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5. Ultrasound-assisted catheter-directed thrombolysis versus surgical pulmonary embolectomy for intermediate-high or high-risk pulmonary embolism: a randomized phase II non-inferiority trial.

Author

Stortecky, Stefan, Barco, Stefano, Windecker, Stephan, Heg, Dik, Kadner, Alexander, Englberger, Lars, and Kucher, Nils

Subjects
PULMONARY embolism, THROMBOSIS, FUNCTIONAL status, TOMOGRAPHY
Abstract

OBJECTIVES We hypothesized that ultrasound-assisted thrombolysis (USAT) is non-inferior to surgical pulmonary embolectomy (SPE) to improve right ventricular (RV) function in patients with acute pulmonary embolism (PE). METHODS In a single-centre, non-inferiority trial, we randomly assigned 27 patients with intermediate-high or high-risk acute PE to undergo either USAT or SPE stratified by PE risk. Primary and secondary outcomes were the baseline-to-72-h difference in right-to-left ventricular (RV/LV) ratio and the Qanadli pulmonary occlusion score, respectively, by contrast-enhanced chest-computed tomography assessed by a blinded CoreLab. RESULTS The trial was prematurely terminated due to slow enrolment. Mean age was 62.6 (SD 12.4) years, 26% were women, and 15% had high-risk PE. Mean change in RV/LV ratio was −0.34 (95% CI −0.50 to −0.18) in the USAT and −0.53 (95% CI −0.68 to −0.38) in the SPE group (mean difference: 0.152; 95% CI 0.032–0.271; P non-inferiority = 0.80; P superiority = 0.013). Mean change in Qanadli pulmonary occlusion score was −7.23 (95% CI −9.58 to −4.88) in the USAT and −11.36 (95% CI −15.27 to −7.44) in the SPE group (mean difference: 5.00; 95% CI 0.44–9.56, P  = 0.032). Clinical and functional outcomes were similar between the 2 groups up to 12 months. CONCLUSIONS In patients with intermediate-high and high-risk acute PE, USAT was not non-inferior when compared with SPE in reducing RV/LV ratio within the first 72 h. In a post hoc superiority analysis, SPE resulted in greater improvement of RV overload and reduction of thrombus burden. [ABSTRACT FROM AUTHOR]

Published
2024
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10. 2021 MiECTiS focused update on the 2016 position paper for the use of minimal invasive extracorporeal circulation in cardiac surgery.

Author

Anastasiadis, Kyriakos, Antonitsis, Polychronis, Murkin, John, Serrick, Cyril, Gunaydin, Serdar, El-Essawi, Aschraf, Bennett, Mark, Erdoes, Gabor, Liebold, Andreas, Punjabi, Prakash, Theodoropoulos, Konstantinos C, Kiaii, Bob, Wahba, Alexander, de Somer, Filip, Bauer, Adrian, Kadner, Alexander, van Boven, Wim, Argiriadou, Helena, Deliopoulos, Apostolos, and Baker, Robert Α

Subjects
ARTIFICIAL blood circulation, CARDIAC surgery, CONSENSUS (Social sciences), OCTOGENARIANS, ANESTHESIA, MINIMALLY invasive procedures, HEART, BLOOD transfusion, ATRIAL fibrillation, MEDICAL care, CARDIOVASCULAR system, REOPERATION, COST effectiveness, QUALITY of life, INTERNATIONAL agencies, TECHNOLOGY, PATIENT care, CARDIOPULMONARY bypass, PERFUSION
Abstract

The landmark 2016 Minimal Invasive Extracorporeal Technologies International Society (MiECTiS) position paper promoted the creation of a common language between cardiac surgeons, anesthesiologists and perfusionists which led to the development of a stable framework that paved the way for the advancement of minimal invasive perfusion and related technologies. The current expert consensus document offers an update in areas for which new evidence has emerged. In the light of published literature, modular minimal invasive extracorporeal circulation (MiECC) has been established as a safe and effective perfusion technique that increases biocompatibility and ultimately ensures perfusion safety in all adult cardiac surgical procedures, including re-operations, aortic arch and emergency surgery. Moreover, it was recognized that incorporation of MiECC strategies advances minimal invasive cardiac surgery (MICS) by combining reduced surgical trauma with minimal physiologic derangements. Minimal Invasive Extracorporeal Technologies International Society considers MiECC as a physiologically-based multidisciplinary strategy for performing cardiac surgery that is associated with significant evidence-based clinical benefit that has accrued over the years. Widespread adoption of this technology is thus strongly advocated to obtain additional healthcare benefit while advancing patient care. [ABSTRACT FROM AUTHOR]

