The antibiofilm activity of a hypochlorous acid (HOCl)-producing electrochemical bandage (e-bandage) was assessed against 14 yeast isolates in vitro . The evaluated e-bandage was polarized at +1.5 V _Ag/AgCl to allow continuous production of HOCl.

(1) Background: Currently, echocardiography is the primary non-invasive diagnostic method used to screen patients with severe aortic valve stenosis (AS) for pulmonary hypertension (PH) by estimating systolic pulmonary artery pressure (sPAP). Other radiological methods have been a focus of research in the past couple of years, as it was shown that by determining the pulmonary artery (PA) diameter, prognostic statements concerning overall mortality could be made in these patients. This study compared established and novel cardiovascular biomarkers with the PA/BSA value to detect PH in patients with severe AS. (2) Methods: The study cohort comprised 188 patients with severe AS undergoing transcatheter aortic valve replacement (TAVR), who were then divided into two groups based on PA/BSA values obtained through CT-angiography. The presence of PH was defined as a PA/BSA ≥ 16.6 mm/m² (n = 81), and absence as a PA/BSA < 16.6 mm/m² (n = 107). Blood samples were taken before TAVR to assess cardiovascular biomarkers used in this study, namely brain natriuretic peptide (BNP), cardiac troponin I (cTnI), high-sensitive troponin (hsTN), soluble suppression of tumorigenesis-2 (sST2), growth/differentiation factor 15 (GDF-15), heart-type fatty acid-binding protein (H-FABP), insulin-like growth factor binding protein 2 (IGF-BP2), and soluble urokinase-type plasminogen activator receptor (suPAR). (3) Results: Patients with a PA/BSA ≥ 16.6 mm/m² showed significantly higher levels of BNP (p = <0.001), GDF-15 (p = 0.040), and H-FABP (p = 0.007). The other investigated cardiovascular biomarkers did not significantly differ between the two groups. To predict a PA/BSA ≥ 16.6 mm/m², cut-off values for the biomarkers were calculated. Here, GDF-15 (p = 0.029; cut-off 1172.0 pg/mL) and BNP (p < 0.001; cut-off 2194.0 pg/mL) showed significant results. Consequently, analyses of combined biomarkers were performed, which yielded IGF-BP2 + BNP (AUC = 0.721; 95%CI = 0.585–0.857; p = 0.004) as the best result of the two-way analyses and GDF-15 + IGF-BP2 + BNP (AUC = 0.727; 95%CI = 0.590–0.864; p = 0.004) as the best result of the three-way analyses. No significant difference regarding the 1-year survival between patients with PA/BSA < 16.6 mm/m² and patients with PA/BSA ≥ 16.6 mm/m² was found (log-rank test: p = 0.452). (4) Conclusions: Although PA/BSA aims to reduce the bias of the PA value caused by different body compositions and sizes, it is still a controversial parameter for diagnosing PH. Combining the parameter with different cardiovascular biomarkers did not lead to a significant increase in the diagnostic precision for detecting PH in patients with severe AS.

OBJECTIVES: The aim of this study was to assess safety and efficiency of multiarterial coronary bypass grafting using bilateral internal thoracic arteries in T-graft technique performed by trainees. METHODS: Patients from January 2005 to February 2023 who had undergone multiarterial coronary bypass grafting using bilateral internal thoracic arteries in T-graft technique were analysed. Patients were divided into 2 groups based on the primary surgeon: consultant and trainees. The primary composite outcome measure was all-cause mortality and coronary reintervention after 5 years. Safety and efficiency were assessed using cumulative sum analysis. RESULTS: A total of 1764 patients were identified, 1114 patients (63.2%) were operated on by consultants, 650 patients (37.8%) by trainees. Mortality rates did not differ (0.8% vs 1.0%, P = 0.4). Consultants performed more distal anastomoses [3.38 (0.96) vs 3.06 (0.76); P < 0.001] and achieved more complete revascularization [n = 895 (92%)] than trainees [n = 460 (80%); P < 0.001]. In the cumulative sum analysis, safety of teaching procedures remains within the acceptable range. There was no increase in the expectation/frequency of the composite outcome measure; instead, the expected frequency decreases up to 150 operations. Duration of the operation averages decrease until the 125th operation. Performed distal anastomoses increased with the rising number of operations. CONCLUSIONS: Our study demonstrates that training operations multiarterial coronary bypass grafting using bilateral internal thoracic arteries in T-graft technique are equally safe regardless of whether they are performed by consultants or trainees. Each trainee experiences an individual learning curve that falls within acceptable error rates and, therefore, the procedure can be safely learned directly

