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Copyright of Cardiology Letters is the property of Slovak Society of Cardiology and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

BACKGROUND: The aim of this study was to present our experience in the treatment of post-myocardial infarction ventricular septal defect and examine the various risk factors. METHODS: This is a retrospective study. From January 2010 to December 2018, 20 patients underwent an urgent/emergency surgical repair of post-myocardial infarction ventricular septal defect. RESULTS: The mortality in our group of patients was 45 %. Non-survivors compared to the survivors were all in cardiogenic shock (p=0.0098), had an emergency/salvage operation (p=0.0055), preoperative mechanical ventilation (p=0.0081), shorter time between intraaortic balloon pressure insertion and surgery (p=0.0115), shorter median time between ventricular septal defect and surgery, postoperative renal replacement therapy (p=0.0498), and more patients had a residual effect (p=0.0022). In multivariate analysis, preoperative mechanical ventilation (p=0.0001), postoperative renal replacement therapy (p=0.0021) and residual defect (p=0.0000027) were shown to be strong predictors for hospital mortality. CONCLUSION: This analysis showed that post-myocardial infarction ventricular septal defect repair is a devastating complication and preoperative mechanical ventilation, postoperative renal replacement therapy and residual defect were identified to be the predictors of mortality. Initial stabilization of the patients, when it is possible, and a delayed repair, may improve the outcome of these patients. [ABSTRACT FROM AUTHOR]

Introduction: Based on a longtime voluntary registry founded by the Ministry of Health of the Slovak Republic in 2012, well-defined data of all adult cardiac surgery procedures performed in Slovakia at the National Institute of Cardiovascular Diseases during the year 2020 are analyzed. Material and method: For this period, a total of 1021 procedures were submitted to the registry from the National Institute of Cardiovascular Diseases. Results: The unadjusted in-hospital survival rate for the 401 isolated coronary artery bypass grafting procedures including urgent and emergency procedures (relatioship on-/off pump 4.5:1) was 97%. For isolated 306 isolated heart valve procedures (30 transcatheter interventions), it was 96.4%. Concerning ventricular assist devices, 11 implantations were registered. In 2020 the number of isolated heart transplantations increased to 26, a rise of 44.4% compared to the previous year. Conclusion: This annual registry represents voluntary public reporting by accumulating actual information for nearly all heart procedures in Slovakia, constitutes advancements in heart medicine, and represents a basis for quality management. In addition the registry demonstrates that the provision of cardiac surgery in Slovakia is up to date, appropriate, and fulltime nationwide patient treatment is guaranteed. [ABSTRACT FROM AUTHOR]

Copyright of Cardiology Letters is the property of Slovak Society of Cardiology and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

OBJECTIVES: Mechanical circulatory support is an established therapy in end-stage heart failure. The EUROMACS registry was created to promote research in these patients. The aim of this report was to present our 12 year experience with the durable mechanical circulatory support devices and compare it with the EUROMACS registry. METHODS: Data from the entire EUROMACS registry from January 2011 to April 2019 were included (4704 implantations in 4410 patients). During the 12 years of our experience, until April 2019,125 mechanical support devices were implanted, in 122 patients. We compare patients' characteristics, operative data and results with the EUROMACS registry and we report the major complications during the observational period. RESULTS: Primary end-point (death) occurred in 40 (32.8 %) patients in our cohort during the followup period, representing the survival rate 75 %, 68 %, and 58 % for 6, 12, 24 months respectively, which compares favourably with the data, reported by the EUROMACS registry, the survival 66 % and 53 % after 1 and 2 years respectively. Cerebrovascular accident occurred in 7 %, a bleeding event in 32 %, significant infection (driveline) in 78 % and a device malfunction in 13 % of the patients. Forty-three patients underwent a heart transplant with hospital and long-term mortality of 11.6 % and 14 % respectively. CONCLUSION: Mechanical circulatory support is a valuable therapeutic option with excellent survival rates, nevertheless it is associated with clinically significant complications rates. The direct comparison between our cohort and the EUROMACS registry showed that early implantation strategy and mini invasive approach may improve survival rates and decrease postoperative complications. [ABSTRACT FROM AUTHOR]

Transcatheter mitral valve replacement (TMVR) with the Tendyne mitral valve has emerged as a novel potential therapy for patients with severe mitral valve disease who are unsuitable candidates for conventional surgery and transcatheter mitral repair with MitraClip. In this communication we present the first two cases that were performed in Slovakia and the V4 countries. Two surgically high risk female patients 78 and 79 years old respectively (EuroScore II 7.8% and 7.4% respectively) also unsuitable candidates for transcatheter mitral repair with MitraClip, underwent transapical TMVR with the Tendyne valve. Both procedures were successful: one of the patients two months after the procedure is doing well, the other patient had a complicated postoperative course and died on postoperative day 4. Moreover we present a brief description of the valve, and of the deployment technique, and an overview of the major clinical studies. [ABSTRACT FROM AUTHOR]

