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Background: Cell loss and subsequent deterioration of contractile function are hallmarks of chronic heart failure (HF). While apoptosis has been investigated as a participant in the progression of HF, it is unlikely that it accounts for the total amount of non-functional tissue. In addition, there is evidence for the presence of necrotic cardiomyocytes in HF. Therefore, the objective of this study was to investigate the necroptotic proteins regulating necroptosis, a form of programmed necrosis, and thereby assess its potential role in human end-stage HF., Methods: Left ventricular samples of healthy controls (C) and patients with end-stage HF due to myocardial infarction (CAD) or dilated cardiomyopathy (DCM) were studied. Immunoblotting for necroptotic and apoptotic markers was performed. Triton X-114 fractionated samples were analyzed to study differences in subcellular localization., Results: Elevated expression of RIP1 (receptor-interacting protein), pSer 227 -RIP3 and its total levels were observed in HF groups compared to controls. On the other hand, caspase-8 expression, a proapoptotic protease negatively regulating necroptosis, was downregulated suggesting activation of necroptosis signaling. Total mixed-lineage kinase domain-like protein (MLKL) expression did not differ among the groups; however, active cytotoxic forms of MLKL were present in all HF samples while they were expressed at almost undetectable levels in controls. Interestingly, pThr 357 -MLKL unlike pSer 358 -MLKL, was higher in DCM than CAD. In HF, the subcellular localization of both RIP3 and pThr 357 -MLKL was consistent with activation of necroptosis signaling. Expression of main apoptotic markers has not indicated importance of apoptosis., Conclusions: This is the first evidence showing that human HF of CAD or DCM etiology is positive for markers of necroptosis which may be involved in the development of HF.

We describe a case of reversible thrombotic mitral valve stenosis following a valve-in-ring transcatheter mitral valve replacement. Life-long oral anticoagulation in patients who underwent transcatheter mitral valve replacement might be beneficial., (© 2017 Wiley Periodicals, Inc.)

Introduction: Minimal invasive aortic valve replacement has become a routine procedure. In this study, we compared the outcomes between conventional and minimal invasive aortic valve replacement via the partial upper sternotomy that were performed in our Institution., Methods: The 5 year survival and postoperative outcomes of 34 patients that underwent isolated MIAVR between the years 2010-2013 were compared with the outcomes of 34 randomly selected patients that underwent conventional AVR, after propensity match analysis., Results: There was no difference between the two groups concerning the early and late postoperative outcomes. MIAVR patients had a longer mean cross-clamp time (p = 0.002) and longer cardiopulmonary bypass time (p = 0.0005) compared to the AVR patients. 5 year mortality and survival were 4.17 % vs 16.67 % (p = 0.20) and 95.8 % vs 83.3 % (p = 0.37) in the MIAVR and AVR groups respectively., Conclusion: This study showed a comparable 5 year survival and postoperative outcomes between the MIAVR and AVR groups. In our opinion, the minimal access aortic valve replacement can be performed safely with excellent long-term results in selected patients (Tab. 4, Fig. 1, Ref. 35).

Introduction: The aim of this study is to summarize results and analyze risk factors for the development of wound infection in heart surgery patients after median sternotomy., Method: In this retrospective analysis with assessment of multiple risk factors, we examined 143 patients with infection after median sternotomy treated with VAC therapy from total of 4,650 patients operated in our department from 2012 to 2015., Results: Total of 143 patients developed significant SSI treated by VAC therapy following cardiac surgery. Of these, only 14 patients developed DSWI and one patient was diagnosed with suspected osteomyelitis. BMI, female gender, and use of BIMA proved to be statistically significant risk factors in our study (p < 0.001). The acuteness of operations did not have a statistically significant effect. However, it had a significant effect on the severity of infection (p < 0.01). The severity of infection proved to be a significant prognostic factor for patients' outcome (p < 0.01)., Conclusion: In our study, BMI, female gender, and use of BIMA (bilateral internal mammary artery) in patients with DM were predictors for the development of SWI. The acuteness of operation did not have a statistically significant effect. However, it had a statistically significant effect on the severity of infection (Tab. 3, Ref. 30).

