Durability of mitral valve reconstruction using the cosgrove edwards annuloplasty band at 5 years : From 23rd World Congress of the World Society of Cardio-Thoracic Surgeons. Split, Croatia. 12-15 September 2013

Oral presentation: 23rd World Congress of the World Society of Cardio-Thoracic Surgeons. Split, Croatia. 12-15 September 2013. Background: In the past, questions have been raised, whether an open flexible annuloplasty band can reliably prevent recurrent mitral valve regurgitation. The purpose of this study was to evaluate the durability of mitral valve repair at midterm, using the Cosgrove-Edwards annuloplasty band in a homogenic patient cohort. Methods: From January 2004 to December 2007, 157 consecutive patients with degenerative mitral valve disease were included in the study. All had quadrangular resection of a P2 prolapse and annuloplasty with a Cosgrove-Edwards annuloplasty band. Clinical and echocardiography follow-up was complete. Results: There was no intraoperative or 30 day mortality. After a mean follow-up of 5.0 ± 1.9 years, survival was 94.3%. At midterm, freedom from reoperations was 98.9%, freedom from thromboembolism was 97.5% and freedom from endocarditis was 99.4%. Echocardiography follow-up showed recurrent mitral valve regurgitation higher than grade 2 in two patients. Mean ejection fraction was 60.3 ± 10.2%, left atrial diameter was 42 ± 7 mm, mean gradient was 3.2 ± 1.4 mmHg, effective orifice area was 3.3 ± 1.3cm², mitral leaflet coaptation length was 7.5 ± 1.9 mm and mitral leaflet tethering height was 6.2 ± 2.3 mm. Conclusion: Mitral valve repair using the Cosgrove annuloplasty band for degenerative mitral valve disease provides an effective and durable form of reconstruction

Biocatalysts for selective introduction of oxygen

Three types of oxygenase biocatalysts are treated in detail in this review: the non-haem iron alkene mono-oxygenases, the haem and vanadium haloperoxidases, and flavin-based Baeyer-Villiger mono-oxygenases. Other oxygenases are briefly included for comparison. Characteristics of the biocatalysts are presented, and the scope and limitations concerning their applicability for the selective introduction of oxygen are discussed. Key issues include catalytic activity, productivity, cloning and expression, as well as process engineering aspects. Various bottlenecks are identified for the different biocatalysts and measures to increase the number of oxygenase reactions in practical use are discussed