In the United States alone, sudden cardiac death (SCD) is responsible for nearly half of all the deaths associated with cardiovascular diseases. Acute myocardial infarction (AMI) survivors are at greater risk of SCD, mostly caused by severe left ventricular (LV) systolic dysfunction and cardiac arrhythmias. A device known as the automated implantable cardioverter-defibrillator (AICD) or implantable cardioverter-defibrillator (ICD) is implantable in the body, capable of delivering cardioversion, performing defibrillation, and (within some modern updates) pacing the heart. The all-cause mortality in patients with implanted ICD saw an adjusted reduction of 44% (HR 0.56, 95% CI: 0.32-1.01; P = 0.053)) in contrast to those with identical baseline. Subjects with implanted ICD three months following a myocardial infarction (MI) displayed insignificant greater mortality than those who did not implant an ICD. The factors favoring the implantation of ICD were, among many, elevated resting heart rate, multiple MIs, the occurrence of non-sustained ventricular tachycardia, syncope episodes, QRS duration of 120 milliseconds (ms), consumption of anti-arrhythmic medicine (often Class III), and MI index of longer than a year. The probability of obtaining an ICD depreciated as patients age. A notable predictor of death is extended periodic repolarization dynamics. To sum, cardioverter-defibrillators help decreases the mortality of all-cause and sudden cardiac death. It is noteworthy that ICDs are only meaningful if implanted following a sufficient post-MI period gap.

Publishing the results of one’s research is an integral part of the scientific process, yet scholarly journals are often seen as black boxes by researchers. What happens to a paper after it is submitted? Who is deciding on its fate? What is the role of the journal editor and the editorial office? How does the peer-review process work, and are its core principles still relevant in today’s changing publishing landscape? In this talk I will discuss these questions in an attempt to de-mystify the peer review process from an editor's perspective, and cover the whats, the hows and the whys of peer review. 

Background: Cardiothoracic (CT) surgery is a dynamic and demanding specialty, which is popular amongst medical students thus, posing as a favourable career choice for many. However, there is a significant proportion of medical students who prefer to choose other specialities instead, for different reasons. Aim of the study: This review aims to identify factors affecting the uptake of cardiothoracic surgery as a career by medical students, junior doctors and trainees globally. Methods: A comprehensive literature review was conducted using PubMed, EMBASE, SCOPUS and CINAHL using specific keywords including “cardiothoracic surgery” AND “medical student” AND “career”. Inclusion and exclusion criteria were also developed to ensure only relevant studies were used for the paper. Information on the perspectives, knowledge, and beliefs on cardiothoracic surgery amongst medical students and trainee doctors worldwide was collected. Results: Most data was sourced from UK and US-based studies with only a minority of literature from other parts of the world. Uptake of cardiothoracic surgery amongst medical students, junior doctors and trainees is generally low, on a global level. Deterring factors identified from this review included work-life balance, professional satisfaction, lifestyle, and family planning, the latter being especially important for female medical students. Conclusion: Although job posts are still being filled, the increasing numbers of medical students losing interest in a career in cardiothoracic surgery needs to be addressed. Areas of future research into this area would be to re-assess medical school curricula and opportunities to engage more in the field whilst at medical school and beyond.

The chalcogen vacancy defects in various transition metal dichalcogenides (TMDCs) have been studied using density functional theory (DFT) calculation. Results reveal that (i) the dissociation energy value depends on both nature of chalcogen and transition metal, (ii) the work function depends marginally on the single or double vacancies, (iii) the defect transforms direct band gap to indirect band gap materials (i.e. the pristine materials show KVKC transition whereas defective materials show ΓVKC) and (iii) the d-orbital of the transition metal plays a vital role in the formation of impurity band.

Surgical treatment of type A dissections is based on best evidence practice for the lack of controlled randomized studies providing definitive scientific evidence. Despite its widespread use, axillary cannulation still remains a debated topic as the preferred method of cannulation and perfusion strategy in the treatment of this complex condition.