Transcatheter mitral valve replacement using balloon-expandable valves is an emerging technique for the treatment of patients with significant mitral regurgitation who have been judged to be inoperable owing to significant mitral valve annulus calcification. Although initial reports have been promising, there remains a lack of consensus as to how to plan for transcatheter mitral valve replacement deployment in terms of appropriateness, sizing, and positioning to mitigate the risks of valve displacement and paravalvular regurgitation. We describe two cases of transcatheter mitral valve replacement in patients with significant mitral valve annulus calcification. The first was complicated by valve displacement into the left atrium, which was successfully managed by surgical redeployment and fixation. The second case was thereafter performed successfully using iterative learning and the application of specific preprocedural planning techniques acquired from a root cause analysis of the first case. We describe our experience with both cases and the specific planning principles required to prevent transcatheter mitral valve replacement displacement in patients with mitral valve annulus calcification., (Copyright © 2016 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.)

Introduction: The transaortic (TAo) approach has been proposed as an alternative to the transapical approach and can be used in concomitant procedures. We use the TAo transcatheter aortic valve replacement (TAVR) with other simultaneous cardiac procedures in high-risk patients who needed surgical management., Materials and Methods: Between September 2013 and September 2015, nine consecutive high-risk patients with severe aortic valve stenosis (AR) and combined tricuspid valve disease or coronary artery disease were treated with TAo TAVR and simultaneous tricuspid valve repair or coronary artery bypass grafting., Results: Mean postoperative pressure gradient at discharge was 13.4 ± 3.2 mmHg and AR grade >2/4 was observed in one case (11.1%). New pacemaker implantation was required in one case (11.1%). Device success was achieved in 88.9% (n = 8), 30-day mortality was in 11.1% (n = 1), and intermediate mortality was in 33.3% (n = 3)., Conclusion: TAo-TAVR approach offers definitive treatment to high-risk patients with coexisting complex cardiac lesions. Despite the relatively high 30-day and intermediate mortality, it is an option for selected high-risk patients., (© 2016 Wiley Periodicals, Inc.)

The current energy needs have put the focus on highly efficient energy storage systems such as supercapacitors. At present, much attention focuses on graphene-like materials as promising supercapacitor electrodes. Here we show that reduced graphite oxide offers a very interesting potential. Materials obtained by oxidation of natural graphite and subsequent sonication and reduction by hydrazine achieve specific capacitances as high as 170 F/g in H2SO4 and 84F/g in (C2H5)4NBF4/acetonitrile. Although the particle size of the raw graphite has no significant effect on the physico-chemical characteristics of the reduced materials, that exfoliated from smaller particles (<75 μm) result more advantageous for the release of the stored electrical energy. This effect is particularly evident in the aqueous electrolyte. Graphene-like materials may suffer from a drop in their specific surface area upon fabrication of electrodes with features of the existing commercial devices. This should be taken into account for a reliable interpretation of their performance in supercapacitors., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Surgical ablation procedure can restore sinus rhythm (SR) in patients with atrial fibrillation (AF) undergoing cardiac surgery. However, it is not known whether it has any impact on clinical outcomes. There is a need for a randomized trial with long-term follow-up to study the outcome of surgical ablation in patients with coronary and/or valve disease and AF. Patients are prospectively enrolled and randomized either to group A (cardiac surgery with left atrial ablation) or group B (cardiac surgery alone). The primary efficacy outcome is the SR presence (without any AF episode) during a 24-hour electrocardiogram after 1 year. The primary safety outcome is the combined end point of death, myocardial infarction, stroke, and renal failure at 30 days. Long-term outcomes are a composite of total mortality, stroke, bleeding, and heart failure at 1 and 5 years. We finished the enrollment with a total of 224 patients from 3 centers in 2 countries in December 2011. Currently, the incomplete 1-year data are available, and the patients who enrolled first will have their 5-year visits shortly. PRAGUE-12 is the largest study to be conducted so far comparing cardiac surgery with surgical ablation of AF to cardiac surgery without ablation in an unselected population of patients who are operated on for coronary and/or valve disease. Its long-term results will lead to a better recognition of ablation's potential clinical benefits., (© 2012 Wiley Periodicals, Inc.)

