Exchangeable heart valve

Congenital heart defects are the most common types of birth defects in humans. Children with congenital heart defects frequently require heart valve replacement with an implant. Unfortunately, conventional heart valve implants do not grow. Therefore, these children are committed to serial re-operations for successively larger implant exchanges. Partial heart transplantation is a new and innovative approach to deliver growing heart valve implants. However, the transplant biology of partial heart transplant grafts remains unexplored...

Fully automated characterization of monoclonal antibody (mAb) charge variants using four-dimensional liquid chromatography-mass spectrometry (4D-LC-MS) is reported and illustrated. Charge variants resolved by cation-exchange chromatography (CEX) using a salt- or pH-gradient are collected in loops installed on a multiple heart-cutting valve and consequently subjected to online desalting, denaturation, reduction and trypsin digestion prior to LC-MS based peptide mapping. This innovation which substantially reduces turnaround time, sample manipulation, loss and artefacts and increases information gathering, is described in great technical detail, and applied to characterize the charge heterogeneity associated with three therapeutic mAbs...

Bacterial nanocellulose (BNC) is a homopolymer of β-1,4 linked glycose, which is synthesized by Acetobacter using simple culturing methods to allow inexpensive and environmentally friendly small- and large-scale production. Depending on the growth media and types of fermentation methods, ultra-pure cellulose can be obtained with different physio-chemical characteristics. Upon biosynthesis, bacterial cellulose is assembled in the medium into a nanostructured network of glucan polymers that are semitransparent, mechanically highly resistant, but soft and elastic, and with a high capacity to store water and exchange gasses...

Amisulpride is a clinically effective antipsychotic drug. It has been recommended for therapeutic drug monitoring in Consensus Guidelines for Therapeutic Drug Monitoring in Neuropsychopharmacology . An integrated multicolumn two-dimensional liquid chromatography system was constructed. Two reversed-phase columns, Supersil ODS2 (150 mm×4.6 mm, 5 μm) and SinoChrom ODS-BP (150 mm×4.6 mm, 5 μm), with different hydrophobicities were employed in the first and second separation dimensions, respectively. A strong cation-exchange short column, Supersil SCX (10 mm×4...

BACKGROUND: The Abiomed Impella 5.5 (Danvers, MA) is a newly developed axial flow transaortic cardiac support device mounted on a 9 Fr steering catheter with a 21 Fr pump cannula. Impella 5.5 is intended for longer use and was approved for 30 days in 2018. This study evaluated the first-in-man series at six high-volume mechanical circulatory support centers in Germany after CE approval. METHODS: The first 46 consecutive patients worldwide underwent implantation in six German centers between March 2018 and September 2019 for post-CE approval evaluation...

A short RNA with the sequence of the antisense strand of Patisiran has been selected as test material for the investigation of its common impurities using three different two-dimensional liquid chromatography (2D-LC) platforms. On the one hand, a quinine (QN) carbamate-based weak anion-exchange (AX) stationary phase (QN-AX) and a classical C18 reversed phase (RP) stationary phase in ion-pair (IP) mode with tripropylammonium acetate, respectively, have been used in the first dimension (1 D) to provide the selectivity for impurities formed during the synthesis of the RNA...

Scientific efforts in the field of computational modeling of cardiovascular diseases have largely focused on heart failure with reduced ejection fraction (HFrEF), broadly overlooking heart failure with preserved ejection fraction (HFpEF), which has more recently become a dominant form of heart failure worldwide. Motivated by the paucity of HFpEF in silico representations, two distinct computational models are presented in this paper to simulate the hemodynamics of HFpEF resulting from left ventricular pressure overload...

AIMS: Persistent mitral valve regurgitation (MR) after continuous flow left ventricular assist device implantation (cfLVAD) is associated with pulmonary hypertension and right ventricular failure with variable effects on survival across published studies. The aim of this study is to determine the incidence and predictors of persistent MR at 6-month follow-up after cfLVAD implantation and its impact on survival, haemodynamics, right ventricular function, and morbidity. METHODS AND RESULTS: We performed a retrospective review of all adult cfLVAD recipients from January 2012 to June 2017 at a single tertiary university hospital with follow-up until April 2019...

Children undergoing congenital cardiac surgery often outgrow the valve implants. These children are thus committed to morbid reoperations for successive exchanges of the vavular implants that they have outgrown. Therefore the holy grail of congenital cardiac surgery is a valve implant that grows with the recipient child. Preserved homografts routinely are used as valve implants, but they do not grow as the child grows because they lose viability during preservation. In contrast, pulmonary autografts and pediatric heart transplants grow with the recipient children...

Until today, ion-pair reversed-phase chromatography is still the dominating method for analytical characterization of synthetic oligonucleotides. Its hyphenation with mass spectrometry, however, has some drawbacks such as ion-suppression in electrospray ionization. To overcome this problem, we present in this work a multiple heart-cutting (MHC) two-dimensional liquid chromatography (2D-LC) method with ultra-violet (UV) and electrospray ionization (ESI) mass spectrometry (MS) detection. A reversed-phase/weak anion-exchange (RP/WAX) stationary phase in the first dimension (1 D) provides the selectivity for separation of structurally closely related oligonucleotide sequences and deletions (shortmers), respectively, using a mixed pH/triethylammonium phosphate buffer gradient at constant organic modifier content...

