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  1. Article: Bioprosthetic Valves for Lifetime Management of Aortic Stenosis: Pearls and Pitfalls.

    Mylonas, Konstantinos S / Angouras, Dimitrios C

    Journal of clinical medicine

    2023  Volume 12, Issue 22

    Abstract: This review explores the use of bioprosthetic valves for the lifetime management of patients with aortic stenosis, considering recent advancements in surgical (SAV) and transcatheter bioprostheses (TAV). We examine the strengths and challenges of each ... ...

    Abstract This review explores the use of bioprosthetic valves for the lifetime management of patients with aortic stenosis, considering recent advancements in surgical (SAV) and transcatheter bioprostheses (TAV). We examine the strengths and challenges of each approach and their long-term implications. We highlight differences among surgical bioprostheses regarding durability and consider novel surgical valves such as the Inspiris Resilia, Intuity rapid deployment, and Perceval sutureless bioprostheses. The impact of hemodynamics on the performance and durability of these prostheses is discussed, as well as the benefits and considerations of aortic root enlargement during Surgical Aortic Valve Replacement (SAVR). Alternative surgical methods like the Ross procedure and the Ozaki technique are also considered. Addressing bioprosthesis failure, we compare TAV-in-SAV with redo SAVR. Challenges with TAVR, such as TAV explantation and considerations for coronary circulation, are outlined. Finally, we explore the potential challenges and limitations of several clinical strategies, including the TAVR-first approach, in the context of aortic stenosis lifetime management. This concise review provides a snapshot of the current landscape in aortic bioprostheses for physicians and surgeons.
    Language English
    Publishing date 2023-11-13
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2662592-1
    ISSN 2077-0383
    ISSN 2077-0383
    DOI 10.3390/jcm12227063
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Heart Xenotransplantation: Current Issues and Perspectives.

    Schizas, Nikolaos / Nazou, Georgia / Angouras, Dimitrios C / Iliopoulos, Dimitrios C / Dedeilias, Panagiotis / Argiriou, Mihalis

    The journal of Tehran Heart Center

    2023  Volume 18, Issue 2, Page(s) 79–81

    Language English
    Publishing date 2023-08-24
    Publishing country Iran
    Document type Editorial
    ZDB-ID 2476998-8
    ISSN 2008-2371 ; 1735-5370 ; 1735-8620
    ISSN (online) 2008-2371
    ISSN 1735-5370 ; 1735-8620
    DOI 10.18502/jthc.v18i2.13315
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Failure properties of ascending thoracic aortic aneurysms with dysfunctional tricuspid aortic valves.

    Sokolis, Dimitrios P / Angouras, Dimitrios C

    Interactive cardiovascular and thoracic surgery

    2021  Volume 33, Issue 6, Page(s) 949–958

    Abstract: Objectives: Ascending thoracic aortic aneurysms (ATAAs) often coexist with dysfunctional tricuspid aortic valves (TAVs). How valvular pathology relates to the aortic wall mechanical properties requires detailed examination.: Methods: Intact-wall and ... ...