Published
2023
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12. Impact of a structured institutional lead management programme at a high volume centre for transvenous lead extractions in Switzerland

Author

Haeberlin, Andreas, Holz, Alexander, Seiler, Jens, Baldinger, Samuel H., Tanner, Hildegard, Roten, Laurent, Madaffari, Antonio, Servatius, Helge, Jenni, Hansjörg, Kadner, Alexander, Erdoes, Gabor, Reichlin, Tobias, and Noti, Fabian

Subjects
610 Medicine & health, Cardiology and Cardiovascular Medicine
Abstract

BACKGROUND: Transvenous lead extraction (TLE) is the recommended management strategy for a variety of cardiac implantable electronic device (CIED) infections, malfunctions and other conditions. Large registries have established the safety and efficacy of TLE per se but temporal outcome data after the introduction of an institutional lead management programme remain scarce. OBJECTIVE: To investigate the impact of a structured institutional lead management programme on TLE outcomes. METHODS: All patients who underwent TLE at our institution between January 2013 and December 2020 were included. We assessed procedural outcomes after TLE for two separate time periods: from January 2013 to December 2018 and January 2019 to December 2020 (after introduction of a structured institutional lead management programme). RESULTS: In 2013–2018, the median number of TLE procedures per year at our centre was 14 (range 10–19, total 84). In 2019/2020, the median number of interventions per year increased to 46 (range 41–51, total 92). Noninfectious indications for TLE became more frequent (p

Published
2023
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13. Safety and Efficacy of Surgical Correction of Anomalous Aortic Origin of Coronary Arteries: Experiences from two Tertiary Cardiac Centers

Author

Pregaldini, Fabio, Widenka, Hannah, Barghout, Mohamed, Gräni, Christoph, Czerny, Martin, Kari, Fabian, Chikvatia, Salome, Kadner, Alexander, and Siepe, Matthias

Subjects
610 Medicine & health
Abstract

OBJECTIVES This study aims to describe the outcomes of surgical correction for anomalous aortic origin of coronary artery (AAOCA) with regard to symptom relief. METHODS We performed a retrospective multicentre study including surgical patients who underwent correction for AAOCA between 2009 and 2022. Patients who underwent concomitant cardiac procedures were also included. However, to analyze symptom relief we only assessed the subgroup of symptomatic patients who underwent isolated correction for AAOCA. RESULTS A total of 71 consecutive patients (median age 55, range 12-83) who underwent surgical correction for AAOCA were included in the study. Right-AAOCA was present in 56 patients (79%), left-AAOCA in 11 patients (15%), single coronary ostium AAOCA in 4 patients (6%). Coronary unroofing was performed in 72% of the patients, coronary reimplantation in 28% and an additional neo-ostium patchplasty in 13% of the patients. In 39% of the patients a concomitant cardiac procedure was performed. During follow-up, no cardiovascular-related death was observed. Three patients (4.2%) had a myocardial infarction and underwent postoperative coronary artery bypass grafting. Six patients (8.5%) needed postoperative temporary mechanical circulatory support. Among the 34 symptomatic patients who underwent isolated AAOCA correction, 70% were completely asymptomatic after surgery, 12% showed symptom improvement and no symptom improvement was observed in 18% of the patients (median follow-up 3.5 years, range 0.3-11.1). CONCLUSIONS Correction for AAOCA can be safely performed with or without concomitant cardiac procedures. Performing AAOCA correction leads to a significant improvement in symptoms for most patients.

