Percutaneous closure of the patent foramen ovale (PFO) is generally regarded as a safe and effective procedure, indicated in patients with a prior PFO-associated stroke. While it is highly safe, rarely, it could be accompanied by a migration of the device, mainly caused by the interplay of a specific PFO morphology and inappropriate device sizing. Herein, we outline a seldom-observed complication of an unintentional detachment of the PFO closure device during implantation, leading to its migration into the abdominal aorta, and a unique management approach. Due to the inability to recapture the occluder with a snare, which is considered to be a mainstay of endovascular retrieval methods, two coronary guidewires were maneuvered through the mesh of the occluder and then captured with a snare proximally to the occluder. This innovative dual-wire–snare system was carefully pulled to the common femoral artery, a position deemed suitable for surgical extraction via arteriotomy, which was achieved successfully.

Background: Post-operative atrial fibrillation (POAF) is a frequent complication after cardiac surgery. It is associated with prolonged hospital stay, increased morbidity, mortality rate and economic costs. The aim of the study was to determine the association between the values of Galectin3 and N-terminal pro-B-type natriuretic peptide (NTproBNP) with POAF after cardiac surgery. Methods: A prospective study enrolled patients aged 18-85 years old admitted due to elective coronary artery bypass graft surgery (CABG) or CABG + aortic valve replacement. The plasma Galectin-3 and NT-proBNP levels were measured one day before surgery postoperative days 1 and 7. Results: The study included a total of 103 patients. POAF was registered in 45 patients. The mean age of patients in whom POAF occurred was 68.8 years, while other patients' mean age was 65.5 years (p=0.028). Patients with POAF did not differ from the group without POAF in the values of Galectin-3 and NT-proBNP preoperatively as well as on the first and seventh postoperative days. Changes in Galectin-3 levels on the first postoperative day had statistically significant value for predicting POAF (AUC=0.627 0.509-0.745 , p<0.05). Decrease in Galectin-3 level con centration on the first postoperative day over 17% increases the risk of developing AF. Conclusions: Preoperative values of Galectin-3 and NTproBNP are not associated with POAF development after cardiac surgery.

Objective: This study aimed to evaluate the long‐term efficacy of a standardized triple procedure—coronary artery bypass grafting (CABG), chordal‐sparing mitral valve replacement, and tricuspid annuloplasty—in high‐risk patients with end‐stage ischemic dilated cardiomyopathy (IsDCM) for whom heart transplantation was not an option. Primary endpoints were survival, reverse ventricular remodeling, and functional recovery. Methods: We prospectively analyzed 42 consecutive patients (mean age 64.7 ± 9.1 years; 85.7% male) with end‐stage IsDCM. All presented with severe secondary mitral and tricuspid regurgitation, left ventricular ejection fraction (LVEF) < 30% (mean 26.4% ± 3.1%), left ventricular end‐diastolic diameter > 7.0 cm (mean 7.3 ± 0.3 cm), and coaptation depth > 1.0 cm. Mean STS‐predicted mortality risk was 22.0% ± 1.5%, and mean EuroSCORE II was 7.0% ± 1.0%. Results: Thirty‐day operative mortality was 2.4% ( n = 1). Significant reverse remodeling occurred: LVEF improved from 26.4% ± 3.1% to 34.6% ± 4.2% ( p < 0.001), and end‐systolic sphericity index decreased from 86.1% to 66.3%. NYHA class improved from 3.5 ± 0.5 to 1.8 ± 0.6 among survivors at 1 year ( p < 0.001). Long‐term survival was 78.5% ± 4.0% at 5 years and 54.8% ± 5.2% at 10 years. Conclusions: In high‐risk end‐stage IsDCM patients, CABG with chordal‐sparing mitral valve replacement and tricuspid annuloplasty facilitates substantial reverse remodeling, durable functional improvement, and excellent long‐term survival. This anatomy‐preserving strategy offers a viable alternative to transplantation or destination therapy for selected patients with advanced heart failure.

Background and Objectives: The optimal management of dilated ascending aorta during aortic valve replacement (AVR) in older or high-risk patients remains debated. While graft replacement is the standard procedure, reductive ascending aortoplasty (RAA) may offer a less invasive, tissue-preserving alternative. This study evaluated long-term RAA outcomes and identified the optimal patient profile. Materials and Methods: In a single-center cohort, 64 patients underwent AVR with unwrapped RAA (2005–2025). Patients were stratified by valve phenotype (tricuspid [TAV], n = 45; bicuspid [BAV], n = 19) and age (<70 years, n = 52; ≥70 years, n = 12). Endpoints were early safety, long-term survival, and aortic redilatation (≥50 mm). Results: Outcomes diverged markedly by subgroup. Patients aged ≥70 years demonstrated excellent 10-year freedom from redilatation (83.3%) with no reinterventions. In contrast, BAV patients had higher redilatation rates (31.6% vs. 8.9%; p = 0.053) and a trend toward more reexploration for bleeding (15.8% vs. 6.7%; p = 0.109). Redilatation and reintervention were concentrated in patients <70 years. Conclusions: RAA with AVR offers favorable long-term durability, but success is highly age-dependent. The procedure is a safe, effective tissue-preserving strategy for selected older patients (≥70 years), particularly those with TAV. However, high redilatation rates in BAV patients suggest that RAA should be avoided in this population, reinforcing graft replacement as preferred for younger patients.

Prosthesis-Free Repair of Partial Atrioventricular Septal Defect in Down Syndrome: A Valve-Sparing Technique - Article abstract #951886

Introduction. The causes of dilated cardiomyopathy can be divided into ischemic and nonischemic. Although the importance of thyroid hormones for proper functioning of the cardiovascular system is well known, dilated cardiomyopathy is a rare presentation of hypothyroidism. Case Report. This is a case report of a 38-year-old man admitted to the Intensive Cardiac Care Unit with signs and symptoms of advanced heart failure. Dilated cardiomyopathy was established by echocardiography, while blood test showed highly elevated levels of thyroid stimulating hormone and decreased levels of free triiodothyronine and free thyroxine. The ejection fraction was significantly improved with levothyroxine replacement therapy. Conclusion. Hypothyroidism should always be considered as the cause of dilated cardiomyopathy. Thyroid hormone tests should be performed in all patients with dilated cardiomyopathy.