    Abstract Objectives: Ascending thoracic aortic aneurysms (ATAAs) often coexist with dysfunctional tricuspid aortic valves (TAVs). How valvular pathology relates to the aortic wall mechanical properties requires detailed examination.
    Methods: Intact-wall and layer-specific mechanical properties from 40 and 21 patients with TAV-ATAAs, respectively, were studied using uniaxial tensile testing, longitudinally and circumferentially. Failure stress (tensile strength), failure stretch (extensibility) and peak elastic modulus (stiffness) measurements, along with histological assays of thickness and elastin/collagen contents, were compared among patients with no valvular pathology (NVP), aortic stenosis (AS) or aortic insufficiency (AI).
    Results: Intact-wall stiffness longitudinally and medial strength and stiffness, in either direction, were significantly lower in AI patients than in AS and NVP patients. Intact-wall/medial thickness and extensibility in either direction were significantly lower in AS patients than in AI and NVP patients. In contrast, intact-wall/medial stiffness circumferentially was significantly higher in AS patients than in NVP patients, consistent with the significantly increased medial collagen in AS patients. Failure properties and medial thickness and elastin/collagen contents were significantly lower (more impaired) in females. The left lateral was the thickest quadrant in NVP patients, but the 4 quadrants were equally thick in AS and AI patients. There were significant differences in strength and stiffness among quadrants, which varied however in the 3 patient groups.
    Conclusions: The aortic wall load-bearing capacity was impaired in patients with ATAA in the presence of TAV stenosis or insufficiency. These findings lend biomechanical support to the current guidelines suggesting lower thresholds for elective ascending aorta replacement in cases of aortic valve surgery.
    MeSH term(s) Aorta/physiopathology ; Aorta, Thoracic/diagnostic imaging ; Aorta, Thoracic/pathology ; Aorta, Thoracic/surgery ; Aortic Aneurysm, Thoracic/complications ; Aortic Aneurysm, Thoracic/diagnostic imaging ; Aortic Aneurysm, Thoracic/surgery ; Aortic Valve/diagnostic imaging ; Aortic Valve/pathology ; Aortic Valve/surgery ; Aortic Valve Stenosis/physiopathology ; Aortic Valve Stenosis/surgery ; Biomechanical Phenomena ; Female ; Humans ; Male ; Tricuspid Valve/diagnostic imaging ; Tricuspid Valve/physiopathology
    Language English
    Publishing date 2021-07-29
    Publishing country England
    Document type Journal Article
    ZDB-ID 2095298-3
    ISSN 1569-9285 ; 1569-9293
    ISSN (online) 1569-9285
    ISSN 1569-9293
    DOI 10.1093/icvts/ivab184
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 5730: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
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    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

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  4. Article ; Online: Regional and directional variations in the layer-specific resistance to tear propagation in ascending thoracic aortic aneurysms.

    Kefalidi, Eirini / Angouras, Dimitrios C / Sokolis, Dimitrios P

    Journal of biomechanics

    2022  Volume 138, Page(s) 111133

    Abstract: Aortic dissection often initiates a few centimeters distal to the coronary ostia in the right lateral wall, with an intimal-medial tear that tends to be transversely directed and occupy half of the aortic circumference, sometimes less, but seldom the ... ...

    Abstract Aortic dissection often initiates a few centimeters distal to the coronary ostia in the right lateral wall, with an intimal-medial tear that tends to be transversely directed and occupy half of the aortic circumference, sometimes less, but seldom the entire circumference. To elucidate these clinical observations, tear tests were presently used to determine the layer-specific resistance to tear propagation in ascending thoracic aortic aneurysms, assessing variations over the four circumferential quadrants and two directions. Aneurysmal tissue strips of standardized dimensions from sixteen patients were anatomically separated into layers (seven hundred and twelve) and an incision made along one-third of their length. They underwent tear testing via uniaxial loading and then unloading before crack propagation had proceeded along their complete length. The average tear tension and tear energy per reference area generated were many-fold greater in outer- (adventitial) compared to inner- (intimal with small medial portion) and middle-layer (medial) strips, explaining why the tear is restricted to the inner wall. They were greater in inner- compared to middle-layer strips of the anterior and left lateral quadrants, suggesting that the tear will propagate to the less-resistant media even if initiated in the intima. In most longitudinally-cut middle- and inner-layer strips, the cracks deviated toward the circumferential direction and tore out through the side, justifying the circumferential course of the tear. Both fracture parameters were significantly higher in the right than the left lateral quadrant in outer-layer strips and the anterior quadrant in middle-layer strips, potentially affecting the circumferential extent of the tear.
    MeSH term(s) Adventitia ; Aneurysm, Dissecting ; Aorta ; Aortic Aneurysm, Thoracic ; Biomechanical Phenomena ; Humans
    Language English
    Publishing date 2022-05-10
    Publishing country United States
    Document type Journal Article
    ZDB-ID 218076-5
    ISSN 1873-2380 ; 0021-9290
    ISSN (online) 1873-2380
    ISSN 0021-9290
    DOI 10.1016/j.jbiomech.2022.111133
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    In stock of ZB MED Cologne/Königswinter

    Zs.A 700: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
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    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

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  5. Article: Investigation of the Role of

    Bobos, Dimitrios / Soufla, Giannoula / Angouras, Dimitrios C / Lekakis, Ioannis / Georgopoulos, Sotirios / Melissari, Euthemia

    Diagnostics (Basel, Switzerland)

    2023  Volume 13, Issue 16

    Abstract: Congenital heart malformations (CHMs) make up between 2 and 3% of annual human births. Bone morphogenetic proteins (BMPs) signalling is required for chamber myocardium development. We examined for possible molecular defects in the bone morphogenetic ... ...