Aims: Surgical ablation procedure can restore sinus rhythm (SR) in patients with atrial fibrillation (AF) undergoing cardiac surgery. However, it is not known whether it has any impact on long-term clinical outcomes., Methods and Results: This multicentre study randomized 224 patients with AF scheduled for valve and/or coronary surgery: group A (left atrial surgical ablation, n = 117) vs. group B (no ablation, n = 107). The primary efficacy outcome was the SR presence (without any AF episode) during a 24 h electrocardiogram (ECG) after 1 year. The primary safety outcome was the combined endpoint of death/myocardial infarction/stroke/renal failure at 30 days. A Holter-ECG after 1 year revealed SR in 60.2% of group A patients vs. 35.5% in group B (P = 0.002). The combined safety endpoint at 30 days occurred in 10.3% (group A) vs. 14.7% (group B, P = 0.411). All-cause 1-year mortality was 16.2% (A) vs. 17.4% (B, P = 0.800). Stroke occurred in 2.7% (A) vs. 4.3% (B) patients (P = 0.319). No difference (A vs. B) in SR was found among patients with paroxysmal (61.9 vs. 58.3%) or persistent (72 vs. 50%) AF, but ablation significantly increased SR prevalence in patients with longstanding persistent AF (53.2 vs. 13.9%, P < 0.001)., Conclusion: Surgical ablation improves the likelihood of SR presence post-operatively without increasing peri-operative complications. However, the higher prevalence of SR did not translate to improved clinical outcomes at 1 year. Further follow-ups (e.g. 5-year) are warranted to show any potential clinical benefit which might occur later.

Introduction: Postpericardiotomy syndrome is a non specific belated reaction of pericardium, epicardium and pleural cavity after cardiac or pericardial injury. It is considered to be a common complication in cardiosurgery with occurrence of 3 to 30 percent. Most likely, the primary cause is a common immunopathic process. It develops within days or even up to six months after either cardiac or pericardial injury or both., Aim: Echocardiography is the leading method in determination of postpericardiotomy syndrome due to the frequency of occurrence, non- specific clinical symptoms (fever, chest pain, cough, dizziness), inaccurate interpretation of examination methods (ECG, X-ray, laboratory tests). We would like to show how to determine the exactly diagnose, how to treat it and what is prognosis of this illness., Results: We have performed a retrospective analysis of 1344 patients, who underwent cardiac surgery in the year 2009. The incidence of post- cardiac surgery syndrome was 12.4 %. In 2.6 % of the studied cases, surgical intervention was needed due to a cardiac tamponade. Int other cases similar to acute pericarditis, symptomatic treatment in duration of several weeks or months with non-steroid antireumatics, salicylic acid or colchicine is sufficient. Therapeutic options in refractory forms are long term oral corticoids or pericardiectomy. During our follow-up, pericardiectomy was necessary to perform in one patient., Conclusion: Postpericardiotomy syndrome, which occurs in early postoperative period, prolongs hospitalisation. In spite of non specific symptoms huge pericardial effusion might be present and can cause cardiac tamponade with haemodynamic failure in later periods. Transthoracic echocardiography is the golden standard in determination of accurate diagnosis (Fig. 6, Ref. 15).

The surgical technique of simultaneous heart transplantation and aortic aneurysm repair has been reported previously. However, there is a subgroup of patients with end-stage cardiomyopathy requiring major aortic surgery who do not meet heart transplant criteria. The optimal treatment strategy for these patients is still to be defined. In this report, we describe the use of an implantable continuous-flow left ventricular assist device (LVAD) as an adjunct to extensive aortic repair for providing patients with an acceptable risk surgical alternative to palliative treatment. To the best of our knowledge, this is the first report of this approach in the published literature.

The position and width of the Raman G-line was analyzed for unintentionally doped single-layered graphene samples. Results indicate a significant heating of the monolayer by the laser beam. Moreover, a weak additional component was resolved in the G-band. The position of the line is independent of the level of doping of the sample. We conclude that this new component is due to the phonons coupled to the intraband electronic transitions.