Published
2023
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16. Impact of a structured institutional lead management programme at a high volume centre for transvenous lead extractions in Switzerland

Author

Haeberlin, Andreas, primary, Holz, Alexander, additional, Seiler, Jens, additional, Baldinger, Samuel H., additional, Tanner, Hildegard, additional, Roten, Laurent, additional, Madaffari, Antonio, additional, Servatius, Helge, additional, Jenni, Hansjrg, additional, Kadner, Alexander, additional, Erdoes, Gabor, additional, Reichlin, Tobias, additional, and Noti, Fabian, additional

Published
2022
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17. 2021 MiECTiS focused update on the 2016 position paper for the use of minimal invasive extracorporeal circulation in cardiac surgery

Author

Anastasiadis, Kyriakos, primary, Antonitsis, Polychronis, additional, Murkin, John, additional, Serrick, Cyril, additional, Gunaydin, Serdar, additional, El-Essawi, Aschraf, additional, Bennett, Mark, additional, Erdoes, Gabor, additional, Liebold, Andreas, additional, Punjabi, Prakash, additional, Theodoropoulos, Konstantinos C, additional, Kiaii, Bob, additional, Wahba, Alexander, additional, de Somer, Filip, additional, Bauer, Adrian, additional, Kadner, Alexander, additional, van Boven, Wim, additional, Argiriadou, Helena, additional, Deliopoulos, Apostolos, additional, Baker, Robert Α, additional, Breitenbach, Ingo, additional, Ince, Can, additional, Starinieri, Pascal, additional, Jenni, Hansjoerg, additional, Popov, Vadim, additional, Moorjani, Narain, additional, Moscarelli, Marco, additional, Di Eusanio, Marco, additional, Cale, Alex, additional, Shapira, Oz, additional, Baufreton, Christophe, additional, Condello, Ignazio, additional, Merkle, Frank, additional, Stehouwer, Marco, additional, Schmid, Christof, additional, Ranucci, Marco, additional, Angelini, Gianni, additional, and Carrel, Thierry, additional

Published
2022
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20. Perioperative Fully Closed-Loop Insulin Delivery in Patients Undergoing Elective Surgery: An Open-Label, Randomized Controlled Trial

Author

Herzig, David, primary, Suhner, Simon, additional, Roos, Jonathan, additional, Schürch, Daniel, additional, Cecchini, Luca, additional, Nakas, Christos T., additional, Weiss, Salome, additional, Kadner, Alexander, additional, Kocher, Gregor J., additional, Guensch, Dominik P., additional, Wilinska, Malgorzata E., additional, Raabe, Andreas, additional, Siebenrock, Klaus A., additional, Beldi, Guido, additional, Gloor, Beat, additional, Hovorka, Roman, additional, Vogt, Andreas P., additional, and Bally, Lia, additional

Published
2022
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21. Third‐generation continuous‐flow left ventricular assist devices: a comparative outcome analysis by device type

Author

Mihalj, Maks, primary, Heinisch, Paul Philipp, additional, Schober, Patrick, additional, Wieser, Monika, additional, Martinelli, Michele, additional, de By, Theo M.M.H., additional, Schefold, Joerg C., additional, Luedi, Markus M., additional, Kadner, Alexander, additional, Carrel, Thierry, additional, Mohacsi, Paul, additional, Hunziker, Lukas, additional, and Reineke, David, additional

Published
2022
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22. The European Registry for Patients with Mechanical Circulatory Support (EUROMACS): third Paediatric (Paedi-EUROMACS) report

Author

de By, Theo M M H, primary, Schweiger, Martin, additional, Hussain, Hina, additional, Amodeo, Antonio, additional, Martens, Thomas, additional, Bogers, Ad J J C, additional, Damman, Kevin, additional, Gollmnan-Tepeköylü, Can, additional, Hulman, Michael, additional, Iacovoni, Attilio, additional, Krämer, Ulrike, additional, Loforte, Antonio, additional, Napoleone, Carlo Pace, additional, Němec, Petr, additional, Netuka, Ivan, additional, Özbaran, Mustafa, additional, Polo, Luz, additional, Pya, Yuri, additional, Ramjankhan, Faiz, additional, Sandica, Eugen, additional, Sliwka, Joanna, additional, Stiller, Brigitte, additional, Kadner, Alexander, additional, Franceschini, Alessio, additional, Thiruchelvam, Timothy, additional, Zimpfer, Daniel, additional, Meyns, Bart, additional, Berger, Felix, additional, and Miera, Oliver, additional

Published
2022
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23. Belastungsdyspnoe und Angina pectoris

