TMVR with the valve was feasible in a study group at high or extreme risk for conventional mitral valve replacement. These results inform trial design of TMVR in lower-risk patients with severe mitral valve regurgitation (Evaluation of the Safety and Performance of the Twelve Intrepid Transcatheter Mitral Valve Replacement System in High Risk Patients with Severe, Symptomatic Mitral Regurgitation - The Twelve Intrepid TMVR Pilot Study; NCT02322840).

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Introduction Coronavirus disease 2019 ( COVID ‐19) is a contagious disease that is caused by the severe acute respiratory syndrome coronavirus 2 ( SARS ‐CoV‐2). Health care workers are at risk of infection from aerosolisation of respiratory secretions, droplet and contact spread. There are a number of procedures that represent a high risk of aerosol generation during cardiothoracic surgery. It is important that adequate training, equipment and procedures are in place to reduce that risk. Recommendations We provide a number of key recommendations, which reduce the risk of aerosol generation during cardiothoracic surgery and help protect patients and staff. These include general measures such as patient risk stratification, appropriate use of personal protective equipment, consideration to delay surgery in positive patients, and careful attention to theatre planning and preparation. There are also recommended procedural interventions during airway management, transoesophageal echocardiography, cardiopulmonary bypass, chest drain management and specific cardiothoracic surgical procedures. Controversies exist regarding the management of low risk patients undergoing procedures at high risk of aerosol generation, and recommendations for these patients will change depending on the regional prevalence, risk of community transmission and the potential for asymptomatic patients attending for these procedures. Changes in management as a result of this statement This statement reflects changes in management based on expert opinion, national guidelines and available evidence. Our knowledge with regard to COVID ‐19 continues to evolve and with this, guidance may change and develop. Our colleagues are urged to follow national guidelines and institutional recommendations regarding best practices to protect their patients and themselves. Endorsed by Australian and New Zealand Society of Cardiac and Thoracic Surgeons and the Anaesthetic Continuing Education Cardiac Thoracic Vascular and Perfusion Special Interest Group.

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GI complications after cardiac surgery remain an uncommon but dreadful complication associated with high mortality. Our findings should prompt a high degree of clinical vigilance in order to make an early diagnosis especially in high risk patients. Further studies aiming to identify independent predictors for GI complications after cardiac surgery are warranted.

the World Health Organization declared coronavirus disease 2019 (COVID-19) a pandemic. The presence of underlying cardiovascular disease (CVD) confers the highest mortality with COVID-19. Thus, patients with CVD must be considered a particularly at-risk population. [1][2][3][4][5] Community transmission, patient-to-patient transmission and health care worker infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are overwhelming health services worldwide. [4][5][6] High quality cardiac care must minimise risk of viral transmission to patients and health care workers. It should adapt resources in the context of reduced access to hospital beds and personal protective equipment (PPE). This consensus statement reviews and summarises data on SARS-CoV-2 infection in pre-existing CVD and acute cardiovascular manifestations of COVID-19, and makes recommendations for cardiac service provision during the pandemic. Development process for the recommendationsA group of CVD experts, drawn from the Cardiac Society of Australia and New Zealand (CSANZ), the Australian and New Zealand Society of Cardiac and Thoracic Surgeons, the National Heart Foundation of Australia and the High Blood Pressure Research Council of Australia, convened in March 2020. Key opinion leaders in cardiology, cardiothoracic surgery and public health with broad geographic representation were consulted. We searched major databases (EMBASE, MEDLINE and PubMed) to identify relevant systematic reviews, randomised controlled trials and clinical case series in English from January 2020 to 25 March 2020. As the majority of studies relating to COVID-19 and CVD at the time of writing were observational in nature, results must be interpreted with caution. Given data limitations, consensus documents produced by international cardiology societies from December 2019 to March 2020 were reviewed. [7][8][9] Experts from key areas (electrophysiology and pacing, interventional cardiology, imaging, cardiothoracic surgery, nursing, hypertension, prevention and rural) generated key recommendations from their respective councils and groups. In addition, social networking platforms (eg, WhatsApp) involving CSANZ board members, cardiology heads of department and key opinion leaders were used to identify relevant resources, guidance documents and protocols. An online living document was shared to facilitate wide input. The full draft underwent peer review by the listed authors as well as external experts in each subspecialty field of cardiology before agreement and acceptance of the final document. Pre-existing cardiovascular disease and COVID-19Patients with COVID-19 and pre-existing CVD are at increased risk of severe disease and death. [1][2][3][4][5] A meta-analysis of eight studies and over 46 000 patients in China reported that hypertension, diabetes and CVD were the most common comorbidities. 5 Baseline CVD conferred the highest odds of any comorbidity for developing severe versus mild COVID-19 (odds ratio [OR], 3.42; 95% CI, 1.88-6.22). Hypertension ...

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AVR with the stentless xenograft results in superior hemodynamics compared to the stented and mechanical valve replacements. AVR in all three groups leads to a significant regression of left ventricular hypertrophy within 6 months. However the reduction in LVM is greater in subjects with stentless and mechanical valves, which may have prognostic significance.