Amblypygids are an arachnid order possessing a unique pair of spined pedipalps: appendages that perform in prey capture, courtship and contest. Pedipalp length, hypothesised to be under sexual selection, varies markedly across amblypygid species, and pedipalp spination, thought to reflect selection for function in prey capture, also differs interspecifically. Differences in pedipalp shape between species may indicate that the relative strength of selection for prey capture and sexual selection vary across the group. However, interspecific differences in pedipalp shape have not been quantified, due to difficulties in identifying homologous features. For the first time, we quantify trends in amblypygid pedipalp shape complexity. We use elliptical Fourier analysis to quantify 2D complexity in pedipalp outlines across eleven species and six genera. We find that complexity significantly decreases as pedipalp length increases. This appears to be driven by relative spine length, suggesting that a trade-off exists between pedipalp length and spination. Furthermore, significant female-biased sexual dimorphism in shape complexity is present in the tibial segment of the amblypygid pedipalp. Our results provide novel insights into the drivers of amblypygid pedipalp evolution, and suggest that a functional trade-off between performance in prey capture and other functions under sexual selection exist in this enigmatic structure.

Brewers’ spent grain (BSG) is a low-value by-product of the brewing process, which is produced in large quantities every year. In this study, the lignocellulosic feedstock was used to run solid state fermentations with Cellulomonas uda. For aerobic processes, maximum cellulase activities of 0.98 nkat∙ml-1, maximum xylanase activities of 5.00 nkat∙ml-1 and cell yields of 0.22 gCells∙gBSG-1 were achieved. Under anaerobic conditions, enzyme activities and cell yields were lower, but valuable liquid products (organic acids, ethanol) were produced with a yield of 0.41 gProd∙gBSG-1. The growth phase of the organisms was monitored by measuring extracellular concentrations of two fluorophores pyridoxin (aerobic) and tryptophan (anaerobic) and by cell count. By applying reductive conditions to the anaerobic approach, the ratio of ethanol to acetate was increased from 1.08 to 1.59 molEtOH∙molAc-1. This ratio was further improved to 9.2 molEtOH∙molAc-1 by lowering the pH from 7.4 to 5.0 without decreasing the final ethanol concentration. A scale up fermentation with 15w% BSG instead of 5w% BSG quadrupled the acetate concentration, whilst ethanol was removed by gas stripping. This study provides various ideas for optimizing and monitoring solid state fermentations, which can support feasibility and incorporation into holistic biorefining approaches in the future.

Aim: To evaluate prevalence of heart failure (HF) medical treatment and its impact on ventricular arrhythmia (VA) and survival among patients implanted with primary prevention ICD/CRTD. Methods and results: The association of treatment and dose (% guideline recommended target) of beta-blockers (BB), Angiotensin-antagonists (AngA), Mineralocorticoid-antagonsits (MRA), and Anti-Arrhythmic Drugs (AAD) after ICD/CRTD implant with VA episodes and mortality was analyzed. We included 186 patients, meanSD age 66.412 years, 15.1% female, 79(42.5%) implanted with an ICD and 107(57.5%) with CRTD. During 3.8 [2.1;6.7] (median[IQR]) years; 52(28%) had VA and 77(41.4%) died. Treatment (medication, % of patients) included: BB (83%), AngA (87%), MRA (59%), and AAD (43.5%). Median doses were 25[12.5;50]% of target for BB or AngA and 25[0;50]% of target for MRA. Treatment with >25% target dose of BB was associated with reduced incident VA. In a multivariable model including age, gender, diabetes, heart rate, and medication doses, increased BB dose was significantly and independently associated with reduced VA (HR 0.443 95%CI 0.222-0.885; p=0.021). On multivariable model for overall mortality including age, gender, renal disease, VA, and medical treatment; VA was associated with increased mortality (HR 2.672; 95% CI 1.429-4.999; p=0.002) and AngA treatment was significantly and independently associated with reduced mortality (HR 0.515; 95% CI 0.285-0.929; p=0.028). Conclusions: In this cohort of real-life HF patients discharged after ICD/CRTD implant, most of the patients were prescribed with guideline-based HF medications albeit with low doses. Higher BB dose was associated with reduced VA, while treatment with AngA was associated with improved survival.