Author

Speck, Sandro, primary, Bastian, Kathleen, additional, Fretz, Valentin, additional, Sieber, Cornel, additional, Linka, Andr, additional, Kadner, Alexander, additional, and Fischer, Thomas A., additional

Published
2022
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24. Dyspnée d’effort et angor

Author

Speck, Sandro, primary, Bastian, Kathleen, additional, Fretz, Valentin, additional, Sieber, Cornel, additional, Linka, Andr, additional, Kadner, Alexander, additional, and Fischer, Thomas A., additional

Published
2022
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25. The European Registry for Patients with Mechanical Circulatory Support (EUROMACS): third Paediatric (Paedi-EUROMACS) report

Author

CTC, Circulatory Health, de By, Theo M M H, Schweiger, Martin, Hussain, Hina, Amodeo, Antonio, Martens, Thomas, Bogers, Ad J J C, Damman, Kevin, Gollmann-Tepeköylü, Can, Hulman, Michael, Iacovoni, Attilio, Krämer, Ulrike, Loforte, Antonio, Napoleone, Carlo Pace, Němec, Petr, Netuka, Ivan, Özbaran, Mustafa, Polo, Luz, Pya, Yuri, Ramjankhan, Faiz, Sandica, Eugen, Sliwka, Joanna, Stiller, Brigitte, Kadner, Alexander, Franceschini, Alessio, Thiruchelvam, Timothy, Zimpfer, Daniel, Meyns, Bart, Berger, Felix, Miera, Oliver, CTC, Circulatory Health, de By, Theo M M H, Schweiger, Martin, Hussain, Hina, Amodeo, Antonio, Martens, Thomas, Bogers, Ad J J C, Damman, Kevin, Gollmann-Tepeköylü, Can, Hulman, Michael, Iacovoni, Attilio, Krämer, Ulrike, Loforte, Antonio, Napoleone, Carlo Pace, Němec, Petr, Netuka, Ivan, Özbaran, Mustafa, Polo, Luz, Pya, Yuri, Ramjankhan, Faiz, Sandica, Eugen, Sliwka, Joanna, Stiller, Brigitte, Kadner, Alexander, Franceschini, Alessio, Thiruchelvam, Timothy, Zimpfer, Daniel, Meyns, Bart, Berger, Felix, and Miera, Oliver

Published
2022

26. Coronary CT FFR vs Invasive Adenosine and Dobutamine FFR in a Right Anomalous Coronary Artery

Author

Bigler, Marius R, Stark, Anselm W, Giannopoulos, Andreas A, Huber, Adrian T, Siepe, Matthias, Kadner, Alexander, Räber, Lorenz, Gräni, Christoph, Bigler, Marius R, Stark, Anselm W, Giannopoulos, Andreas A, Huber, Adrian T, Siepe, Matthias, Kadner, Alexander, Räber, Lorenz, and Gräni, Christoph

Abstract

We present the management of an anomalous coronary artery originating from the opposite sinus of Valsalva with comprehensive diagnostic workup including noninvasive coronary computed tomography (CT) derived fractional flow reserve (FFR) and invasive dobutamine-volume challenge-FFR/intravascular ultrasound. After surgical operation, treatment success was quantified by anatomical and functional analysis in postoperative CT. (Level of Difficulty: Advanced.).

Published
2022

29. Initial experience with minimally invasive extracorporeal circulation in coronary artery bypass graft reoperations

Author

Heinisch, Paul Philipp , primary, Mihalj, Maks, additional, Haliguer, Elif, additional, Gahl, Brigitta, additional, Winkler, Bernhard, additional, Venetz, Philipp, additional, Jenni, Hansjoerg, additional, Schober, Patrick, additional, Erdoes, Gabor, additional, Luedi, Markus M., additional, Schefold, Joerg C., additional, Kadner, Alexander, additional, Huber, Christoph, additional, and Carrel, Thierry P., additional

Published
2022
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30. Supplemental Material - 2021 MiECTiS focused update on the 2016 position paper for the use of minimal invasive extracorporeal circulation in cardiac surgery

