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Medicina
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Advancements in Cardiovascular Medicine and Interventional Radiology
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Advancements in Cardiovascular Medicine and Interventional Radiology

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Cardiology".

Deadline for manuscript submissions: closed (10 April 2025) | Viewed by 4924

Special Issue Editors

Prof. Dr. Juš Kšela

E-Mail Website
Guest Editor
Department of Cardiovascular Surgery, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia
Interests: minimally invasive cardiac surgery; heart transplantation; mechanical circulatory support; PTE surgery; CIED extraction
Special Issues, Collections and Topics in MDPI journals
Dr. Dimitrij Kuhelj

E-Mail Website
Guest Editor
Clinical Institute of Radiology, University Medical Centre Ljubljana, Zaloska 7, 1000 Ljubljana, Slovenia
Interests: vascular and non-vascular interventional radiology; diagnostic imaging; endovascular treatment of aorta; peripheral arteries and veins
Prof. Dr. Matjaz Bunc

E-Mail Website
Guest Editor
Department of Cardiology, University Medical Centre Ljubljana, 1525 Ljubljana, Slovenia
Interests: TAVI; TMVR; M-TEER; T-TEER; coronary interventions; PV leaks; CSR
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Heart and circulatory disorders remain the leading cause of morbidity and mortality globally, accounting for 1 in 3 deaths worldwide or around 60,000 deaths in one day or one death every 1.5 seconds. This estimated loss of more than 20 million lives annually worldwide constantly urges medical professionals to seek novel and advanced treatment strategies to properly address the disease burden and to help the affected individuals.

The field of cardiovascular disease management has seen remarkable advancements in recent decades, driven by innovative technologies, research breakthroughs, and evolving therapeutic strategies in various medical disciplines, including interventional cardiology, cardiovascular surgery, and interventional radiology. The evolution of novel medication, development of minimally invasive interventional and surgical procedures, the integration of various treatment modalities, and personalized medicine approaches have revolutionized the way we diagnose, treat, follow, and prevent cardiovascular disorders.

We would like to invite you to submit papers thematically connected to the scope of this Special Issue.

Authors are welcome to submit original articles, reports on novel treatment strategies and advances in decision making, clinical outcome studies, comparative studies, narrative reviews, scoping reviews, systematic reviews, and meta-analyses. We believe that Advancements in Cardiovascular Medicine and Interventional Radiology is an ideal platform to exchange perspectives and novelties in the management of cardiovascular disorders.

Prof. Dr. Juš Kšela
Dr. Dimitrij Kuhelj
Prof. Dr. Matjaz Bunc
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Medicina is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2200 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • cardiology and interventional cardiology
  • electrophysiology
  • cardiovascular surgery
  • interventional radiology
  • minimally invasive therapies
  • novel techniques in cardiovascular treatment

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Published Papers (5 papers)

