AIM:To determine the procedural characteristics, results, and long-term outcomes of the first 500 consecutive patients undergoing transcatheter aortic valve implantation (TAVI) at the MC Medicor International Center for Cardiovascular Diseases Izola (Slovenia). METHODS:Data were collected from the institutional registry. The date of death was obtained from the National BIRPIS system by using the patient's health insurance card number. The difference in 30-day mortality was assessed between two consecutive cohorts of 250 patients, patients who received self-expandable (SEV) and those with balloon-expandable (BEV) valves, and between patients ≤80 and >80 years old. RESULTS:Between December 2016 and September 2023, 500 patients (80±6 years, 52% men, EuroScore II, 4.09±4.11), including 3.2% with degenerated surgical prosthesis, underwent TAVI. After predilatation (57%), SEV was implanted in 87.5% and BEV in 12.5% of the patients. The mean postprocedural gradient was 10±4 mm Hg, with more than moderate regurgitation in 0.4%. Emergency cardiac/vascular surgery was performed in 1.4%, and stroke occurred in 0.8%. The new permanent pacemaker (PPM) rate decreased from 19% to 7% (P<0.001) in the second cohort, and the mean postprocedural transaortic gradient was significantly lower after SEV compared with BEV (9±4 vs 13±4 mm Hg; P<0.001). There was no difference in 30-day mortality between the first and second cohort of 250 patients (1.2% vs 1.2%; P=1.000), cohorts of 50 patients from number 0 to 500 (0% vs 2.0%; P=0.391), SEV and BEV groups (0.9% vs 1.6%; P=0.487), and patients ≤80 and >80 years old (2.0% vs 0.4%; P=0.119). CONCLUSION:TAVI results in our study are comparable with international standards. PPM rate decreased over time, and postprocedural gradient was lower after SEV. Learning curve, type of valve, and patient age did not affect 30-day mortality.

Transapical (TA) aortic valve replacement was an integral part of the Placement of Transcatheter Aortic Valves (PARTNER) trial. Enrollment during the randomized trial included 104 transapical (premarket approval TA [PMA-TA]) and 92 surgical aortic valve replacements (SAVR) within the TA cohort. On completion of the trial, enrollment continued in a nonrandomized continued access (NRCA) program. We compared the outcomes of NRCA-TA procedures with those of PMA-TA and SAVR.In 22 centers, 975 patients underwent TA aortic valve replacement as part of the NRCA registry. Inclusion and exclusion criteria were unchanged from the previously reported PARTNER trial. All patients were followed up for at least 1 year.Thirty-day or in-hospital mortality was 8.8% for the NRCA-TA cohort, compared with 10.6% and 12.0% for the PMA-TA and SAVR patients, respectively (p = 0.54). One-year mortality in the NRCA-TA cohort was 22.1%, not significantly lower than the mortality in PMA-TA and SAVR patients at 29.0% and 25.3%, respectively (p = 0.27). Thirty-day or in-hospital stroke was 2.2% among NRCA-TA patients in contrast to the 6.7% stroke rate observed in the PMA-TA group and 5.4% in SAVR patients (p = 0.008). Lower rates of neurologic adverse events in the NRCA-TA group persisted at 1 year compared with the PMA-TA and SAVR patients.Among the 975 patients in the NRCA-TA cohort, rates of major outcomes including death and stroke compared favorably with outcomes of PMA-TA and SAVR patients enrolled in the PARTNER trial. This trend toward improved outcomes may be attributed to improved patient selection, individual centers surmounting the procedural learning curve, and refinements in surgical technique.

Potentiometric sensors are broadening their application scope because they are affordable and scalable devices capable of being used in-field and online. In that frame, the use of proton-conducting solid-state electrolytes in these sensors architecture offers the possibility to operate at high temperatures, with high physical and chemical stabilities. A potential application for this kind of sensor is tritium monitoring in future fusion reactors. The first steps toward the development of this analytical tool will be devices capable of measuring hydrogen in high temperature applicationsIn the present work, a potentiometric sensor based on BaCe0.6Zr0.3Y0.1O3-α (BCZY) solid-state proton-conductor was tested for hydrogen monitoring at 325 °C, 350 °C and 375 °C. BCZY was synthesized by the solid-state method and characterized using XRD. The sensor's linear range, accuracy and limit of detection were evaluated at the selected temperatures (325 °C, 350 °C and 375 °C). Moreover, sensors presented a very short response and recovery times (<100 s).

Background: Transcatheter aortic valve implantation (TAVI) has become a standard of care for the treatment of symptomatic aortic stenosis in the elderly. The aim of the present study is to describe initial results in the international cardiovascular centre MC Medicor and compare them with the results of the recently published pivotal international trials. Methods: A retrospective analysis of consecutive patients undergoing TAVI was performed. The data were obtained from a prospective Medicor registry of percutaneous cardiovascular interventions. Results: Between 12 December 2016 and 6 June 2020, a total of 109 TAVI were performed. The patients were on average 81 years old and had EuroScore II of 3.95. Mean aortic valve gradient by echocardiography was 46 mmHg and aortic valve area 0.8 cm2. Percutaneous femoral approach was used in all but one patient. Balloon predilatation was performed in 36.7%. TAVI valve was successfully implanted in 98.2% and balloon postdilatation was performed in 15.6%. Mean post TAVI gradient was 9 mmHg. Moderate aortic regurgitation was recorded in 3.7% and severe in none of the patients. New permanent pacemaker was required in 22.9% (95% confidence interval (CI) 15.4% - 32.0%). One patient had a transient ischemic attack. Emergency pericardiocentesis was performed in 2.7% (95%, CI 0.6% - 7.8%), open-heart surgery in 1.8% (95%, CI 0.2% - 6.5%), vascular surgery in 0.9% (95%, CI 0.0% - 5.0%) and additional haemostasis of the ileofemoral artery with covered stents in 1.8% (95%, CI 0.2% - 6.5%) In-hospital and 30-day mortality rates were 1.8% (95%, CI 0.2% -6.6%), 1-year mortality 3.1% (95%, CI 0.0% - 6.5%), 2-year mortality 5.6% (95%, CI 0.0% - 11.4%) and 3-year mortality 14.2% (95%, CI 0.0% - 29.6%). Conclusion: Initial TAVI results in MC Medicor are good and comparable with the results of recently published international pivotal trials.