Copyright of Cardiology Letters is the property of Slovak Society of Cardiology and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aim: To evaluate survival and to analyse causes of mortality and morbidity in patients after left ventricular assist device (LVAD) implantation. To conceive our current strategy of LVAD use in the treatment of heart failure (HF). Patients and methods: One hundred and twenty-seven patients (88% men) were analysed. Mean age was 49.6 ± 11.7 years. All patients were in NYHA class IV, left ventricular ejection fraction was 18.4 ± 5.4%, and cardiac index 1.8 ± 0.5 L/min/m2. At the time of implant, 74% of patients were inotrope-dependent (Intermacs profile 1-3), 15% of patients were in cardiogenic shock (Intermacs 1). LVAD implant strategy was bridge to transplant in 53%, bridge to decision in 42%, and destination therapy in 5% of patients. Results: Mean duration on LVAD was 426 days. Twelve months after implantation, 57% of patients were alive on LVAD, 17% underwent heart transplant, and 26% of patients died. Two years after implantation 40% of patients were alive on LVAD, 31% underwent heart transplant, and 29% of patients died. The most frequent cause of hospital mortality was bleeding (46%). Pump thrombosis and multi-organ failure were the most frequent causes of long-term mortality (23% each). Driveline infections were the dominant reason for rehospitalisation (27%). Conclusions: Due to long-term experience with LVAD implantation with favourable results and a lower activity in our transplant programme, we prefer an early LVAD implant to an uncertain, and presumably long, waiting period for an appropriate donor in the case of haemodynamic instability of a transplant candidate. In the assessment of transplant urgency, patients with similar circulatory status who cannot receive an LVAD are prioritized over those with an implanted LVAD. [ABSTRACT FROM AUTHOR]

In this case series we present our initial experience with the implantation of the SynCardia total artificial heart (TAH) in three patients, the first of which was the first SynCardia TAH implantation in the Visegrad Four (V4) countries. The first and the third patients, after 195 and 126 days of TAH support respectively, experienced successful heart transplants, while the second patient on postoperative day 11 died due to a ruptured undiagnosed brain aneurysm. Our results show that the SynCardia TAH is an alternative therapy in patients with severe end-stage biventricular heart failure waiting for heart transplantation. It is an intermediate step until the development of genetically modified animal hearts, engineered bioartificial hearts or hearts from induced pluripotent stem cells could replace the failing heart in patients with end-stage heart disease. [ABSTRACT FROM AUTHOR]

BACKGROUND: The purpose of this study is to report our experience in performing transapical (TA) TAVR with a balloon-expandable valve only by cardiac surgeons, with on site interventional cardiology support. METHODS: A retrospective review of 97 consecutive patients that underwent TA TAVR due to severe symptomatic aortic stenosis was performed from 2012 to 2016. Median follow-up time was 20.5 months. Preoperative risk factors and postoperative outcomes were evaluated using Valve Academic Research Consortium-2 definitions. RESULTS: All patients were high risk with a mean Euroscore of 7.28±7.77. Five year and 30-day mortality were 9.3 % and 1.1 %, respectively. Ninty six (98.9 %) of the patients had no or mild paravalvular leak seen by transesophageal echocardiography after implantation. Device success was 91.8%. Postoperatively there was a significant increase of the ejection fraction (50.8±7.1 % preoperatively vs 53.1±7.7 % postoperatively, p=0.009) and reverse remodeling of the left ventricle (left ventricular end-diastolic diameter preoperatively 50.8±7.1 mm vs 49.2±8.1 mm postoperatively, p=0.031). CONCLUSION: Our experience demonstrates that TA TAVR can be performed only by cardiac surgeons, with on site interventional cardiology support safely and successfully with low and comparable postoperative mortality and rate of complications. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Implantation of a total artificial heart is an alternative to durable biventricular assist device support in selected patients. We present our initial experience with the implantation of the SynCardia total artificial heart (TAH) in three patients. The first patient, was the first SynCardia (TAH) implantation in the Visegrad Four (V4) countries. METHOD: Three patients with severe refractory end stage biventricular heart failure listed for heart transplant were indicated for SynCardia TAH implantation. RESULTS: We present in details the perioperative and postoperative outcomes of these patients. The first and the third patient, after 195 and 126 days of TAH support respectively, had a successful heart transplants, the second patient died on 11th postoperative day. The cause of death was brain bleeding due to ruptured undiagnosed brain aneurysm. CONCLUSION: SynCardia TAH is an alternative therapy in patients with end-stage biventricular heart failure waiting for heart transplantation. The SynCardia TAH with pulsatility resembles the physiologic circulation, improves the condition of the patients and increases survival compared to the biventricular assist devices. It is an intermediate step until the development of genetically modified animal hearts, engineered bioartificial hearts or hearts from induced pluripotent stem cells that would replace the failing heart in the patients with end-stage heart disease (Tab. 2, Fig. 1, Ref. 27). Text in PDF www.elis.sk. [ABSTRACT FROM AUTHOR]

