Background: Upper partial sternotomy (UPS) as one of the less invasive cardiac surgical approaches has become the standard procedure in the valve surgery in our institution. In the study period, we have performed 1,781 cardiac operations through this approach. We report about the results of mitral valve repair via UPS.

Objectives: Combined mitral, tricuspid and aortic valve surgery is one of the most demanding cardiac procedures associated with high operative mortality. Current literature reports operative mortality rates up to 17%. In this context, the advantages of minimal invasive approach through an upper partial sternotomy (UPS) is still unsettled in view of the prolonged operation time and the consequent additional risk. The aim of this study is to report the preliminary results of UPS and to compare them to the standard median sternotomy (MS).

High acquisition cost of the pumps along with frequent need for readmissions and long hospital stays of LVAD-therapy are associated with a high financial burden for caregivers. Prevention of complications and the consequent need of re-hospitalization must prompt prospective studies in order to improve quality of life and reduce costs.

Objectives: Recruitment of (prospective) residents in cardiac surgery has become increasingly challenging. Applying innovative, low-cost, and easily accessible models for surgical training is another burden for many teaching hospitals. As 3D printing is an established tool for additional preoperative planning at our department, we developed a wet lab equivalent for surgical aortic valve replacement (SAVR) using 3D-printed aortic valves and a self-made training concept. To evaluate a low-cost and easily reproducible model was the aim of our study.

In den vergangenen Jahren ist die Zahl der geriatrischen Patienten im Bereich der kardiovaskulären Chirurgie kontinuierlich gestiegen. Dieser Beitrag stellt häufige Komplikationen sowie deren Ursachen vor und zeigt Möglichkeiten zur Verbesserung der täglichen Praxis auf. Zusätzlich zu den chirurgischen Kenntnissen ist das präoperative Risikomanagement für den Erfolg der Rehabilitation essenziell. Das präoperative Risikomanagement stellt eine große Herausforderung dar, da Fähigkeiten und Defizienz der Patienten nicht altersbezogen und schwierig zu erfassen sind. Daher ist eine Strategie, die präoperative Risiken frühzeitig erkennt und Einfluss darauf nehmen kann, äußerst hilfreich. Die präoperative geriatrische Untersuchung zur Beurteilung der präoperativen Risiken ist zwingend erforderlich. Diese Untersuchung gibt Informationen bezüglich Kognition, Mobilität und Aktivitäten des täglichen Lebens. Ein postoperatives Delir hat signifikante Auswirkungen auf den Heilungsprozess und das Gesamtergebnis und sollte daher schon im Vorfeld erkannt und behandelt werden. Um eine Aspirationspneumonie infolge einer Dysphagie zu vermeiden, ist die Anwendung einer speziellen klinischen Diagnostik erforderlich. Ein wichtiger Faktor für die erfolgreiche Rehabilitation ist die adäquate enterale Ernährung. Um bei Infektionen eine optimale antibiotische Therapie durchzuführen, wird empfohlen, dass ein Antibiotic-Stewardship-Experte Teil des geriatrischen Rehabilitationsteams ist. Nach einem Jahr beträgt die Inzidenz für ein posttraumatisches Stresssyndrom auf der Intensivstation zwischen 25 und 33%. Es ist zwingend notwendig, dass die Patienten und ihre Angehörigen während der Rehabilitation psychologische Unterstützung erhalten.

Tolerance is a phenomenon first discovered in septic patients and resulting in a second status of immune paralysis and a high susceptibility for secondary infections. Tolerance is induced by endotoxin (LPS) stimulation of Toll-like receptor 4 (TLR4) but can also be triggered by endogenous TLR4 ligands like the S100 proteins S100A8/A9 in sterile inflammation. We investigated the effect of mechanical stress of cardiopulmonary bypass on human monocytes by examining inflammatory cytokines and reactivity of patients’ monocytes on inflammatory stimulation in vitro.

Introduction: The contemporary risk and long-term outcomes of reoperation for replacement of infected prosthetic material are not well known. The aim of our study was to quantify the short-term progression in terms of early death and to describe the long-term trend by means of the current quality of life.

Objectives: Cardiac sarcomas are rare and the pathogenesis of this disease is widely unknown. In some sarcomas mutations have been found and highlighted the pathogenetic role of the genetic alterations underlying this disease. In this contribution we summarize clinical data from our center and present a selected case which was analyzed for epigenetic alterations by studying DNA methylation of cytosine guanine dinucleotides which is a key epigenetic modification affecting gene transcription and genome integrity.

Objectives: The frequency of primary malignant cardiac tumors is often characterized by results of autopsy series since they rarely occur in clinical care.

Purpose: The current study sought to demonstrate the advantages offered by PET/CT in patients supported with continuous-flow left ventricular assist devices (CF-LVADs) in detecting infection and the consequent impact on clinical decisions.

Objective: To describe findings and predictors of in-hospital mortality in patients requiring repeated coronary angiogram for cardiac ischemic complications following heart surgery.

Objectives: Despite advances of medical treatment, in some circumstances extra corporeal life support (ECLS) represents the only therapeutic alternative for patients in cardiogenic shock. The aim of this study is to report on our extensive experience with ECLS therapy and to evaluate 30-day mortality linked with the procedure.

Objectives: Heparin induced thrombocytopenia type II (HIT II) is a rare but life threatening side effect of heparin therapy that occurs in up to 3% of all heparin-treated patients and it is a demanding therapeutic challenge in patients undergoing left ventricular assist device (LVAD) implantation. We present our experience with off-pump LVAD implantation under extracorporeal life support (ECLS) in patients suffering from HIT II.

Background: This study has been conceived to compare two groups of patients who underwent aortic valve replacement using the conventional and the minimally-invasive technique.

Introduction: One advantage of off pump coronary artery bypass grafting might be the avoidance of manipulation at the aorta. This is achieved by omitting the extracorporeal circulation (ECC) and T-graft-anastomosis. The aim of this study was, to evaluate the impact of T-graft-anastomosis on outcome after bypass-surgery.

Kreislaufunterstützungssysteme spielen eine zunehmende Rolle in der Behandlung der terminalen Herzinsuffizienz. Aufgrund ihrer Kontaktfläche mit dem Blut stellen thromboembolische Komplikationen häufig den limitierenden Faktor in der Therapie mit Kreislaufunterstützungssystemen dar. Der nachfolgende Artikel gibt einen Überblick über klinische Charakteristika und therapeutische Maßnahmen.