Izhodišče: Katetrska vstavitev aortne zaklopke (TAVI) je v zadnjih letih postala prevladujoča metoda za zdravljenje degenerativne aortne stenoze pri starejših bolnikih. Prispevek prikazuje prve rezultate zdravljenja s TAVI v mednarodnem kardiovaskularnem centru MC Medicor in jih primerja z najpomembnejšimi mednarodnimi raziskavami zadnjih let. Metode: V retrospektivno raziskavo smo vključili zaporedno serijo bolnikov, pri katerih smo opravili TAVI. Podatke smo pridobili iz lastnega registra perkutanih kardioloških posegov. Rezulati: Med 12. decembrom 2016 in 6. junijem 2020 smo TAVI opravili pri 109 bolnikih s povprečno starostjo 81 let in EuroScore II 3.95. Srednji ultrazvočni gradient na aortni zaklopki je znašal 46 mm Hg, izračunana površina ustja pa 0,8 cm2. Pri vseh bolnikih, razen pri enem, smo uporabili perkutani pristop preko femoralne arterije. Balonsko predilatacijo smo izvedli v 36,7 %, novo zaklopko vsadili v 98,2 % in jo balonsko postdilatirali v 15,6 %. Srednji ultrazvočni gradient po TAVI je znašal 9 mm Hg. Zmerna aortna regurgitacija je bila prisotna v 3,7 % (95 % IZ 1,0–9,1 %), huda pa pri nobenem od bolnikov. Nov srčni spodbujevalec je potrebovalo 22,9 % bolnikov (95 % IZ 15,4–32,0 %). En bolnik je imel tranzitorno ishemično kap. Urgentno perikardiocentezo smo opravili v 2,7 % (95 % IZ 0,6–7,8 %), srčno operacijo v 1,8 % (95 % IZ 0,2–6,5 %), žilno operacijo v 0,9 % (95 % IZ 0,0–5,0 %) in hemostazo s prekritimi žilnimi opornicami v 1,8 % (95 % IZ 0,2–6,5 %). Bolnišnična in 30-dnevna umrljivost sta bili 1,8 % (95 % IZ 0,2–6,5 %), enoletna 3,1 % (95 % IZ 0,0–6,5 %), dvoletna 5,6 % (95 % IZ 0,0–11,4 %) in triletna 14,2 % (95 % IZ 0,0–29,6 %). Zaključek: Začetni rezultati TAVI v Medicorju so ugodni in primerljivi z najpomembnejšimi mednarodnimimi raziskavami zadnjih let.

Femoropopliteal bypass is a surgical procedure used in the advanced stages of peripheral arterial disease on lower limb arteries. The most common cause of arterial peripheral disease is the atherosclerotic plaque, which significantly narrows the vascular lumen. This kind of lesion is treated with vascular interventions. Those are divided into endovascular percutaneous interventions and into classic surgical interventions. In addition there is emerging a new endoscopic method in vascular bypass operations as an alternative to the already existing classic surgical intervention. Endoscopic vein harvesting is a minimally invasive surgical technique that enables vein dissection and its usage for vascular bypass with the help of videoscopic equipment. The case report presents a 68-years old male with diagnosed peripheral arterial disease. He was a suitable candidate for surgical treatment, therefore a femoropopliteal bypass was done in his right lower extremity. The distinctive note of this operation was the usage of anewer technique, that is, endoscopic vein harvesting of the greater saphenous vein.

Femoropopliteal bypass is a surgical procedure used in the advanced stages of peripheral arterial disease on lower limb arteries. The most common cause of arterial peripheral disease is the atherosclerotic plaque, which significantly narrows the vascular lumen. This kind of lesion is treated with vascular interventions. Those are divided into endovascular percutaneous interventions and into classic surgical interventions. In addition there is emerging a new endoscopic method in vascular bypass operations as an alternative to the already existing classic surgical intervention. Endoscopic vein harvesting is a minimally invasive surgical technique that enables vein dissection and its usage for vascular bypass with the help of videoscopic equipment. The case report presents a 68-years old male with diagnosed peripheral arterial disease. He was a suitable candidate for surgical treatment, therefore a femoropopliteal bypass was done in his right lower extremity. The distinctive note of this operation was the usage of anewer technique, that is, endoscopic vein harvesting of the greater saphenous vein.

In this association study the authors compared the insertion/deletion (I/D) angiotensin-I converting enzyme (ACE) gene polymorphism in females and males with premature myocardial infarction (MI). I/D ACE gene polymorphism was tested in 738 subjects: 302 patients with MI (151 men and 151 women) and 436 healthy subjects (207 men and 229 women). In women the ACE-DD genotype was not associated with MI (OR 1.1, 95% CI 0.6-2.1, p=0.6), whereas the ACE-DD genotype conferred a 2-fold independent risk for MI in men (95% CI=1.2-3.4; p=0.013) after adjustment for cardiovascular risk factors. The authors found evidence for the sex difference in the effect of the ACE-DD genotype on MI risk. The ACE-DD genotype conferred a 2-fold independent risk for premature MI in males.