Introduction Iatrogenic facial nerve palsy is distressing to the patient and clinician. The deformity is aesthetically displeasing, and can be functionality problematic for oral competence, dental lip trauma and speech. Furthermore such injuries have litigation implications. Marginal mandibular nerve (MMN) palsy causes an obvious asymmetrical smile. MMN is at particular risk during procedures such as rhytidoplasties, mandibular fracture, tumour resection and neck dissections. Cited causes for the high incidence are large anatomical variations, unreliable landmarks, an exposed course and tumour grade or nodal involvement dictating requisite nerve sacrifice. An alternative cause for post-operative asymmetry is damage to the cervical branch of the facial nerve or platysmal dysfunction. This tends to have a transient course and recovers. Distinction between MMN palsy and palsy of the cervical branch of the facial nerve should therefore be made. In 1979 Ellenbogen differentiated between MMN palsy and “Pseudo-paralysis of the mandibular branch of the facial nerve”. Despite this, there is paucity in the literature & confusion amongst clinicians in distinguishing between these palsies, and there is little regarding these post-operative sequelae and neck dissections. Method This article reflects on the surgical anatomy of the MMN and cervical nerve in relation to danger zones during lymphadenectomy. The authors review the anatomy of the smile. Finally, we utilise case studies to evaluate the differences between MMN palsy and its pseudo-palsy to allow clinical differentiation. Conclusion Here we present a simple method for clinical differentiation between these two prognostically different injuries, allowing appropriate reassurance, therapy & management.

DNA-barcoding and DNA-based species delimitation are major tools in DNA taxonomy. Sampling has been a central debate in this context, because the geographical composition of samples affect the accuracy and performance of DNA-barcoding. Performance of complex DNA-based species delimitation is to be tested under simpler conditions in absence of geographic sampling bias. Here, we present an empirical data set sampled from a single locality in a Southeast-Asian biodiversity hotspot (Laos: Phou Pan mountain). We investigate the performance of various species delimitation approaches on a megadiverse assemblage of herbivore chafer beetles (Coleoptera: Scarabaeidae) to infer whether species delimitation suffers in the same way from exaggerate infraspecific variation despite the lack of geographic genetic variation that led to inconsistencies between entities from DNA-based and morphology-based species inference in previous studies. For this purpose, a 658 bp fragment of the mitochondrial cytochrome c oxidase subunit 1 (cox1) was analysed for a total of 186 individuals of 56 morphospecies. Tree based and distance based species delimitation methods were used. All approaches showed a rather limited match ratio (max. 77%) with morphospecies. PTP and TCS prevailingly over-splitted morphospecies, while 3% clustering and ABGD also lumped several species into one entity. ABGD revealed the highest congruence between molecular operational taxonomic units (MOTUs) and morphospecies. Disagreements between morphospecies and MOTUs were discussed in the context of historically acquired geographic genetic differentiation, incomplete lineage sorting, and hybridization. The study once again highlights how important morphology still is in order to correctly interpret the results of molecular species delimitation.

Introduction: Among the multiple complex pathophysiological mechanisms underlying COVID-19 pneumonia, immunothrombosis has been shown to play a key role. One of the most dangerous consequences of the prothrombotic imbalance is the increased incidence of micro- and macro-thrombotic phenomena, especially deep vein thrombosis (DVT) and pulmonary embolism (PE). Methods: We investigated the correlation between radiological and clinical-biochemical characteristics of a cohort of hospitalized COVID-19 patients. Results: PE was confirmed in 14/61 (23%) patients, five (35.7%) had DVT. The radiographic findings, quantified by Qanadli score, correlated with the clinical score and biochemical markers. The ratio between the right and left ventricle diameter measured at CT scan correlated with the length of hospital stay. Conclusion: In our cohort radiological parameters showed a significant correlation with clinical prognostic indices and scores, thus suggesting that a multidisciplinary approach is advisable in the evaluation of PE in COVID-19 patients.

Purpose: Considering the anti-inflammatory effect of atorvastatin and the role of medical comorbidities such as hypertension and coronary artery disease on prognosis of the COVID-19 patients, we aimed to assess the effect of atorvastatin add-on therapy on mortality due to COVID-19. Methods: We conducted a retrospective cohort study, including patients who were hospitalized with confirmed diagnosis of severe COVID-19. Baseline characteristics and related clinical data of patients were recorded. Clinical outcomes consist of in hospital mortality, need for invasive mechanical ventilation and hospital length of stay. COX regression analysis models were used to assess the association of independent factors to outcomes. Results: Atorvastatin was administered for 421 out of 991 patients. The mean age was 61.640±17.003 years. Older age, higher prevalence of hypertension and coronary artery disease reported in patients who received atorvastatin. These patients had shorter hospital length of stay (P=0.001). Based on COX proportional hazard model, in hospital use of atorvastatin was associated to decrease in mortality (HR=0.679, P=0.005) and lower need for invasive mechanical ventilation (HR=0.602, P=0.014). Conclusions: Atorvastatin add-on therapy in patient with severe COVID-19 was associated with lower in hospital mortality and reduced the risk of need for invasive mechanical ventilation which support to continue the prescription of the medication.

