Abstract

The purpose of this communication is to provide an overview of modern cardiac valvular devices for replacement and reconstruction used worldwide, as well as innovative technologies and devices poised to improve clinical performance.

Abstract

Among the different techniques of mitral valve repair (involving chordea, commissures, papillary muscles, leaflets, or annulus), the annuloplasty remains a difficult problem-solving step. Since invention of the first ring, which was rigid and closed, the concept of annuloplasty has taken into consideration the following objectives: to make the available leaflet tissue well fitted to the systolic mitral orifice by repairing the length and shape of the dilated annulus, prevent its further dilatation, and provide a support to the fragile area after a partial leaflet resection.

Abstract

During recent years, a rapid progress in the area of minimally invasive heart surgery has been seen. In addition to operations through smaller incisions and those without a complete median sternotomy, minimally invasive in cardiac surgery also means-and this might be even more important-performing the operation without cardiopulmonary bypass (CPB). Documented evidence indicates that CPB is an independent risk factor for end-organ injury after heart surgery. However, discussion continues regarding whether off-pump coronary artery bypass (OPCAB) techniques allow the same (or better) outcomes in longterm graft patency, myocardial damage, and associated morbidity compared with the classic operation done on CPB. That is one of the reasons the German insurance companies still do not accept OPCAB techniques as a viable alternative for surgical coronary revascularization, although the avoidance of CPB appears to have the greatest potential to minimize procedural costs and, consequently, provide economic benefit.

Abstract

Indications for endoluminaI treatment of occlusive aorto-iliac disease are well known. Endovascular grafting is a technique currently being evaluated for its efficacy for treatment of aneurysmal disease. The success of those techniques is due to their favorable results and non-invasive characteristics. X-ray contrast angiography (CA) is the most currently used imaging modality for endovascular procedures; however, the iodinated contrast agent is directly responsible for systemic and renal adverse effects in 3% to 12% of patients.

Abstract

The concept of transluminal treatment of vascular obstruction by the percutaneous approach was introduced by Dotter and Judkins, in 1964. Percutaneous transluminal angioplasty (PTA) developed rapidly into an extremely important therapeutic modality for relieving symptomatic obstructions in major arteries. However, it was not until 1969 that Dotter reported the successful placement of coiled stainiess steel wire endarterial tube grafts, with the aid of a catheter, into the popliteal arteries of dogs. This procedure stimulated the worldwide development and clinical application of endovascular stenting.