Copyright of Cardiology Letters is the property of Slovak Society of Cardiology and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Cardiology Letters is the property of Slovak Society of Cardiology and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Cardiology Letters is the property of Slovak Society of Cardiology and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background:  Mechanical assist device indications have changed in recent years. Reduced incidence of complications, better survival, and the third generation of mechanical support devices contributed to this change. In this single-center study, we focused on two time periods that are characterized by the use of different types of mechanical support devices, different patient characteristics, and change in the indications., Methods:  The data were processed from the European Registry for Patients with Mechanical Circulatory Support (EUROMACS). We retrospectively defined two time intervals to reflect changes in ventricular assist device technology (period 1: 2007-2015; period 2: 2016-20222). A total of 181 patients underwent left ventricular assist device implantation. Device utilization was the following: HeartMate II = 52 (76.4%) and HeartWare = 16 (23.6%) in period 1 and HeartMate II = 2 (1.8%), HeartMate 3 = 70 (61:9%), HeartWare = 29 (25.7%), SynCardia TAH = 10 (8.8%), and BerlinHeart EXCOR = 2 (1.8%) in period 2. The outcomes of the time intervals were analyzed and evaluated., Results:  Survival was significantly higher during the second time period. Multivariate analysis revealed that age and bypass pump time are independent predictors of mortality. Idiopathic cardiomyopathy, bypass time, and the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) score are independent predictors of adverse events. Furthermore, the first period was noted to be at an increased risk of the following adverse events: pump thrombosis, gastrointestinal bleeding, and bleeding events., Conclusion:  Despite the higher risk profile of the patients and persistent challenges, during the second period, there was a significant decrease in mortality and morbidity. The use of the HeartMate 3 device may have contributed to this result., Competing Interests: None declared., (Thieme. All rights reserved.)

Although left ventricular assist device implantation represents the majority of durable mechanical circulatory support implants for patients with advanced heart failure, as many as 20 to 30% will subsequently have right heart failure requiring extended inotropic support or short-term mechanical circulatory support, and the total artificial heart is an established tool in the bridge to transplant armamentarium. The aim of this short report is to present our center's experience with the use of SynCardia total artificial heart. Between November 2017 and April 2021, 10 SynCardia total artificial heart devices were implanted. Of the 10 patients who underwent total artificial heart implantation, 6 (60%) were successfully bridged to transplant with a median time of 6.5 (interquartile range [IQR] 6-8) months, and 4 patients died on device support during the index hospitalization. The 30-day, 1-year, and 3-year survival rates after heart transplantation were the same at 66.7% (4/6). Despite the uncertain future of total artificial hearts, it remains a viable option for patients who require biventricular bridge to transplant or for a select subset of patients with advance heart failure who may not otherwise survive., Competing Interests: None declared., (Thieme. All rights reserved.)

Objectives: The use of ventricular assist devices (VADs) in children is increasing. However, absolute numbers in individual centres and countries remain small. Collaborative efforts such as the Paedi-European Registry for Patients with Mechanical Circulatory Support (EUROMACS) are therefore essential for combining international experience with paediatric VADs. Our goal was to present the results from the fourth Paedi-EUROMACS report., Methods: All paediatric (<19 years) patients from the EUROMACS database supported by a VAD were included. Patients were stratified into a congenital heart disease (CHD) group and a group with a non-congenital aetiology. End points included mortality, a transplant and recovery. Cox proportional hazard models were used to explore associated factors for mortality, cerebrovascular accident and pump thrombosis., Results: A total of 590 primary implants were included. The congenital group was significantly younger (2.5 vs 8.0 years, respectively, P < 0.001) and was more commonly supported by a pulsatile flow device (73.5% vs 59.9%, P < 0.001). Mortality was significantly higher in the congenital group (30.8% vs 20.4%, P = 0.009) than in the non-congenital group. However, in multivariable analyses, CHD was not significantly associated with mortality [hazard ratio (HR) 1.285; confidence interval (CI) 0.8111-2.036, P = 0.740]. Pump thrombosis was the most frequently reported adverse event (377 events in 132 patients; 0.925 events per patient-year) and was significantly associated with body surface area (HR 0.524, CI 0.333-0.823, P = 0.005), CHD (HR 1.641, CI 1.054-2.555, P = 0.028) and pulsatile flow support (HR 2.345, CI 1.406-3.910, P = 0.001) in multivariable analyses., Conclusions: This fourth Paedi-EUROMACS report highlights the increasing use of paediatric VADs. The patient populations with congenital and non-congenital aetiologies exhibit distinct characteristics and clinical outcomes., (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.)

Introduction: As the utilization of left-ventricular assist devices (LVADs) continues to rise and patients experience extended survival duration with these devices, the overall incidence of adverse events and complications has shown a notable increase. Among the major adverse events, thromboembolic complications are particularly significant. The aim of this study is to present our experience and assess the risk of thromboembolic complications after implantation of durable continuous-flow left-ventricular assist devices (CF-LVAD) in patients with end-stage heart failure., Patients and Methods: From 2007 to 2022, 169 left ventricular continuous-flow durable mechanical assist devices were implanted at our institute. Three types of devices were employed: HeartMate II (n = 54, 32%), HeartMate 3 (n = 70, 41.4%), and Heart Ware (n = 45, 26.6%). The data were extracted from the EUROMACS register., Results: Thromboembolic complication, pump thrombosis was observed in 11/169 patients (6.5%), with 2 patients experiencing stroke after embolism to the central nervous system. Among these cases, 10 patients (90.9%) were equipped with the Heart Ware device while 1 patient (9.1%) had the Heart Mate II device implanted. Nine patients received the durable device as a bridge to transplant therapy and two as a bridge to candidacy. The overall mean age of the patients was 47.6±10.2 years, with 2 women and 10 men. The pump thrombosis was managed through thrombolytic therapy, high-intensity heparin anticoagulation protocol, pump exchange, pump explantation, and early heart transplant. The combined hospital and long-term mortality rate was 4/11 patients (36.4%)., Conclusion: Based on our experience, thromboembolic complications presenting primarily as pump thromboses, were a relatively common phenomenon experienced in association with the second-generation continuous-flow devices, but rarely seen with the third-generation devices. Thrombolysis followed by early heart transplantation proved to be a safe treatment option (Tab. 1, Ref. 14). Text in PDF www.elis.sk Keywords: durable mechanical assist device, durable left ventricular assist devices, outcomes, thromboembolic complications.

