Behandlung des Hypoplastischen Linksherz Syndroms: eine Bilanz über 12 Jahre

Analyse des dreistufigen operativen Behandlungskonzeptes bei Patienten mit Hypoplastischen Linksherz Syndrom

Transcatheter mitral valve implantation: different fixation techniques

Transcatheter mitral valve implantation provides an off-pump treatment option for mitral valve regurgitation, especially for secondary mitral regurgitation. It offers an opportunity for the treatment of a large cohort of patients not referred for conventional surgery. One of the biggest challenges is the development of a valved stent that suits the complex anatomy of the native mitral valve. Furthermore, secure anchorage of the device is difficult in the mitral area without clearly defined structures. In the last few years, various new self-expanding nitinol valved stents for transapical implantation in the beating heart have been developed. Different design iterations were conducted to improve fixation and overall stent performance. The risk of paravalvular leakage was decreased and reproducibility enhanced. This article reviews the major achievements in the development process of our apically fixed mitral valved stent over the last few years, with prototypes that provide secure stent deployment, high reproducibility and low paravalvular leakage rates

Right ventricular outflow tract reconstruction with the Labcor® stentless valved pulmonary conduit

OBJECTIVES The right ventricular outflow tract reconstruction is a common necessity in congenital cardiac surgery. As homograft availability is limited, alternatives need to be evaluated. The Labcor® conduit consists of a porcine tricomposite valve assembled inside a bovine pericardium tube. This study presents intermediate-term results for its utilization for right ventricular outflow tract reconstruction. METHODS Labcor conduits were implanted in 53 patients (February 2009-July 2016). We analysed perioperative data, freedom from conduit failure and risk factors for conduit dysfunction. RESULTS The most common diagnosis was Tetralogy of Fallot (n = 20, 37.7%). The median age at surgery was 10.0 [interquartile range (IQR) 4.9-14.3] years. Pulmonary artery plasty (n = 37, 69.8%) and augmentation of the right ventricular outflow tract (n = 16, 30.2%) were often part of the procedure. The median conduit size was 21 (range 11-25) mm. There was no in-hospital death. The median follow-up after surgery was 4.6 (IQR 3.4-5.6) years. Fourteen patients (27.5%) developed conduit failure with stenosis being the main cause. Freedom from conduit failure was 98.0% at 2 and 80.5% at 5 years. The median longevity of the conduit was 7.4 years (95% confidence interval 5.1-9.8 years). Younger age and smaller conduit size were related to conduit failure. CONCLUSIONS Utilization of the Labcor conduit revealed acceptable intermediate-term results. The conduit appeared to be functioning sufficiently well within the first 5 years in the majority of patients. The higher rate of failure concerning smaller conduits might be associated with somatic outgrowth; however, conduit degeneration as common and long-term outcome still needs to be evaluated

How can networks help encourage the development and professionalisation of innovative early STEM Education in a changing world?

Maailma muuttuu monimutkaisemmaksi ja vaatii muun muassa STEM*-osaamista ja lukutaitoa oppijoilta, yhteisön jäseniltä ja yhteiskunnilta. Siksi laadukkaalle varhaiselle STEM-koulutukselle tarvitaan laajaa puolustamista. Tässä artikkelissa hahmotellaan, kuinka vaikutusverkostot (joita on muodostettu käsittelemään monimutkaisia sosiaalisia tai ympäristökysymyksiä) voivat edistää varhaisen STEM-koulutuksen kehittämistä ja ammattimaistumista. Sen tavoitteena on tukea alaa kehittäviä oppilaitoksia lisäämään työnsä vaikutusta paremman ja helposti saavutettavan koulutuksen puolesta maailmanlaajuisesti. Tutkittuaan varhaisen STEM-koulutuksen suunniteltuja vaikutuksia nykyisessä kontekstissa esitellään erilaisia verkostotyyppejä ja arvioidaan koulutusorganisaatioiden ja niiden verkostokumppaneiden verkostomaisia lähestymistapoja useissa maissa. Se pohtii verkostojen eri toimintoja ja menestystekijöitä suhteessa kirjoittajien kuuden organisaation verkostoihin omissa maissaan ja analysoi verkostoja mahdollisuuksien ja haasteiden mukaan. Paperi argumentoi verkostoyhteistyön merkityksellisyyden ja verkostojen potentiaalin muutoksen vaikuttajina osoittaen niiden vaikutusta STEM-koulutuksen parantamiseen muuttuvassa maailmassa. Lyhenne "STEM" LUMAa vastaava kansainvälinen lyhenne, joka tarkoittaa tiedettä, teknologiaa, tekniikkaa, tietotekniikkaa ja matematiikkaa. Artikkelissa STEM Education määritellään koulutukseksi, jossa yhdistyvät tieteen, teknologian, (tieto)tekniikan ja matematiikan käsitteet ja menetelmät integroidulla tieteenaloja muuttavalla tavalla.The world is becoming more complex and requires, among other skills, STEM1knowledge and literacy of its learners, community members, and societies alike. Thus, an extensive advocacy for quality early STEM Education is needed. This paper outlines how impact networks (formed to address complex social or environmental issues) can promote the development and professionalisation of early STEM Education. It aims to support field-developing institutions to increase the impact of their work for a better and easily accessible education worldwide. After reviewing the intended impact of early STEM Education in the present context, the paper presentsvarious network types and then assesses the network approaches of educational organisations and their network partners in multiple countries. It reflects on the various functions and success factors of networks in relation to the authors’ six organisations’ networks in their respective countries and analyses the networks according to opportunities and challenges. The paper argues for the relevance of network collaborations and for the potential of networks as agents of change, exemplifying their impact on improving STEM Education in a changing world. The abbreviation “STEM” stands for science, technology, (information) engineering/computer science, and mathematics. We define STEM Education as an education combining science, technology, (information) engineering, and math concepts and methods in an integrated way that transforms the discipline of science.nonPeerReviewe

Tissue Engineered Transcatheter Pulmonary Valved Stent Implantation: Current State and Future Prospect

Patients with the complex congenital heart disease (CHD) are usually associated with right ventricular outflow tract dysfunction and typically require multiple surgical interventions during their lives to relieve the right ventricular outflow tract abnormality. Transcatheter pulmonary valve replacement was used as a non-surgical, less invasive alternative treatment for right ventricular outflow tract dysfunction and has been rapidly developing over the past years. Despite the current favorable results of transcatheter pulmonary valve replacement, many patients eligible for pulmonary valve replacement are still not candidates for transcatheter pulmonary valve replacement. Therefore, one of the significant future challenges is to expand transcatheter pulmonary valve replacement to a broader patient population. This review describes the limitations and problems of existing techniques and focuses on decellularized tissue engineering for pulmonary valve stenting.Other UBCNon UBCReviewedFacultyResearcherOthe