Author

Anastasiadis, Kyriakos, Antonitsis, Polychronis, Murkin, John, Serrick, Cyril, Gunaydin, Serdar, El-Essawi, Aschraf, Bennett, Mark, Erdoes, Gabor, Liebold, Andreas, Punjabi, Prakash, Theodoropoulos, Konstantinos C, Kiaii, Bob, Wahba, Alexander, de Somer, Filip, Bauer, Adrian, Kadner, Alexander, van Boven, Wim, Argiriadou, Helena, Deliopoulos, Apostolos, Baker, Robert Α, Breitenbach, Ingo, Ince, Can, Starinieri, Pascal, Jenni, Hansjoerg, Popov, Vadim, Moorjani, Narain, Moscarelli, Marco, Di Eusanio, Marco, Cale, Alex, Shapira, Oz, Baufreton, Christophe, Condello, Ignazio, Merkle, Frank, Stehouwer, Marco, Schmid, Christof, Ranucci, Marco, Angelini, Gianni, and Carrel, Thierry

Subjects
FOS: Clinical medicine, Cardiology, 110323 Surgery
Abstract

Supplemetary Material for 2021 MiECTiS focused update on the 2016 position paper for the use of minimal invasive extracorporeal circulation in cardiac surgery by Kyriakos Anastasiadis, Polychronis Antonitsis, John Murkin, Cyril Serrick, Serdar Gunaydin, Aschraf El-Essawi, Mark Bennett, Gabor Erdoes, Andreas Liebold, Prakash Punjabi, Konstantinos C Theodoropoulos, Bob Kiaii, Alexander Wahba, Filip de Somer, Adrian Bauer, Alexander Kadner, Wim van Boven, Helena Argiriadou, Apostolos Deliopoulos, Robert Α Baker, Ingo Breitenbach, Can Ince, Pascal Starinieri, Hansjoerg Jenni, Vadim Popov, Narain Moorjani, Marco Moscarelli, Marco Di Eusanio, Alex Cale, Oz Shapira, Christophe Baufreton, Ignazio Condello, Frank Merkle, Marco Stehouwer, Christof Schmid, Marco Ranucci, Gianni Angelini, Thierry Carrel in Perfusion

Published
2022
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36. Surgical versus transcatheter repair for secondary mitral regurgitation: A propensity score–matched cohorts comparison

Author

Okuno, Taishi, primary, Praz, Fabien, additional, Kassar, Mohammad, additional, Biaggi, Patric, additional, Mihalj, Maks, additional, Külling, Mischa, additional, Widmer, Sonja, additional, Pilgrim, Thomas, additional, Grünenfelder, Jürg, additional, Kadner, Alexander, additional, Corti, Roberto, additional, Windecker, Stephan, additional, Wenaweser, Peter, additional, and Reineke, David, additional

Published
2021
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37. Use of minimal invasive extracorporeal circulation in cardiac surgery: principles, definitions and potential benefits. A position paper from the Minimal invasive Extra-Corporeal Technologies international Society (MiECTiS)

Author

Anastasiadis, Kyriakos, Murkin, John, Antonitsis, Polychronis, Bauer, Adrian, Ranucci, Marco, Gygax, Erich, Schaarschmidt, Jan, Fromes, Yves, Philipp, Alois, Eberle, Balthasar, Punjabi, Prakash, Argiriadou, Helena, Kadner, Alexander, Jenni, Hansjoerg, Albrecht, Guenter, van Boven, Wim, Liebold, Andreas, de Somer, Fillip, Hausmann, Harald, Deliopoulos, Apostolos, El-Essawi, Aschraf, Mazzei, Valerio, Biancari, Fausto, Fernandez, Adam, Weerwind, Patrick, Puehler, Thomas, Serrick, Cyril, Waanders, Frans, Gunaydin, Serdar, Ohri, Sunil, Gummert, Jan, Angelini, Gianni, Falk, Volkmar, Carrel, Thierry, Anastasiadis, Kyriakos, Murkin, John, Antonitsis, Polychronis, Bauer, Adrian, Ranucci, Marco, Gygax, Erich, Schaarschmidt, Jan, Fromes, Yves, Philipp, Alois, Eberle, Balthasar, Punjabi, Prakash, Argiriadou, Helena, Kadner, Alexander, Jenni, Hansjoerg, Albrecht, Guenter, van Boven, Wim, Liebold, Andreas, de Somer, Fillip, Hausmann, Harald, Deliopoulos, Apostolos, El-Essawi, Aschraf, Mazzei, Valerio, Biancari, Fausto, Fernandez, Adam, Weerwind, Patrick, Puehler, Thomas, Serrick, Cyril, Waanders, Frans, Gunaydin, Serdar, Ohri, Sunil, Gummert, Jan, Angelini, Gianni, Falk, Volkmar, and Carrel, Thierry