Background: Clinical assessment and laboratory markers provide valuable information on tissue perfusion and enhance the optimalisation of management in the treatment of patients on extracorporeal membrane oxygenation (ECMO). The PCO2 gap is a reliable marker of cardiac output (CO) and perfusion. The aim of this study was to evaluate the PCO2 gap as a marker of tissue hypoperfusion and to compare it to lactate and SvO2., Methods: A single-center retrospective study on 131 adult cardiac patients who underwent ECMO implantation in the period between 2010 and 2021. Baseline characteristics, laboratory markers and mortality were analyzed., Results: There was a statistically significant difference in the plasmatic levels of lactate, SvO2 and PCO2 gap between patients that survived and those who died post ECMO implantation (3.6±3.29 vs 7.15±7.38 mmol/l, p<0.001; 69.13±9 vs 67.38±10%, p<0.001; 7.65±2.93 vs 8.34±3.71, p<0.001 respectively). There was a statistically significant difference in PCO2 gap in the first 5 arterial blood gas (ABG) samples post ECMO implantation between patients that survived and those who died (9.08±4.79 vs 10.37±5.35, p<0.003). For SvO2, this difference was not statistically significant (69.82±11.91 vs 68.51±11.72, p<0.104). There was a statistically significant but low negative correlation between SvO2 and PCO2 gap post ECMO implantation (r = ‒0.354, p<0.001)., Conclusion: The PCO2 gap is a valuable biomarker for monitoring tissue perfusion in patients on ECMO. It is associated with increased mortality and should be an integral part of clinical evaluation. (Tab. 1, Fig. 5, Ref. 26). Text in PDF www.elis.sk Keywords: PCO2 gap, VA-ECMO, lactate.

Photothermal therapy (PTT) mediated at the nanoscale has a unique advantage over currently used cancer treatments, by being spatially highly specific and minimally invasive. Although PTT combats traditional tumor treatment approaches, its clinical implementation has not yet been successful. The reasons for its disadvantage include an insufficient treatment efficiency or low tumor accumulation. Here, we present a promising new PTT platform combining a recently emerged two-dimensional (2D) inorganic nanomaterial, MoO x , and a tumor hypoxia targeting element, the monoclonal antibody M75. M75 specifically binds to carbonic anhydrase IX (CAIX), a hypoxia marker associated with many solid tumors with a poor prognosis. The as-prepared nanoconjugates showed highly specific binding to cancer cells expressing CAIX while being able to produce significant photothermal yield after irradiation with near-IR wavelengths. Small aminophosphonic acid linkers were recognized to be more effective over the combination of poly(ethylene glycol) chain and biotin-avidin-biotin bridge in constructing a PTT platform with high tumor-binding efficacy. The in vitro cellular uptake of nanoconjugates was visualized by high-resolution fluorescence microscopy and label-free live cell confocal Raman microscopy. The key to effective cancer treatment may be the synergistic employment of active targeting and noninvasive, tumor-selective therapeutic approaches, such as nanoscale-mediated PTT. The use of active targeting can streamline nanoparticle delivery increasing photothermal yield and therapeutic success., Competing Interests: The authors declare no competing financial interest., (© 2023 The Authors. Published by American Chemical Society.)

Background and Objectives : Surgical revascularisation of patients with atherosclerosis of the ascending aorta remains a challenge. Different surgical strategies have been described in coronary surgical patients to offer alternative revascularisation strategies other than the conventional surgical revascularisation in patients unsuitable for it. The aim of this study is to compare the real-world outcomes between two groups of patients who underwent off-pump surgery (left internal mammary artery graft to the left anterior descending artery) or a hybrid with a percutaneous revascularisation procedure at a later stage. Materials and Methods : This is a single-centre retrospective observational study. Between the years 2010 and 2021, 91/6863 patients (1.33%) were diagnosed with severe atherosclerosis of the ascending aorta. All the patients were treated with off-pump revascularisation (91 patients), and the cardiologist would decide at a later stage whether the rest of the vessels would be treated with percutaneous revascularisation (25 patients). Results : There was no statistical difference in the various preoperative characteristics, except for coronary artery left main disease (30.30% vs. 64%; p = 0.0043). The two groups had no statistical differences in the perioperative characteristics and postoperative complications. The 1-, 5-, and 10-year mortality rates in the two groups were 6.1% vs. 0%, 59% vs. 80%, and 93.9% vs. 100%, respectively (off-pump vs. hybrid with percutaneous revascularisation procedure, p = 0.1958). Conclusions : Both strategies have high long-term comparable mortality. The off-pump surgery and the HCR procedure at a later stage may be solutions for these high-risk patients, but the target treatment should be complete HCR revascularisation during the index hospitalization.