Objectives: This review evaluates procedural and technical advancements in branched and fenestrated thoracic endovascular aortic repair (B-/F-TEVAR) for aortic arch pathologies, with the main focus on the clinical outcomes, including stroke and mortality. Methods: A narrative review of the literature was conducted to assess the evolution of B-/F-TEVAR devices, including branched and fenestrated designs. Key factors such as technical success, perioperative outcomes, and long-term performance were examined across various patient cohorts, with the focus on mortality and stroke. Results: B-/F-TEVAR achieves high technical success rates (84%-100%), with 30-day mortality and stroke rates typically ranging from 0% to 25% and 3% to 36%, respectively. Fenestrated repairs are particularly suited for pathologies involving the lesser aortic curvature, offering reduced mortality (as low as 2% in some studies), while branched repairs provide greater adaptability for complex anatomies, albeit with higher stroke rates in certain cohorts. Conclusions: B-/F-TEVAR has emerged as a feasible treatment option for selected high-risk patients with aortic arch pathology, achieving high technical success. Although outcomes may improve with growing experience, stroke remains a significant complication, and reintervention rates highlight the need for long-term durability.

To correlate intraoperative near-infrared spectroscopy (NIRS) values with neurologic outcomes in patients undergoing total aortic arch replacement using the frozen elephant trunk (FET) technique. Retrospective, single-center registry study using a two-way repeated-measures analysis of variance. Between November 2013 and December 2023, 427 patients were treated for acute and chronic aortic pathologies using the FET procedure. A total of 166 patients with complete NIRS data at all predefined time points were included and retrospectively divided into two groups: patients diagnosed by experienced radiologists and clinicians with stroke and without stroke after FET. Bilateral NIRS values were recorded continuously and at seven critical time points in each patient, and correlations were made between left- and right-sided NIRS values and stroke. A total of 23 patients (13.9%) were diagnosed with stroke. There was a significantly higher in-hospital mortality in patients with stroke (21.7%) compared with patients without stroke (7.7%, p = 0.037). Left-sided regional cerebral oxygenation did not show significant difference in patients with versus without stroke (p = 0.550). Differences were detected in right-sided regional cerebral oxygenation trends (p < 0.001) and interhemisphere NIRS at specified time points (p = 0.009). The interaction, time × stroke, however, did not show significant results in any analysis (p > 0.05). NIRS is a reliable tool to monitor intraoperative frontal lobe cerebral oxygen saturation. However, its use to predict postoperative stroke remains limited. Further refinements are needed to develop the technique into a prediction tool.

OBJECTIVE: The aim of this study was to determine the indication and optimal timing for performing a hemiarch procedure in patients undergoing valve-sparing root replacement (VSRR). METHODS: We conducted a retrospective study on 986 patients undergoing VSRR at three tertiary care centres. Inclusion criteria were all patients undergoing elective VSRR. Exclusion criteria were age 0.999). Similarly, no difference was found for aortic reinterventions (P = 0.13) or survival (P = 0.5). This was also true for patients with heritable thoracic aortic disease. However, in patients with a bicuspid aortic valve, the intervention rate was significantly higher in the hemiarch group (10.8% vs 0%, P = 0.016). There was no significant difference in the 30-day incidence of cerebrovascular accidents between the groups (5% vs 2.7% in the hemiarch group, P = 0.117). Only the distal ascending diameter showed a tendency with better outcome over 45 mm for the hemiarch procedure; otherwise, we found no reliable cut-off values based on ascending length, diameter-to-height index or ascending length-to-height index. CONCLUSIONS: Our findings conclusively demonstrate that concomitant hemiarch replacement does not increase the perioperative risk in young patients undergoing VSRR. However, concomitant replacement does not seem to protect from aortic reinterventions during medium-term follow-up.