2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Developed with the special contribution of the Heart Failure Association (HFA) of the ESC.

ACC/AHA
: American College of Cardiology/American Heart Association
ACCF/AHA
: American College of Cardiology Foundation/American Heart Association
ACE
: angiotensin-converting enzyme
ACEI
: angiotensin-converting enzyme inhibitor
ACS
: acute coronary syndrome
AF
: atrial fibrillation

/pdf/2016-esc-guidelines-for-the-diagnosis-and-treatment-of-acute-z18hg30pp1.pdf

2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure

/pdf/2016-esc-guidelines-for-the-diagnosis-and-treatment-of-acute-53v7yllhiz.pdf

ESC guidelines for the diagnosis and treatment of acute and chronic heart failure 2012 : The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association (HFA) of the ESC

https://anmco.it/uploads/u_cms/media/2014/12/798e9298d77b7b8c9aa0514e43fe95a2.pdf

ESC guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association (HFA) of the ESC.

2018 ESC/ESH Guidelines for the management of arterial hypertension.

/pdf/biological-versus-mechanical-heart-valve-prostheses-has-the-xp755j1q2i.pdf

Biological versus Mechanical Heart Valve Prostheses. Has the Paradigm Shifted Definitively

Introduction The management of induction and maintenance immunosuppression therapy after heart transplantation (HT) remains a controversial issue. The dosage and the timing has been a changing target. We aimed at evaluate the incidence of acute cellular rejection (ACR) [≥1R grade], major infection and survival in first year after HT in patients receiving two different induction immunosuppression regimes and with a reduction in intensity of triple maintenance immunosuppression dose. Methods From November-2003 to June-2016, 317 patients were submitted to HT. After excluding those with pediatric age (n=8), those with previous renal or hepatic transplantation (n=2), those submitted to retransplantation (n=2), patients with early death without endomiocardial biopsy (n=10) and those in a transition maintenance regime (n=26), the study population resulted in 269 patients. These patients were divided in two groups: patients receiving the previous regime of two doses of basiliximab (group A, n=211) and those receiving a single dose of basiliximab (group B, n=58). All the patients were treated with a maintenance standard triple immunosuppressive regimen of corticosteroids, an inhibitor of calcineurin and mycophenolate mofetil but more immunosuppressive load in group A. Results Mean age of the recipients (group A vs. group B) was 54.6±10.6vs.55.0±9.8 years (p=0.808); 77.3%vs.75.9% were male (p=0.861); 28.4%vs.28.1% were diabetic (p=0.957); and ischemic etiology was present in 39.8%vs 41.0% of the patients (p=0.798), respectively. No differences were found, at first year, between the two groups concerning global ACR incidence (55.0%vs.56.9%, p=0.882, respectively) but major ACR (≥2R grade) was slightly superior in group B (16.6%vs.27.6%, p=0.080, respectively). Time-free from major ACR at 3rd, 6th and 12th months was, respectively 91.0±2.0%vs.84.5%±4.8%; 86.7±2.3%vs.74.1±5.7%; and 83.4±2.6%vs.72.4±5.9% (p=0.048). Time-free from major infection at 3rd, 6th and 12th months was, respectively 89.6±2.1%vs.82.8±5.0%; 87.7±2.3%vs.79.3±5.3%; and 84.4±2.5%vs.79.3±5.3% (p=0.253). No differences were found concerning survival at 3rd, 6th and 12th months (94.3±1.6%vs.94.8±2.9%; 92.4±1.8%vs.93.1±3.3%; and 90.0±2.1%vs.91.4±3.7%, (p=0.771) respectively). Conclusion With this study, we verified that lowering doses of induction and maintenance therapy was responsible for increase cases of major ACR at first year of heart transplant. However, no differences were found concerning the incidence of major infection and early survival. Hence, effective immunosuppression induction regimen can apparently be done safely with a single dose regime without compromising survival at first year after HT.

Heart transplantation: Early Results of Two Different Regimes of Immnunosuppression.

Commentary: Long-term outcomes of surgical aortic valve replacement: Difficult to match!

Mitral valve repair, especially for degenerative disease, is increasingly gaining the preference of the surgical community and is now given a Class I indication in the guidelines. Results are progressively better and the procedure more reproducible. After the original works by Carpentier and colleagues Duran and Ubago and others who, in the 70s and 80s, defined the basic concepts and designed the techniques still in use today, in what became known as the French Correction, only relatively minor modifications were introduced, all based on the same principles defined initially. Exceptions to this are, conceivably, the Alfieri procedure, used by some surgeons in some cases, and the artificial chordae (polytetrafluoroethylene), pioneered by Frater and now accepted by the majority. Countless numbers of minor modifications have been described that may either be technical improvements or adjuncts to help in assuring the surgeon that the immediate end result is going to be adequate before the valve can reinitiate function, that is, after discontinuation of cardiopulmonary bypass. The latter better defines the method described by Morisaki and colleagues, from Osaka, Japan, in this issue of the Journal. In their work, the authors made a retrospective review of 350 patients who underwent mitral valve repair with the loop technique via median sternotomy or right mini-thoracotomy, over a 10-year period. They used gentian violet “ink-dotted” lines between the rough and clear zones

Manuel J. Antunes

Papers

Biological versus Mechanical Heart Valve Prostheses. Has the Paradigm Shifted Definitively

Heart transplantation: Early Results of Two Different Regimes of Immnunosuppression.

Commentary: Long-term outcomes of surgical aortic valve replacement: Difficult to match!

Commentary: Techniques of mitral valve repair: Is there still "gunpowder" to be invented?

the incidence of cerebrovascular accidents: letter 2 Coronary surgery with intermittent aortic cross-clamping: a word of caution on