Cardiac surgery-associated acute kidney injury is a common post-operative complication, mostly due to increasing oxidative stress. Recently, molecular hydrogen (H 2 gas) has also been applied to cardiac surgery due to its ability to reduce oxidative stress. We evaluated the potential effect of H 2 application on the kidney in an in vivo model of simulated heart transplantation. Pigs underwent cardiac surgery within 3 h while connected to extracorporeal circulation (ECC) and subsequent 60 min of spontaneous reperfusion of the heart. We used two experimental groups: T-pigs after transplantation and TH-pigs after transplantation treated with 4% H 2 mixed with air during inhalation of anesthesia and throughout oxygenation of blood in ECC. The levels of creatinine, urea and phosphorus were measured in plasma. Renal tissue samples were analyzed by Western blot method for protein levels of nuclear factor erythroid 2-related factor 2 (Nrf2), Kelch-like ECH-associated protein 1 (Keap-1), and superoxide dismutase (SOD1). After cardiac surgery, selected plasma biomarkers were elevated. However, H 2 therapy was followed by the normalization of all these parameters. Our results suggest activation of Nrf2/Keap1 pathway as well as increased SOD1 protein expression in the group treated with H 2 . The administration of H 2 had a protective effect on the kidneys of pigs after cardiac surgery, especially in terms of normalization of plasma biomarkers to control levels., Competing Interests: No conflicts of interest, financial or otherwise, as declared by the authors.

Molybdenum disulfide (MoS 2 ) few-layer films have gained considerable attention for their possible applications in electronics and optics and also as a promising material for energy conversion and storage. Intercalating alkali metals, such as lithium, offers the opportunity to engineer the electronic properties of MoS 2 . However, the influence of lithium on the growth of MoS 2 layers has not been fully explored. Here, we have studied how lithium affects the structural and optical properties of the MoS 2 few-layer films prepared using a new method based on one-zone sulfurization with Li 2 S as a source of lithium. This method enables incorporation of Li into octahedral and tetrahedral sites of the already prepared MoS 2 films or during MoS 2 formation. Our results discover an important effect of lithium promoting the epitaxial growth and horizontal alignment of the films. Moreover, we have observed a vertical-to-horizontal reorientation in vertically aligned MoS 2 films upon lithiation. The measurements show long-term stability and preserved chemical composition of the horizontally aligned Li-doped MoS 2 ., Competing Interests: The authors declare no competing financial interest., (© 2023 The Authors. Published by American Chemical Society.)

Introduction: Cardiac myxoma is a rare benign cardiac tumor observed in approximately 0.5-1 case per 1 million people per year. The aim of this study is to review our 12-year experience in the surgical treatment of cardiac myxoma with an emphasis on the clinical, pathologic, diagnostic, and surgical features., Methods and Patients: From January 2010 to December 2022, 90 patients (0.67 %) with cardiac myxomas were surgically treated in our institute. Patients´ demographics, cardiac and surgical medical history, surgical procedures, and pre- and post-operative data were analyzed. The median follow-up time was 76 (1-216) months., Results: The mean age of the patients was 59.4 ± 13.5 years, with a higher prevalence of women. The most common preoperative symptoms were arterial embolism and dyspnea, and 35.6 % of patients were asymptomatic. Only 8.9 % of the patients had systemic and constitutional manifestations. The most common location of cardiac myxoma was in the left atrium, followed by the right atrium. Recurrent myxoma developed in 3 patients (2.7 %), and the mean time of recurrence was 55 ± 19.7. Hospital and long-term mortality were 2.2 % and 15.6 %, respectively., Conclusion: Cardiac myxoma is the most common heart tumor with a low incidence. Surgical excision yields very good short and long-term outcomes with low recurrence rate after surgery, and remains the treatment of choice (Tab. 4, Fig. 2, Ref. 13). Text in PDF www.elis.sk Keywords: cardiac myxoma, cardiac tumor, recurrence, survival.

Background: In patients following aortic valve replacement (AVR) for aortic regurgitation, a transient reduction in ejection fraction (TREF) sometimes occurs in the postoperative period without a clear remediable cause, which leads to a spontaneous improvement without the need for a specific treatment., Objective: To study the incidence and risk factors of TREF following AVR for aortic regurgitation., Methods: We designed a single-centre retrospective observational study. A total of 164 patients were enrolled in the study: 82 in the regurgitation group and 82 in the stenosis group. Data were obtained from international registries and patient documentation., Results: There were statistically significant differences in TREF between the regurgitation and stenosis groups (9.76 % and 0 %, respectively, p = 0.004). There was zero hospital mortality in both regurgitation and stenosis groups. The presence of TREF had no impact on long-term survival., Conclusion: Our results show that transient reduction in ejection fraction is a relatively common phenomenon following aortic valve replacement for aortic regurgitation and that in our study population it had no effect on short- and long-term survival (Tab. 2, Fig. 1, Ref. 15).