OBJECTIVES: This study examines the impact of anatomical and procedural factors on Valve Academic Research Consortium-2-defined vascular complications at the femoral access site in transcatheter aortic valve replacement (TAVR) with third generation transcatheter heart valve (THV)-systems. BACKGROUND: Randomized clinical trials reported on vascular complications with current THV-systems. However, clinical presentation and consequences of these events are not well studied...

PURPOSE: Persistent mitral valve regurgitation (MR) after continuous flow left ventricular assist device implantation (cfLVAD) is associated with pulmonary hypertension and right ventricular (RV) failure with variable effects on survival across published studies. The aim of this study is to determine the incidence and predictors of persistent MR at 6-month follow up after cfLVAD implantation and its impact on survival, hemodynamics, RV function and morbidity. METHODS: Retrospective review of all adult cfLVAD recipients from January 2012 to June 2017 at a single tertiary university hospital...

PURPOSE: Patients with IPF and cardiopulmonary failure caused by secondary pulmonary hypertension have poor prognoses. If lung oxygen exchange capacity is completely lost and secondary heart failure caused by pulmonary exacerbation was appeared, it is difficult to maintain survival via conventional peripheral ECMO alone. We used Oxy-RVAD(RA-PA ECMO) as novel configuration delivered via anterior thoracotomy to treat end-stage IPF patients with RHF. METHODS: Patients with RHF caused by secondary pulmonary hypertension, who had a bridge to LT, were indicated for Oxy-RVAD placement...

BACKGROUND: As a measure of the global left ventricular afterload, valvuloarterial impedance (ZVA) can be estimated using transthoracic echocardiography (TTE) and invasive measuring methods. The objective of this study was to compare the performance of TTE in measuring ZVA with invasive haemodynamics, direct Fick and thermodilution (TD), in patients with severe aortic stenosis (AS). METHODS: This is a retrospective cohort study of 66 patients with severe AS who underwent TTE and bilateral heart catheterisation preaortic valve replacement...

Creatine is an important metabolite involved in muscle contraction. Administration of exogenous creatine (Cr) or phosphocreatine (PCr) has been used for improving exercise performance and protecting the heart during surgery including during valve replacements, coronary artery bypass grafting and repair of congenital heart defects. In this work we investigate whether it is possible to use chemical exchange saturation transfer (CEST) MRI to monitor uptake and clearance of exogenous creatine and phosphocreatine following supplementation...

Approximately 5% of percutaneous pulmonary valve implantation are at risk for coronary compression. Therefore, PPVI is contra-indicated if coronary anomalies and tested coronary flow impairment are observed. Simultaneous right ventricular outflow tract ballooning and coronary angiography are mandatory elucidating contraindications for PPVI. We present the case of a 22-year-old young lady following Rastelli repair with chronic right heart failure. Weighing the risk of several offered surgical options, she underwent successful PPVI following minimally invasive direct coronary artery bypass (MIDCAB) procedure...

The metalloprotease ADAM17 (a disintegrin and metalloprotease 17) regulates EGF-receptor and TNFα signaling, thereby not only protecting the skin and intestinal barrier, but also contributing to autoimmunity. ADAM17 can be rapidly activated by many stimuli through its transmembrane domain (TMD), with the seven membrane-spanning inactive Rhomboids (iRhom) 1 and 2 implicated as candidate regulatory partners. However, several alternative models of ADAM17 regulation exist that do not involve the iRhoms, such as regulation through disulfide bond exchange or through interaction with charged phospholipids...

BACKGROUND: Over the past decade, the importance of person-centered care has led to increased interest in patient-reported outcome measures (PROMs). In cardiovascular care, selecting an appropriate PROM for clinical use or research is challenging because multimorbidity is often common in patients. The aim was therefore to provide an overview of heart-disease specific PROMs and to compare the content of those outcomes using a bio-psycho-social framework of health. METHODS: A scoping review of heart disease-specific PROMs, including arrhythmia/atrial fibrillation, congenital heart disease, heart failure, ischemic heart disease, and valve diseases was conducted in PubMed (January 2018)...

A novel multilayer modulator chip offering a robust miniaturized interface for multi-dimensional liquid chromatography has been developed. The thermoplastic microfluidic device comprises five tailor-made functional layers and the chip is compatible with commercially available switching-valve technology. The modulator chip allows for robust ultra-high-pressure operation up to 65 MPa. Peak-dispersion characteristics of system peaks were assessed directly at the valve outlet by monitoring fluorescein injection profiles with laser-induced fluorescence detection...

Purpose : Peak and maximal oxygen uptake ([Formula: see text] and [Formula: see text], respectively) are used in assessing aerobic power. For swimmers with physical impairments, it is unclear whether the physiological variables obtained in 200-m and Nx200-m tests are similar. The objective of this study is to assess the validity of [Formula: see text] as an estimator of [Formula: see text] and complementary physiological variables, in particular, carbon dioxide production ([Formula: see text]), respiratory exchange ratio (RER), minute-ventilation ([Formula: see text] and absolute (HR) and relative (%HRmax) heart rates-which were obtained in a time trial test (200-m) and an incremental intermittent test (Nx200-m) performed by swimmers with physical impairments...