In this work, the enumeration algorithms presented in parts I and II for the globally optimal synthesis of heat exchanger networks are extended to consider non-isothermal mixing. The previous models are modified by adding non-isothermal mixing constraints and new models are constructed to target the bounds of the energy consumption and the binding exchanger minimum approximation temperature. These new models are solved using algorithms that involve solving the solution of systems of equations instead of mathematical programming. We also present two alternatives for optimizing each enumerated structure, namely, the use of a global solver, or the use of a golden search with simple resolution of non-isothermal mixing model for fixed energy consumption. The non-isothermal mixing model is reformulated as a convex model, either solved using nonlinear programming or a programming-free methodology, i.e. solving Karush-Kuhn-Tucker equations. A global optimum search algorithm is developed and examples are tested comparing the proposed strategies.

A gas-liquid stirred tank reactor (STR) has some problems, such as low mass transfer efficiency, high exhaust gas oxygen concentration, and low product conversion rate, due to limitations of stirring speed and input power. This article proposes a method to enhance the gas-liquid mass transfer in a STR using circulating jet internals. When a circulating jet is added, the average bubble size in the reactor is reduced to 1.26 mm, and the overall gas holdup is increased to 8.23%, which is an increase of 3.62 times of the original STR. The gas-liquid volumetric mass transfer coefficient is increased to 0.05556 s-1, which is 4.84 times of the original STR. The unit volume power is increased by only 1.4 times. These data provide references for the design and scale-up of new jet STRs.

Objectives: The aim of our study is to examine the efficacy and safety of intravenous magnesium sulfate in moderate-severe acute bronchiolitis. Working hypothesis: Intravenous magnesium sulfate treatment may be effective in the treatment of patients with bronchiolitis . Study design: Retrospective, single-center cohort study Methodology: We conducted a study in 150 infants presenting with moderate to severe acute bronchiolitis. A total of 150 infants aged 1 month to 2 years who presented with acute bronchiolitis to our pediatric emergency department between January 2018 and March 2019 were admitted into the study. The demographic characteristics, clinical score, and management of the patients were examined. Results: A total of 150 infants were analyzed: 62 in the magnesium sulfate group (Group I) and 88 in the supportive care group (Group II). Baseline clinical characteristics were similar in both groups. Length of hospitalization was significantly shorter in Group II. Clinical severity scores were also lower significantly earlier in Group I (p=0.031, p=0.008, respectively at first and fourth hour). Conclusions: Intravenous magnesium treatment in moderateto severe acute bronchiolitis does not appear to conferany significant decrease in clinical severity scores when compared to only supportive care

As part of the European Union-funded project designated PARTN-ER, the European Cooperative Study Group for Pediatric Rare Tumors (EXPeRT) is continuously developing consensus recommendations in order to harmonize standard care for very rare solid tumors of children and adolescents. This paper presents the internationally recognized recommendations for the diagnosis and treatment of sex cord stromal tumors (SCST). The clinical approach to sex cord stromal tumors of the testis (TSCST) and ovary (OSCST) depends on histological differentiation and tumor stage. Virtually all TSCSTs present as localized non-metastatic tumors, with excellent prognosis after complete resection. In contrast, the prognosis of OSCSTs may be adversely affected by tumor spillage during surgery or presence of metastases. In these cases, cisplatin-based chemotherapy is recommended. Of note, some SCSTs may develop in the context of tumor predisposition syndromes e.g. DICER-1, so that specific follow-up is indicated. SCSTs should be diagnosed and treated according to standardized recommendations that include reference pathology, genetic testing for tumor predisposition syndromes in selected cases, and stratified adjuvant chemotherapy in patients with unfavorable risk profile. To ensure high quality of diagnosis and therapy, patients should be enrolled into prospective registries.

Numerous studies in the past 10 years have reported on the neurocognitive sequalae of pediatric Sleep Disordered Breathing (SDB). Variations in criteria used to define SDB in conjunction with the wide variety of neuropsychological measures selected to evaluate cognitive consequences of SDB have resulted in discrepancies within the literature. This review summarizes the extant literature regarding cognitive effects of pediatric SDB across domains of global intelligence, attention, executive function, memory, language, and visuospatial ability. This review also addresses the proposed etiology underlying neurocognitive consequences of pediatric SDB. The differences in findings across the literature are highlighted and discussed throughout.