Introduction: Based on a longtime voluntary registry founded by the Ministry of Healthcare of the Slovak Republic in 2012 and endorsed by the National Institute of Cardiovascular Diseases, well-defined data of all adult cardiac surgery procedures performed during the year 2021 are analyzed., Material and Method: For this period, data on 947 procedures were submitted to the registry., Results: The unadjusted in-hospital survival rate for the 352 isolated coronary artery bypass grafting procedures including urgent and emergency procedures (relationship on-/off pump 3.8 : 1) was 96.3 %. For 331 isolated heart valve procedures (33 transcatheter interventions), it was 95.5 %. Concerning ventricular assist devices, 19 implantations were registered. In 2021 the number of isolated heart transplantations was 16, which is a decrease by 38.5 % as compared to the previous year., Conclusion: These annually registered data are collected from voluntary public reporting and accumulate actual information on nearly all heart procedures carried out in the National Institute of Cardiovascular Diseases. These data capture advancements in heart medicine and represent the basis for quality management. In addition, the registry demonstrates that the provision of cardiac surgery in Slovakia is up to date, appropriate, and nationwide patient treatment is guaranteed all the time (Tab. 14, Fig. 2, Ref. 5). Text in PDF www.elis.sk Keywords: heart valve surgery, outcomes, coronary artery bypass grafting, aortic surgery, heart transplantation.

Right heart failure is a huge challenge in left ventricular assist device therapy and its occurrence is associated with increased mortality and morbidity. Other options include the use od temporary right ventricular assist device, use of two continous flow biventricular assist devices, use of total artificial heart and the use of paracorporeal biventricular assist devices.In this report we described the successful use of the paracorporeal pulsatile Berlin Heart EXCOR system as a bridge to transplant in a 62 years old patient with end-stage biventricular heart failure (Tab. 1, Fig. 3, Ref. 22). Keywords: biventricular heart failure, mechanical circulatory support, biventricular assist device, Berlin Heart EXCOR system, heart transplantation.

Competing Interests: The authors report no conflict of interest.

The few-layer transition metal dichalcogenides (TMD) are an attractive class of materials due to their unique and tunable electronic, optical, and chemical properties, controlled by the layer number, crystal orientation, grain size, and morphology. One of the most commonly used methods for synthesizing the few-layer TMD materials is the chemical vapor deposition (CVD) technique. Therefore, it is crucial to develop in situ inspection techniques to observe the growth of the few-layer TMD materials directly in the CVD chamber environment. We demonstrate such an in situ observation on the growth of the vertically aligned few-layer MoS 2 in a one-zone CVD chamber using a laboratory table-top grazing-incidence wide-angle X-ray scattering (GIWAXS) setup. The advantages of using a microfocus X-ray source with focusing Montel optics and a single-photon counting 2D X-ray detector are discussed. Due to the position-sensitive 2D X-ray detector, the orientation of MoS 2 layers can be easily distinguished. The performance of the GIWAXS setup is further improved by suppressing the background scattering using a guarding slit, an appropriately placed beamstop, and He gas in the CVD reactor. The layer growth can be monitored by tracking the width of the MoS 2 diffraction peak in real time. The temporal evolution of the crystallization kinetics can be satisfactorily described by the Avrami model, employing the normalized diffraction peak area. In this way, the activation energy of the particular chemical reaction occurring in the CVD chamber can be determined.

Competing Interests: The authors declare no conflict of interest.

Molybdenum disulfide (MoS 2 ) nanosheets exhibit anisotropic optical and electronic properties, stemming from their shape and electronic structure. Unveiling this anisotropy for study and usage in materials and devices requires the ability to control the orientation of dispersed nanosheets, but to date this has proved a challenging proposition. Here, we demonstrate magnetic field driven alignment of MoS 2 nanosheets in a liquid crystal (LC) polymer and unveil the optical properties of the resulting anisotropic assembly. Nanosheet optical anisotropy is observed spectroscopically by Raman and direction-dependent photoluminescence (PL) measurements. Resulting data indicate significantly lower PL emission due to optical excitation with electric field oscillation out of plane, parallel to the MoS 2 c -axis, than that associated with perpendicular excitation, with the dichroic ratio I perp / I par = 3. The approach developed here provides a useful route to elucidate anisotropic optical properties of MoS 2 nanosheets and to utilize such properties in new materials and devices.

Unique structure and ability to control the surface termination groups of MXenes make these materials extremely promising for solid lubrication applications. Due to the challenging delamination process, the tribological properties of two-dimensional MXenes particles have been mostly investigated as additive components in the solvents working in the macrosystem, while the understanding of the nanotribological properties of mono- and few-layer MXenes is still limited. Here, we investigate the nanotribological properties of mono- and double-layer Ti 3 C 2 T x MXenes deposited by the Langmuir-Schaefer technique on SiO 2 /Si substrates. The friction of all of the samples demonstrated superior lubrication properties with respect to SiO 2 substrate, while the friction force of the monolayers was found to be slightly higher compared to double- and three-layer flakes, which demonstrated similar friction. The coefficient of friction was estimated to be 0.087 ± 0.002 and 0.082 ± 0.003 for mono- and double-layer flakes, respectively. The viscous regime was suggested as the dominant friction mechanism at high scanning velocities, while the meniscus forces affected by contamination of the MXenes surface were proposed to control the friction at low sliding velocities.

