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Ascending thoracic aortic aneurysms (ATAA) were resected from patients during graft replacement and non-aneurysmal vessels during autopsy. Tissues were histomechanically tested according to region and orientation, and the experimental recordings reduced with a Fung-type strain--energy function, affording faithful biomechanical characterisation of the vessel response. The material and rupture properties disclosed that ATAA and non-aneurysmal aorta were stiffer and stronger circumferentially, accounted by preferential collagen reinforcement. The deviation of microstructure in the right lateral region, with a longitudinal extracellular matrix and smooth muscle element sub-intimally, reflects the regional differences in material properties identified. ATAA had no effect on strength, but caused stiffening and extensibility reduction, corroborating our histological observation of deficient elastin but not collagen content. Our findings may serve as input data for the implementation of finite element models, to be used as improved surgical intervention criteria, and may further our understanding of the pathophysiology of ATAA and aortic dissection.

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Prosthetic valve thrombosis is a potentially life-threatening complication associated with high morbidity and mortality. Transthorasic and transoesophageal echocardiography play an important role to the diagnosis and provides incremental information about the optimal treatment strategy, while fluoroscopy and cardiac computed tomography may be of added value. Guidelines differ on whether surgical treatment or fibrinolysis should be the treatment of choice for the management of left-sided prosthetic valve thrombosis and these uncertainties underline the need for further prospective randomized controlled trials. Thrombus size, New York Heart Association functional class of the patient, the possible contraindications, the availability of each therapeutic option and the clinician's experience are important determinants for the management of prosthetic valve thrombosis.

Background:The risk stratification of coronary heart disease (CHD) and/or heart failure (HF) patients with easily measured electrocardiographic markers is of clinical importance. The aim of this meta-analysis is to indicate whether increased QT dispersion (QTd) is associated with fatal and nonfatal outcomes in patients with CHD and/or HF. Methods:We systematically searched MEDLINE and Cochrane databases without restrictions until August 15, 2018 using the keyword "QT dispersion". Studies including data on the association between QTd and all-cause mortality, sudden cardiac death (SCD) or arrhythmic events in patients with HF and/or CHD were classified as eligible. Results:In the analysis including patients with CHD and/or HF, we found that QTd did not differ significantly in patients with SCD compared to no SCD patients while QTd was significantly greater in the group of all-cause mortality patients and in patients who experienced a sustained ventricular arrhythmia. Subgroup analysis showed that in myocardial infarction studies, QTd was significantly higher in patients with