    Abstract Congenital heart malformations (CHMs) make up between 2 and 3% of annual human births. Bone morphogenetic proteins (BMPs) signalling is required for chamber myocardium development. We examined for possible molecular defects in the bone morphogenetic protein 2 and 4 (
    Language English
    Publishing date 2023-08-21
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2662336-5
    ISSN 2075-4418
    ISSN 2075-4418
    DOI 10.3390/diagnostics13162717
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  6. Article ; Online: Bilateral versus Single Internal-Thoracic-Artery Grafts.

    Angouras, Dimitrios C

    The New England journal of medicine

    2017  Volume 376, Issue 18, Page(s) e37

    MeSH term(s) Coronary Artery Bypass ; Humans ; Mammary Arteries/transplantation ; Retrospective Studies ; Treatment Outcome
    Language English
    Publishing date 2017--04
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 207154-x
    ISSN 1533-4406 ; 0028-4793
    ISSN (online) 1533-4406
    ISSN 0028-4793
    DOI 10.1056/NEJMc1703358
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    In stock of ZB MED Cologne/Königswinter

    Ua VI Zs.34: Show issues Location:
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  7. Article ; Online: Disseminated Intravascular Coagulation Post Endovascular Aortic Repair.

    Schizas, Nikolaos / Nazou, Georgia / Antonopoulos, Constantine / Angouras, Dimitrios C

    Vascular and endovascular surgery

    2023  Volume 57, Issue 7, Page(s) 738–748

    Abstract: Background: Disseminated Intravascular Coagulation (DIC) after Endo-Vascular Aneurysm Repair (EVAR) is a highly uncommon clinical entity. With only a few case-reports available, its management strategy still remains enigmatic.: Objectives: The ... ...

    Abstract Background: Disseminated Intravascular Coagulation (DIC) after Endo-Vascular Aneurysm Repair (EVAR) is a highly uncommon clinical entity. With only a few case-reports available, its management strategy still remains enigmatic.
    Objectives: The purpose of this study was to retrieve, synthesize, and appraise all existing data for DIC after EVAR.
    Materials and methods: All published articles regarding DIC post-EVAR were identified from 3 major databases and analyzed. Clinical parameters, predisposing factors, along with mortality and morbidly were assessed.
    Results: The total number of publications included in the review was 15 describing 17 cases. DIC presented with a broad spectrum of clinical manifestations, while the time of diagnosis varied significantly. Endoleak was the main causative factor, with an incidence reaching 71%. The mortality of DIC after EVAR reached 29%, regardless of the therapeutic approach chosen. DIC was treated effectively in 47% of the patients (8/17), with better outcomes among patients who received conservative therapy or among those who were submitted to endovascular interventions.
    Conclusions: DIC after EVAR, although rare, is a potentially lethal clinical condition which requires prompt diagnosis and urgent medical consideration. Treatment of endoleak may help in quick restoration of normal parameters.
    MeSH term(s) Humans ; Endoleak/diagnostic imaging ; Endoleak/etiology ; Endoleak/therapy ; Endovascular Aneurysm Repair ; Aortic Aneurysm, Abdominal/surgery ; Disseminated Intravascular Coagulation/diagnosis ; Disseminated Intravascular Coagulation/etiology ; Disseminated Intravascular Coagulation/therapy ; Treatment Outcome ; Endovascular Procedures/adverse effects ; Blood Vessel Prosthesis Implantation/adverse effects ; Risk Factors ; Retrospective Studies
    Language English
    Publishing date 2023-03-22
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2076272-0
    ISSN 1938-9116 ; 1538-5744
    ISSN (online) 1938-9116
    ISSN 1538-5744
    DOI 10.1177/15385744231165231
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    In stock of ZB MED Cologne/Königswinter

    Zs.A 622: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
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  8. Article ; Online: Huge asymptomatic left atrial myxoma resected through a superior septal approach.