Objectives: A third paediatric report has been generated from the European Registry for Patients with Mechanical Circulatory Support (EUROMACS). The purpose of EUROMACS, which is operated by the European Association for Cardio-Thoracic Surgery, is to gather data related to durable mechanical circulatory support for scientific purposes and to publish reports with respect to the course of mechanical circulatory support therapy. Since the first report issued, efforts to increase compliance and participation have been extended. Additionally, the data provided the opportunity to analyse patients of younger age and lower weight., Methods: Participating hospitals contributed pre-, peri- and long-term postoperative data on mechanical circulatory support implants to the registry. Data for all implants in paediatric patients (<19 years of age) performed from 1 January 2000 to 31 December 2020 were analysed. This report includes updates of patient characteristics, implant frequency, outcome (including mortality rates, transplants and recovery rates) as well as adverse events including neurological dysfunction, device malfunction, major infection and bleeding., Results: Twenty-five hospitals contributed 537 registered implants in 480 patients. The most frequent aetiology of heart failure was any form of cardiomyopathy (59%), followed by congenital heart disease and myocarditis (15% and 14%, respectively). Competing outcomes analysis revealed that a total of 86% survived to transplant or recovery or are ongoing; at the 2-year follow-up examination, 21.9% died while on support. At 12 months, 45.1% received transplants, 7.5% were weaned from their device and 20.8% died. The 3-month adverse events rate was 1.59 per patient-year for device malfunction including pump exchange, 0.7 for major bleeding, 0.78 for major infection and 0.71 for neurological events., Conclusions: The overall survival rate was 79.2% at 12 months following ventricular assist device implant. The comparison of survival rates of the early and later eras shows no significant difference. A focus on specific subgroups showed that survival was less in patients of younger age (<1 year of age; P = 0.01) and lower weight (<20 kg; P = 0.015). Transplant rates at 6 months continue to be low (33.2%)., (© The Author(s) 2022. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.)

Objectives: In the third report of the European Registry for Patients with Mechanical Circulatory Support of the European Association for Cardio-Thoracic Surgery, outcomes of patients receiving mechanical circulatory support are reviewed in relation to implant era., Methods: Procedures in adult patients (January 2011-June 2020) were included. Patients from centres with <60% follow-ups completed were excluded. Outcomes were stratified into 3 eras (2011-2013, 2014-2017 and 2018-2020). Adverse event rates (AERs) were calculated and stratified into early phase (<3 months) and late phase (>3 months). Risk factors for death were explored using univariable Cox regression with a stepwise time-varying hazard ratio (<3 vs >3 months)., Results: In total, 4834 procedures in 4486 individual patients (72 hospitals) were included, with a median follow-up of 1.1 (interquartile range: 0.3-2.6) years. The annual number of implants (range: 346-600) did not significantly change (P = 0.41). Both Interagency Registry for Mechanically Assisted Circulatory Support class (classes 4-7: 23, 25 and 33%; P < 0.001) and in-hospital deaths (18.5, 17.2 and 11.2; P < 0.001) decreased significantly between eras. Overall, mortality, transplants and the probability of weaning were 55, 25 and 2% at 5 years after the implant, respectively. Major infections were mainly noted early after the implant occurred (AER<3 months: 1.44 vs AER>3 months: 0.45). Bilirubin and creatinine levels were significant risk factors in the early phase but not in the late phase after the implant., Conclusions: In its 10 years of existence, EUROMACS has become a point of reference enabling benchmarking and outcome monitoring. Patient characteristics and outcomes changed between implant eras. In addition, both occurrence of outcomes and risk factor weights are time dependent., (© The Author(s) 2022. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.)

Background: Allograft pathologies, such as valvular, coronary artery, or aortic disease, may occur early and late after cardiac transplantation. Cardiac surgery after heart transplantation (CASH) may be an option to improve quality of life and allograft function and prolong survival. Experience with CASH, however, has been limited to single-center reports., Methods: We performed a retrospective, multicenter study of heart transplant recipients with CASH between January 1984 and December 2020. In this study, 60 high-volume cardiac transplant centers were invited to participate., Results: Data were available from 19 centers in North America ( n = 7), South America ( n = 1), and Europe ( n = 11), with a total of 110 patients. A median of 3 (IQR 2-8.5) operations was reported by each center; five centers included ≥ 10 patients. Indications for CASH were valvular disease ( n = 62), coronary artery disease (CAD) ( n = 16), constrictive pericarditis ( n = 17), aortic pathology ( n = 13), and myxoma ( n = 2). The median age at CASH was 57.7 (47.8-63.1) years, with a median time from transplant to CASH of 4.4 (1-9.6) years. Reoperation within the first year after transplantation was performed in 24.5%. In-hospital mortality was 9.1% ( n = 10). 1-year survival was 86.2% and median follow-up was 8.2 (3.8-14.6) years. The most frequent perioperative complications were acute kidney injury and bleeding revision in 18 and 9.1%, respectively., Conclusion: Cardiac surgery after heart transplantation has low in-hospital mortality and postoperative complications in carefully selected patients. The incidence and type of CASH vary between international centers. Risk factors for the worse outcome are higher European System for Cardiac Operative Risk Evaluation (EuroSCORE II) and postoperative renal failure., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Gökler, Aliabadi-Zuckermann, Kaider, Ambardekar, Antretter, Artemiou, Bertolotti, Boeken, Brossa, Copeland, Generosa Crespo-Leiro, Eixeré-Esteve, Epailly, Farag, Hulman, Khush, Masetti, Patel, Ross, Rudež, Silvestry, Suarez, Vest and Zuckermann.)