The manufacture of a liquid metal ion source based on carbon nanotubes is described. Multi-wall carbon nanotubes were attached to the tip of a tungsten needle forming a fibre which was subsequently coated with a layer of indium. The onset of ion emission was observed at about 850 V, a value much lower than that for a conventional indium needle emitter. However, the nanotube fibres degrade rapidly at higher voltages and eventually disappear from the needle.

The superposition of the quantum rotational motion (tunneling) of the encapsulated Sc(2)C(2) complex with the classical rotational motion of the surrounding C(84) molecule in a powder crystal of Sc(2)C(2)@C(84) fullerite is investigated by theory. Since the quantum rotor is dragged along by the C(84) molecule, any detection method which couples to the quantum rotor (in casu the C(2) bond of the Sc(2)C(2) complex) also probes the thermally excited classical motion (uniaxial rotational diffusion and stochastic meroaxial jumps) of the surrounding fullerene. The dynamic rotation-rotation response functions in frequency space are obtained as convolutions of quantum and classical dynamic correlation functions. The corresponding Raman scattering laws are derived, and the overall shape of the spectra and the width of the resonance lines are studied as functions of temperature. The results of the theory are confronted with experimental low-frequency Raman spectra on powder crystals of Sc(2)C(2)@C(84) [M. Krause et al., Phys. Rev. Lett. 93, 137403 (2004)]. The agreement of theory with experiment is very satisfactory in a broad temperature range.

The discovery of fullerenes in 1985 opened a completely new field of materials research. Together with the single-wall carbon nanotubes (SWCNTs) discovered later, these curved carbon networks are a playground for pure as well as applied science. We present a review of Raman spectroscopy of fullerenes, SWCNTs and composite materials. Beginning with pristine C(60), we discuss intercalated C(60) compounds and polymerized C(60), as well as higher and endohedral fullerenes. Concerning SWCNTs, we show how the diameter distribution can be obtained from the Raman spectra and how doping modifies the spectra. Finally, the Raman response of C(60) encapsulated into SWCNTs (C(60) peapods) is discussed.

We report the observation of quantized rotational states of a diatomic C2 unit in solid endohedral fullerene C(2)Sc(2)@C(84). The rotational transitions induce a periodic line pattern in the low energy Raman spectrum. The rotational constant B and the C-C distance were found to be 1.73 cm(-1) and 0.127 nm, respectively. Density functional calculations revealed an intrinsic rotational barrier of the order of only a few meV for the C2 unit. The Schrödinger equation involving the potential barrier was solved and the Raman tensor matrix elements were calculated, yielding good quantitative agreement with the experiment. To our best knowledge this is the first intrinsic rotational spectrum of a diatomic plane molecular rotor.

Photoselective resonance Raman scattering from laser ablation grown single-wall carbon nanotubes is demonstrated to be consistent with a response from tubes with all geometrically allowed helicities. This information is drawn from an analysis of the resonance scattering by combining ab initio calculations for the mode frequencies with evaluations of the resonance cross sections for isolated tubes. The resonance excitation was found to exhibit an oscillatory behavior. To match the experiments and the calculations, the frequencies obtained from the latter must be up-shifted by 8.5% on the average. This stiffening is ascribed to the tube-tube interaction in the carbon nanotube bundles.

This paper presents the case report of a 50-year-old woman with a triple valve lesion of rheumatic origin and ischemic coronary disease. The patient underwent successful simultaneous triple valve surgery; the aortic and mitral valves were replaced by mechanical prostheses, and the tricuspid valve was repaired by annuloplasty, together with three aorto-coronary bypasses and endarterectomy of the right coronary artery. The peri- and postoperative courses were uneventful and the patient was discharged from hospital in good clinical condition 12 days after surgery.

The authors analyze 50 patients with endarterectomy of the coronary arteries during the periods of 1972-1974 and 1988-1990. The results of endarterectomy of the right and left coronary artery provide evidence of its justification in indicated cases whereby contrary to some departments the results of endarterectomy of the left coronary artery are comparable with endarterectomy of the right coronary artery.