    Kollias, Vasilios D / Angouras, Dimitrios C / Koufopoulos, Nektarios / Dougenis, Dimitrios

    Interactive cardiovascular and thoracic surgery

    2021  Volume 33, Issue 3, Page(s) 499

    MeSH term(s) Heart Atria/diagnostic imaging ; Heart Atria/surgery ; Heart Neoplasms/diagnostic imaging ; Heart Neoplasms/surgery ; Humans ; Myxoma/diagnostic imaging ; Myxoma/surgery
    Language English
    Publishing date 2021-04-26
    Publishing country England
    Document type Journal Article
    ZDB-ID 2095298-3
    ISSN 1569-9285 ; 1569-9293
    ISSN (online) 1569-9285
    ISSN 1569-9293
    DOI 10.1093/icvts/ivab111
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    In stock of ZB MED Cologne/Königswinter

    Zs.A 5730: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
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    ab Jg. 2022: Lesesaal (EG)

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  9. Article ; Online: Adding Inflammation to the Perfect Cytokine Storm: Concerns Related to Extracorporeal Membrane Oxygenation for COVID-19 Patients.

    Angouras, Dimitrios C / Kollias, Vasilios D / Dougenis, Dimitrios

    ASAIO journal (American Society for Artificial Internal Organs : 1992)

    2020  Volume 66, Issue 8, Page(s) e110

    MeSH term(s) Betacoronavirus ; COVID-19 ; China ; Coronavirus ; Coronavirus Infections ; Cytokines ; Extracorporeal Membrane Oxygenation ; Humans ; Inflammation ; Pandemics ; Pneumonia, Viral ; SARS-CoV-2
    Chemical Substances Cytokines
    Keywords covid19
    Language English
    Publishing date 2020-07-27
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 759982-1
    ISSN 1538-943X ; 0162-1432 ; 1058-2916
    ISSN (online) 1538-943X
    ISSN 0162-1432 ; 1058-2916
    DOI 10.1097/MAT.0000000000001233
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    Uk I Zs.199: Show issues Location:
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    Zs.B 2435: Show issues Location:
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  10. Article: Can the Ratio SUVmax of the Lesion/SUVmax of Mediastinal Tissues Guide the Choice of Surgical Access for the Resection of Thymic Epithelial Tumors?

    Moraitis, Sotirios D / Agrafiotis, Apostolos C / Skoura, Evangelia / Kalkanis, Dimitrios / Moraitis, Dimitrios / Tomos, Periklis / Liakakos, Theodoros / Angouras, Dimitrios

    Frontiers in surgery

    2022  Volume 9, Page(s) 852906

    Abstract: Background: There are studies showing the utility of the 18-fluorodeoxyglucose positron emission tomography (: Methods: All patients who presented an anterior mediastinal lesion with a high suspicion of being of thymic origin were included in a ... ...

    Abstract Background: There are studies showing the utility of the 18-fluorodeoxyglucose positron emission tomography (
    Methods: All patients who presented an anterior mediastinal lesion with a high suspicion of being of thymic origin were included in a prospective database. A ratio inferior to 1 could predict a benign nature and less aggressive behavior, and a minimally invasive approach was performed. A ratio superior to 1 suggested a malignant and aggressive behavior, and a median sternotomy (or a thoracotomy) was performed.
    Results: There were 15 male (mean age 44.6 ± 16.26 years, range 25-73) and 15 female patients (mean age 50.1 ± 16.94 years, range 25-76). When the ratio is inferior to 1, it predicts benign disease in 80% of cases. When it is superior to 1, it predicts in half of cases advanced histological types (high risk thymomas and thymic carcinomas). On the contrary, it can quite accurately predict advanced Masaoka-Koga stages.
    Conclusions: The protocol of this study is in accordance with the current literature showing the utility of
    Language English
    Publishing date 2022-03-15
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2773823-1
    ISSN 2296-875X
    ISSN 2296-875X
    DOI 10.3389/fsurg.2022.852906
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