Heterostructures composed of 2D materials are already opening many new possibilities in such fields of technology as electronics and magnonics, but far more could be achieved if the number and diversity of 2D materials were increased. So far, only a few dozen 2D crystals have been extracted from materials that exhibit a layered phase in ambient conditions, omitting entirely the large number of layered materials that may exist at other temperatures and pressures. This work demonstrates how such structures can be stabilized in 2D van der Waals (vdw) stacks under room temperature via growing them directly in graphene encapsulation by using graphene oxide as the template material. Specifically, an ambient stable 2D structure of copper and iodine, a material that normally only occurs in layered form at elevated temperatures between 645 and 675 K, is produced. The results establish a simple route to the production of more exotic phases of materials that would otherwise be difficult or impossible to stabilize for experiments in ambient., (© 2022 The Authors. Advanced Materials published by Wiley-VCH GmbH.)

Thin films of transition-metal dichalcogenides are potential materials for optoelectronic applications. However, the application of these materials in practice requires knowledge of their fundamental optical properties. Many existing methods determine optical constants using predefined models. Here, a different approach was used. We determine the sheet conductance and absorption coefficient of few-layer PtSe 2 in the infrared and UV-vis ranges without recourse to any particular model for the optical constants. PtSe 2 samples with a thickness of about 3-4 layers were prepared by selenization of 0.5 nm thick platinum films on sapphire substrates at different temperatures. Differential reflectance was extracted from transmittance and reflectance measurements from the front and back of the sample. The film thickness, limited to a few atomic layers, allowed a thin-film approximation to calculate the optical conductance and absorption coefficient. The former has a very different energy dependence in the infrared, near-infrared, and visible ranges. The absorption coefficient exhibits a strong power-law dependence on energy with an exponent larger than three in the mid-infrared and near-infrared regions. We have not observed any evidence for a band gap in PtSe 2 thin layers down to an energy of 0.4 eV from our optical measurements., Competing Interests: The authors declare no competing financial interest., (© 2021 The Authors. Published by American Chemical Society.)

Recently, few-layer PtSe 2 films have attracted significant attention due to their properties and promising applications in high-speed electronics, spintronics and optoelectronics. Until now, the transport properties of this material have not reached the theoretically predicted values, especially with regard to carrier mobility. In addition, it is not yet known which growth parameters (if any) can experimentally affect the carrier mobility value. This work presents the fabrication of horizontally aligned PtSe 2 films using one-zone selenization of pre-deposited platinum layers. We have identified the Se : Pt ratio as a parameter controlling the charge carrier mobility in the thin films. The mobility increases more than twice as the ratio changes in a narrow interval around a value of 2. A simultaneous reduction of the carrier concentration suggests that ionized impurity scattering is responsible for the observed mobility behaviour. This significant finding may help to better understand the transport properties of few-layer PtSe 2 films., Competing Interests: There are no conflicts to declare., (This journal is © The Royal Society of Chemistry.)

Background: The aim of this study was to present our experience in the treatment of post-myocardial infarction ventricular septal defect and examine the various risk factors., Methods: This is a retrospective study. From January 2010 to December 2018, 20 patients underwent an urgent /emergency surgical repair of post-myocardial infarction ventricular septal defect., Results: The mortality in our group of patients was 45 %. Non-survivors compared to the survivors were all in cardiogenic shock (p=0.0098), had an emergency/salvage operation (p=0.0055), preoperative mechanical ventilation (p=0.0081), shorter time between intraaortic balloon pressure insertion and surgery (p=0.0115), shorter median time between ventricular septal defect and surgery, postoperative renal replacement therapy (p=0.0498), and more patients had a residual effect (p=0.0022). In multivariate analysis, preoperative mechanical ventilation (p=0.0001), postoperative renal replacement therapy (p=0.0021) and residual defect (p=0.0000027) were shown to be strong predictors for hospital mortality., Conclusion: This analysis showed that post-myocardial infarction ventricular septal defect repair is a devastating complication and preoperative mechanical ventilation, postoperative renal replacement therapy and residual defect were identified to be the predictors of mortality. Initial stabilization of the patients, when it is possible, and a delayed repair, may improve the outcome of these patients (Tab. 3, Ref. 17).

Objectives: Mechanical circulatory support is an established therapy in end-stage heart failure. The EUROMACS registry was created to promote research in these patients. The aim of this report was to present our 12 year experience with the durable mechanical circulatory support devices and compare it with the EUROMACS registry., Methods: Data from the entire EUROMACS registry from January 2011 to April 2019 were included (4704 implantations in 4410 patients). During the 12 years of our experience, until April 2019,125 mechanical support devices were implanted, in 122 patients. We compare patients´ characteristics, operative data and results with the EUROMACS registry and we report the major complications during the observational period., Results: Primary end-point (death) occurred in 40 (32.8 %) patients in our cohort during the follow-up period, representing the survival rate 75 %, 68 %, and 58 % for 6, 12, 24 months respectively, which compares favourably with the data, reported by the EUROMACS registry, the survival 66 % and 53 % after 1 and 2 years respectively. Cerebrovascular accident occurred in 7 %, a bleeding event in 32 %, significant infection (driveline) in 78 % and a device malfunction in 13 % of the patients. Forty- three patients underwent a heart transplant with hospital and long-term mortality of 11.6 % and 14 % respectively., Conclusion: Mechanical circulatory support is a valuable therapeutic option with excellent survival rates, nevertheless it is associated with clinically significant complications rates. The direct comparison between our cohort and the EUROMACS registry showed that early implantation strategy and mini invasive approach may improve survival rates and decrease postoperative complications (Tab. 3, Fig. 3, Ref. 16).