Abstract

Minimal invasive extracorporeal circulation (MiECC) systems have initiated important efforts within science and technology to further improve the biocompatibility of cardiopulmonary bypass components to minimize the adverse effects and improve end-organ protection. The Minimal invasive Extra-Corporeal Technologies international Society was founded to create an international forum for the exchange of ideas on clinical application and research of minimal invasive extracorporeal circulation technology. The present work is a consensus document developed to standardize the terminology and the definition of minimal invasive extracorporeal circulation technology as well as to provide recommendations for the clinical practice. The goal of this manuscript is to promote the use of MiECC systems into clinical practice as a multidisciplinary strategy involving cardiac surgeons, anaesthesiologists and perfusionists.

Published
2021

38. Graft preservation solutions in cardiovascular surgery

Author

Winkler, Bernhard, Reineke, David, Heinisch, Paul Philip, Schönhoff, Florian, Huber, Christoph, Kadner, Alexander, Englberger, Lars, Carrel, Thierry, Winkler, Bernhard, Reineke, David, Heinisch, Paul Philip, Schönhoff, Florian, Huber, Christoph, Kadner, Alexander, Englberger, Lars, and Carrel, Thierry

Abstract

Vein grafts are still the most commonly used graft material in cardiovascular surgery and much effort has been spent in recent years on investigating the optimal harvesting technique. One other related topic of similar importance remained more or less an incidental one. The storage solutions of vein grafts following procurement and prior to implantation are, despite their assumed impact, a relatively neglected theme. There is no doubt that the endothelium plays a key role in long-term patency of vein grafts, but the effects of the different storage solutions on the endothelium remain unclear. In a review of the literature, we could find 20 specific papers that addressed the question, of which the currently available preservation solutions are superior, harmless, damaging or ineffective. The focus lies on saline and autologous whole blood. Besides these two storage media, novel or alternative solutions have been investigated with surprising findings. In addition, a few words will be spent on potential alternatives and novel solutions on the market. As there is currently no randomized clinical trial regarding saline versus autologous whole blood available, this review compares all previous studies and methods of analysis to provide a certain level of evidence on this topic. In summary, saline has negative effects on the endothelial layers and therefore may compromise graft patency. Related factors, such as distension pressure, may outbalance the initial benefit of autologous whole blood or storage solutions and intensify the harmful effects of warm saline. In addition, there is no uniform consent on the superiority of autologous whole blood for vein graft storage. This may open the door to alternatives such as the University of Wisconsin solution or one of the specific designed storage solutions like TiProtec™ or Somaluthion™. Whether these preservation solutions are superior or advantageous remains the subject of further studies.

Published
2021

43. Prolonged Pediatric Extracorporeal Membrane Oxygenation Support with Cardiopulmonary Failure in Juvenile Myelomonocytic Leukemia

Author

Bartkevics, Maris, Hennig, Bert, Güngör, Tayfun; https://orcid.org/0000-0002-3261-1186, Ammann, Roland, Kadner, Alexander; https://orcid.org/0000-0003-3024-6514, Bartkevics, Maris, Hennig, Bert, Güngör, Tayfun; https://orcid.org/0000-0002-3261-1186, Ammann, Roland, and Kadner, Alexander; https://orcid.org/0000-0003-3024-6514

Abstract

We report a case of a child survival after extracorporeal membrane oxygenation (ECMO) support of 25 days for cardiopulmonary failure and septic shock in the context of juvenile myelomonocytic leukemia (JMML). ECMO support is still a matter of debate for the management of septic patients with malignancy. However, these patients are at increased risk for early death secondary to pulmonary complications due to leukostasis, direct pulmonary infiltration with WBC, and systemic inflammatory response syndrome following malignant cell lysis. Despite the high risk of complications, ECMO support must be discussed as part of management, providing better outcome in this group of patients.

Published
2020

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