Commentary to JOCS-2021-OA-0579

Surgical implantation of a complete or incomplete ring to reduce the valve annulus and improve leaflet coaptation is the mainstay of mitral valve surgery. The Cardioband® system (Edwards Lifesciences, Irvine, CA, USA) was designed to address the pathophysiological mechanism of annular dilatation through a catheter-based approach. We present the histopathological workup of a Cardioband® device, which had been implanted 21 months earlier in a 34-year-old male with ischemic cardiomyopathy. Device examination demonstrate a well-positioned and securely anchored device. The described tissue reactions may have an impact on choice of device and timing in case of re-do surgery.

Commentary to JOCS-2020-OA-1345

The current COVID-19 pandemic has a huge impact on society and economy and represents one of the biggest challenges for healthcare systems all over the world. Reports from health-care-institutions in different countries show a variety of crisis exit strategies. Although experiences in handling of the pandemic have accumulated over the last 7 months, it is clear that measures to prevent a collapse of the health-care-systems have to be adapted to local political and socioeconomic structures. The aim of this review is to give insight in crisis exit strategies in Switzerland, highlighting the role and impact of COVID-19 in the field of cardiac surgery.

Fungal osteomyelitis is uncommon after cardiac surgery. A case of Candida albicans and S. epidermidis osteomyelitis with device infection after implantation of a left ventricular assist device in a male patient is presented. After confirmation with microbiological and radiological examinations, debridement was performed. Surgical specimens grew C. albicans and S. epidermidis. Fluconazole, daptomycin and negative pressure wound therapy failed to achieve healing. Total sternectomy and pectoralis muscle flap reconstruction were performed. There was no recurrent infection for C. albicans on a prolonged antifungal regime. The combination of antifungal therapy and aggressive surgical debridement may be useful to control fungal osteomyelitis.