Incidence of permanent pacemaker implantation after cardiac surgery : A single centre experience

Publisher Copyright: © 2019 Martiņš Kalejs et al., published by Sciendo 2019. Copyright: Copyright 2019 Elsevier B.V., All rights reserved.Permanent pacemaker implantation (PPI) after open heart surgery is required in 0.4-8.5% of patients. The aim of our study was to determine the incidence of PPI after cardiac surgery at Pauls Stradiņš Clinical University Hospital and to assess its influence on intrahospital outcomes. This was a single-centre retrospective study. We reviewed all patients who underwent either open heart surgery or transcatheter aortic valve implantation (TAVI) between the years 2015 and 2017. Included were all patients with PPI postoperatively before discharge. We compared the patient demographics, and perioperative state, incidence of PPI and intrahospital stay among groups. After cardiac surgery a total of 135 (4.2%) patients received a PPI. The PPI incidence was highest in the tricuspid valve intervention group - 8.8% followed by aortic valve replacement (AVR) patients with 3.3%. After TAVI incidence of PPI was 4.0% after Sapien valve and 8% after CoreValve implantations, respectively. Incidence of PPI after TAVI with the Sapien valve was not significantly higher when compared to conventional AVR, but it was significantly higher after TAVI with CoreValve. Regardless of the initial procedure a need for PPI significantly increased the total length of hospital stay.publishersversionPeer reviewe

Biomechanical properties of human dilated ascending aorta

Publisher Copyright: © 2019 Ivars Brečs et al., published by Sciendo 2019. Copyright: Copyright 2019 Elsevier B.V., All rights reserved.Aneurysms of ascending aorta are dilatation of the first part of the human aorta. They commonly show no clinical symptoms. This condition increases the risk of aorta dissection, which is a life-threatening condition. In this study we attempted to elucidate the changes in the biomechanical properties that occur in the dilated human ascending aorta. Fourteen specimens of ascending aorta wall were mechanically tested under a uniaxial tensile test. Two specimens from each ascending aorta anterior region were cut in longitudinal and circumferential directions. The samples were stretched until rupture of the sample occurred. The obtained experimental data were processed to determine maximal stress, maximal strain and the tangential modulus of elasticity in the linear part of the stress-strain curve. The obtained results showed a remarkable anisotropy of the ascending aorta tissue. We found higher strength of the tissue in the circumferential direction than in the longitudinal direction. There were no statistically significant differences between the strains of the samples. Tangential modulus of elasticity of the aortic samples in the longitudinal direction was significantly lower than the elastic modulus of the samples in the circumferential direction. The tissue in the circumferential direction is stronger and stiffer than in the longitudinal direction.Peer reviewe

Long-term complications evidenced studying the explanted Gore® HELEX® atrial septal defect occluder seven years after implantation : a case report

We present the results of the first morphological study of a Gore® HELEX® Septal Occluder 30 mm that was explanted seven years after interventional implantation due to a significant left-to-right shunt (7 mm) which resulted from the stretching of the concomitant patent foramen ovale by the occluder after atrial septal defect closure. Complete endothelialization of the surface of the device, the formation of the connective tissue around the implant, minor chronic inflammation, the appearance of foreign body giant cells and weakened myocardial cells adjacent to the implant as well as enhanced expression of matrix metalloproteinases were demonstrated.publishersversionPeer reviewe