Phragmites australis is the dominant species in the Yellow River Delta and plays an important role in wetland ecosystems. Ecological responses of the P. australis community to soil properties were investigated in 96 areas along the coastal-inland regions in the Yellow River Delta of China. The aim was to evaluate the relationship between phenotypic variation and environmental factors, reveal which functional traits could well respond to changes in electrical conductivity and soil water content, and the ecological strategies of P. australis. Within the range of soil water content (9.39–36.92%) and electrical conductivity (0.14–13.29 ms/cm), the results showed that the effects of soil water content and salinity were not equally important for the characterization of the morphological and physiological variability, and that plant functional traits including leaf traits and stem traits responded more strongly to soil salinity than soil water content. Our results suggested that salinity leads to reduced average height, specific leaf area, leaf area, and base stem diameter, but increased leaf water content and leaf thickness. The relationships between functional traits and electrical conductivity were generally linear and logarithmic. The coefficients of variation of morphological traits showed more phenotypic plasticity than the physiological traits. Salinity also led to the stress tolerator/competitor-stress tolerator (S/CS) strategies of P. australis; with the decrease of environmental stress, the main strategy gradually moved to the competitor (C) strategy, making P. australis the dominant species in the Yellow River Delta. KEYWORDS: Soil water content, Electrical conductivity, Functional traits, Plasticity, Life strategies.

1. Metadata plays an essential role in the long term preservation, reuse, and interoperability of data. Nevertheless, creating useful metadata can be sufficiently difficult and weakly-enough incentivised that many datasets may be accompanied by little or no metadata. One key challenge is, therefore, how to make metadata creation easier and more valuable. We present a solution that involves creating domain specific metadata schemes that are as complex as necessary and as simple as possible. These goals are achieved by co-development between a metadata expert and the researchers (i.e. the data creators). The final product is a bespoke metadata scheme into which researchers can enter information (and validate it) via the simplest of interfaces: a web browser application and a spreadsheet. 2.We provide the R package [‘dmdScheme‘](https://CRAN.R-project.org/package=dmdScheme) [@Krug2019] for creating a template domain specific scheme. We describe how to create a domain specific scheme from this template, including the iterative co-development process, and the simple methods for using the scheme, and simple methods for quality assessment, improvement, and validation. 3.The process of developing a metadata scheme following the outlined approach was successful, resulting in a metadata scheme which is used for the data generated in our research group. The validation quickly identifies forgotten metadata, as well as inconsistent metadata, therefore improving the quality of the metadata. Multiple output formats are available, including XML. 4. Making the provision of metadata easier while also ensuring high quality must be a priority for data curation initiatives. We show how both objectives are achieved by very close collaboration between metadata experts and researchers to create domain specific schemes. A near-future priority is to provide methods to interface domain specific schemes with general metadata schemes, such as the Ecological Metadata Language, to increase interoperability.

Background: The provision of Section 2302 of the 2010 Patient Protection and Affordable Care Act (ACA) allowed pediatric patients who are enrolled in Medicaid to receive hospice care concurrently with curative treatment (i.e., concurrent hospice care). Because it is a relatively new model of care and very little is known about the characteristics of children with cancer who receive it, the purpose of the current study was to compare demographic, health, and community characteristics of children who received standard hospice care versus concurrent hospice care. Procedure: This study was a retrospective, comparison study with national Medicaid files provided by the Center for Medicare and Medicaid Services (CMS). The sample included 1,685 pediatric patients under the age of 20 who were diagnosed with cancer, were enrolled in hospice between 2011 and 2013, and received standard hospice care (n= 1,008) or concurrent hospice care (n = 655). Results: Children of non-Caucasian race with multiple complex chronic conditions, mental/behavioral health problems technology dependence, and brain and orbital tumors, were more likely to be enrolled in concurrent care than in standard hospice care. The proportion of children enrolled in concurrent care versus standard hospice care was larger in rural areas, low-income communities, and in the Southern states. Conclusions: The enhanced uptake of concurrent care by traditionally underserved populations is promising. Concurrent hospice care, which allows for continued medical treatment and hospice care, could enhance access to hospice within these populations by offering a more blended model of care.

