valve tissue from 25 sVHD patients using molecular and microbiological methods. Methods: Twenty-five sVHD patients were selected randomly from an observational cohort study (March 2016 to January 2017). The explanted native heart valves were examined using microbiological methods and immunohistological structural analysis. In addition, the bacterial metagenome of the heart valve tissue was determined using next-generation sequencing. Results: The use of sonication as a pretreatment of valve tissue from 4 sVHD patients permitted successful detection of Clostridium difficile, Enterococcus faecalis, Staphylococcus saccharolyticus, and Staphylococcus haemolyticus using microbial cultivation. Histological staining revealed intramural localization. Metagenome analysis identified a higher rate of bacterial infiltration in 52% of cases. The pathogen spectrum included both gram-positive and gram-negative bacteria. Conclusions: Microbiological and molecular biological studies are necessary to detect the spectrum of bacteria in a calcified heart valve. Metagenome analysis is a valid method to gain new insight into the polymicrobial pathophysiology of sVHD. Our results suggest that an undetected proportion of sVHD might be triggered by chronic inflammation or influenced by secondary bacterial infiltration.

Published
2020

47. Outcome of patients treated with extracorporeal life support in cardiogenic shock complicating acute myocardial infarction: 1-year result from the ECLS-Shock study

Author

Lackermair, Korbinian, primary, Brunner, Stefan, additional, Orban, Mathias, additional, Peterss, Sven, additional, Orban, Martin, additional, Theiss, Hans D., additional, Huber, Bruno C., additional, Juchem, Gerd, additional, Born, Frank, additional, Boulesteix, Anne-Laure, additional, Bauer, Axel, additional, Pichlmaier, Maximilian, additional, Hausleiter, Jörg, additional, Massberg, Steffen, additional, Hagl, Christian, additional, and Guenther, Sabina P. W., additional

Published
2020
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