Background Outcomes of Ewing sarcoma (ES) in low and middle income countries lags behind the rest of the world owing to multiple tumoral, logistical and socio-economic factors. The data of outcomes and toxicity in these countries is sparse, especially in the adolescent and adult (AA) population and merits exploration Procedure This was a retrospective analysis of prospectively collected data of non-metastatic AA-ES patients, who received standard institutional combination chemotherapy regimen (EFT-2001) along with surgery or definitive radiotherapy. Various cohorts were analyzed for treatment-related toxicities, event- free survival (EFS) and overall survival (OS). Results There were 235 patients (primary safety cohort, PSC) with median age of 23 years. One hundred and ninety six were treatment naïve (primary efficacy cohort, PEC) and of these 119 had surgery. In PEC, at a median follow up of 36.4 months, estimated 5 year EFS and OS were 60.9% (95% CI 53.1% - 69.9%) and 84.5% (95% CI 77.7% - 91.9%), respectively. Of these, 158 complying with intended treatment, had an estimated 5 year EFS of 63.1% (95% CI 54.8%-72.6%). In multivariate analysis, good prognostic factors included longer symptom duration, ≥ 99% necrosis and treatment completion. Among PSC, grade 3-4 toxicities were febrile-neutropenia (50.6%), anemia (55.3%), peripheral neuropathy (15.7%), with 3 (1.3%) chemo-toxic deaths. Conclusions The outcomes of AA non-metastatic ES patients treated with EFT-2001 regimen were comparable to those reported by others, with acceptable toxicity and can be considered as standard-of-care, especially in LMICs.

The aim of the study was to determine the effect of stand species composition on PAHs accumulation. The study covered the soils of the stands of the Rybnik Forest District, which are under the influence of one of the highest deposition of industrial emissions in Europe. Pine, pine-oak and oak stands growing in the same soil conditions were selected for the study. Samples for further analyses were collected from the organic horizon, from the humus mineral horizon and from the mineral horizon. Organic C content, N content, pH, alkaline cation content, as well as microbiological biomass of C, N, extracellular and intracellular enzyme activity were determined in the soil samples. PAH content was determined in the soil samples. Additionally, the soil organic matter fractions were determined: free light fraction (fLF), occluded light fraction (oLF) and mineral associated fraction (MAF). Pine stand soils were characterized by the highest average PAHs content. The oak stand soils were characterized by the lowest PAHs accumulation and high enzymatic activity. The study confirms the important role of the stand species composition in shaping the quality and quantity of SOM and soil acidification, which in turn is reflected in microbial activity and PAHs accumulation in forest soils. PAHs accumulation in forest soils is related to the fractional composition of SOM, which is the effect of the influence of species composition through the supplied aboveground and belowground biomass. A strong correlation between the PAH content and C content of the light soil fraction of OM was noted.

Background and aim of the study This study aims to provide an overview of clinical outcome after bioprosthetic aortic root replacement and lifetime event-risk estimates of mortality and valve-related events, and the potential effect of type of prosthesis used. Methods A systematic literature search was conducted between January 2000 and August 2019. Inclusion criteria: aortic root replacement in adults. Data were pooled by inverse-variance weighting and entered a microsimulation model to calculate lifetime event-risk and (event-free) life expectancy. Results Of 2,106 publications, 31 were included (N = 5,227 patients, 74% stentless valves). Mean age was 65.4 years (74% male). Pooled early mortality was 5.5% (95% CI: 4.3-7.2%). During follow-up (mean 4.1 years, total 22.706 patient-years), late mortality was 4.8%/patient-year and reoperation 0.9%/patient-year. Linearized-occurrence-rates for thromboembolism, endocarditis, and hemorrhagic events:1.2; 0.9 and 0.5 %/patient-year; no significant difference between stented and stentless prosthesis. Translating into a 60-year-old patient, an estimated life expectancy of 14 years (general population: 22 years) and lifetime risks of thromboembolism, endocarditis and reintervention of 21%, 13%, and 8%, respectively is expected. Conclusions The study shows impaired survival and a notable lifetime risk of valve-related events after bioprosthetic aortic root replacement. The risk of thromboembolism is prominent, especially during earlier follow-up, suggesting higher risk of thromboembolism early after operation. Type of prosthesis, stented or stentless, is not associated with higher valve-related events. Moreover, this study could be used as a benchmark to compare outcome with other aortic root replacement procedures.

A document by Meghan Duffy. Click on the document to view its contents.