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7 pages, 245 KiB  
Article
Oxidative Stress in Postoperative Atrial Fibrillation: Does Malondialdehyde Hold Predictive Value?
by Urska Intihar, Arta Krasniqi, Anze Djordjevic, Jan Zmazek, Harun Avdagic, Jus Ksela and Miha Antonic
Medicina 2025, 61(5), 778; https://doi.org/10.3390/medicina61050778 - 22 Apr 2025
Viewed by 191
Abstract
Background and Objectives: Postoperative atrial fibrillation (POAF) is a common complication following cardiac surgery, associated with increased morbidity and prolonged hospital stays. Oxidative stress has been implicated in POAF pathogenesis, with malondialdehyde (MDA), a marker of lipid peroxidation, proposed as a potential [...] Read more.
Background and Objectives: Postoperative atrial fibrillation (POAF) is a common complication following cardiac surgery, associated with increased morbidity and prolonged hospital stays. Oxidative stress has been implicated in POAF pathogenesis, with malondialdehyde (MDA), a marker of lipid peroxidation, proposed as a potential biomarker. However, conflicting evidence exists regarding its predictive value. This study aimed to assess the association between serum MDA levels and POAF incidence in patients undergoing cardiac surgery. Materials and Methods: This prospective observational study included 99 consecutive patients undergoing elective on-pump cardiac surgery. Patients with preoperative atrial fibrillation, chronic kidney disease requiring dialysis, or emergency surgery were excluded. Blood samples for MDA measurement were collected at six perioperative time points: preoperatively, intraoperatively after aortic clamp release, and at 8, 24, 48, and 72 h postoperatively. Patients were monitored for new-onset POAF during the first three postoperative days. Statistical analyses included independent samples t-tests, Mann–Whitney U-tests, and Fisher’s exact tests, with significance set at p < 0.05. Results: POAF occurred in 33 (33%) patients. Patients who developed POAF were significantly older (p = 0.017) and had higher EuroSCORE II values (p = 0.019). No significant differences were observed in serum MDA concentrations between POAF and non-POAF patients at any measured time point. The incidence of POAF was higher in patients undergoing valvular surgery (p = 0.014). Conclusions: Serum MDA levels were not associated with POAF development, suggesting that lipid peroxidation alone may not play a central role in POAF pathogenesis. These findings challenge the predictive value of MDA for POAF risk stratification. Future research should explore alternative oxidative stress markers and their potential therapeutic implications in POAF prevention. Full article
(This article belongs to the Special Issue Advancements in Cardiovascular Medicine and Interventional Radiology)
14 pages, 1213 KiB  
Article
An Integrative Machine Learning Model for Predicting Early Safety Outcomes in Patients Undergoing Transcatheter Aortic Valve Implantation
by Abilkhair Kurmanaliyev, Kristina Sutiene, Rima Braukylienė, Ali Aldujeli, Martynas Jurenas, Rugile Kregzdyte, Laurynas Braukyla, Rassul Zhumagaliyev, Serik Aitaliyev, Nurlan Zhanabayev, Rauan Botabayeva, Yerlan Orazymbetov and Ramunas Unikas
Medicina 2025, 61(3), 374; https://doi.org/10.3390/medicina61030374 - 21 Feb 2025
Viewed by 757
Abstract
Background: Early safety outcomes following transcatheter aortic valve implantation (TAVI) for severe aortic stenosis are critical for patient prognosis. Accurate prediction of adverse events can enhance patient management and improve outcomes. Aim: This study aimed to develop a machine learning model [...] Read more.
Background: Early safety outcomes following transcatheter aortic valve implantation (TAVI) for severe aortic stenosis are critical for patient prognosis. Accurate prediction of adverse events can enhance patient management and improve outcomes. Aim: This study aimed to develop a machine learning model to predict early safety outcomes in patients with severe aortic stenosis undergoing TAVI. Methods: We conducted a retrospective single-centre study involving 224 patients with severe aortic stenosis who underwent TAVI. Seventy-seven clinical and biochemical variables were collected for analysis. To handle unbalanced classification problems, an adaptive synthetic (ADASYN) sampling approach was used. A fined-tuned random forest (RF) machine learning model was developed to predict early safety outcomes, defined as all-cause mortality, stroke, life-threatening bleeding, acute kidney injury (stage 2 or 3), coronary artery obstruction requiring intervention, major vascular complications, and valve-related dysfunction requiring repeat procedures. Shapley Additive Explanations (SHAPs) were used to explain the output of the machine learning model by attributing each variable’s contribution to the final prediction of early safety outcomes. Results: The random forest model identified left femoral artery diameter and aortic valve calcification volume as the most influential predictors of early safety outcomes. SHAPs analysis demonstrated that smaller left femoral artery diameter and higher aortic valve calcification volume were associated with poorer early safety prognoses. Conclusions: The machine learning model highlights of early safety outcomes after TAVI. These findings suggest that incorporating these variables into pre-procedural assessments may improve risk stratification and inform clinical decision-making to enhance patient care. Full article
(This article belongs to the Special Issue Advancements in Cardiovascular Medicine and Interventional Radiology)
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11 pages, 264 KiB  
Article
Evaluating the Impacts of Procedural and Patient-Specific Factors on the Outcomes of Transcatheter Aortic Valve Implantation (TAVI)
by Abilkhair Kurmanaliyev, Rima Braukylienė, Ali Aldujeli, Rassul Zhumagaliyev, Serik Aitaliyev and Ramunas Unikas
Medicina 2025, 61(1), 94; https://doi.org/10.3390/medicina61010094 - 9 Jan 2025
Viewed by 974
Abstract
Background: Transcatheter aortic valve implantation (TAVI) has emerged as a pivotal intervention for managing severe aortic stenosis in high-risk surgical patients. Objective: This study aimed to evaluate the impacts of procedural factors and patient characteristics on TAVI outcomes, with a focus [...] Read more.
Background: Transcatheter aortic valve implantation (TAVI) has emerged as a pivotal intervention for managing severe aortic stenosis in high-risk surgical patients. Objective: This study aimed to evaluate the impacts of procedural factors and patient characteristics on TAVI outcomes, with a focus on survival rates, cardiac mortality, and associated complications. Methods: A retrospective, single-center study involving 224 patients who underwent TAVI at the Lithuanian University of Health Sciences from September 2021 to April 2023 was conducted. Data encompassing demographic characteristics, medical history, procedural specifics, and follow-up outcomes were analyzed. Survival and adverse events were assessed at 30 days, 6 months, and 12 months post-TAVI. Results: The study included 224 patients. The mean age in the non-death group was 80 ± 6.17 years (range, 49–91), while that in the cardiac death group was 81.5 ± 6.14 years (range, 70–94; p = 0.079). Males accounted for 37.7% of the non-death group and 50% of the cardiac death group (p = 0.304). Statistical analyses identified factors significantly associated with mortality and complications. The overall survival rate was 88.8%, with cardiac-related mortality observed in 8% of patients. Increased fluoroscopy time (p < 0.001), a higher contrast volume (p = 0.005), and less improvement in aortic valve velocity post-TAVI (p = 0.031) were significantly associated with cardiac mortality. Advanced age and a reduced left ventricular ejection fraction (<50%) were prominent predictors of adverse outcomes. Patients with non-coronary cusp calcification exhibited lower cardiac mortality (p = 0.005), while mitral valve regurgitation was linked to poorer outcomes (p = 0.015). Logistic regression analysis underscored the incremental risks posed by procedural complexities and comorbidities. Conclusions: Procedural factors such as fluoroscopy duration and contrast volume, along with patient-specific attributes including age, left ventricular function, and valve calcification patterns, critically influence TAVI outcomes. These findings emphasize the need for tailored procedural strategies and patient management protocols to mitigate risks and enhance the efficacy of TAVI interventions. Full article
(This article belongs to the Special Issue Advancements in Cardiovascular Medicine and Interventional Radiology)
8 pages, 1629 KiB  
Article
Prevention of Air Embolism in Extracorporeal Membrane Oxygenation Systems: An In Vitro Study on Protection of Central Venous Catheter Lumen
by Danilo Franco, Nejc Krasna, Robert Novak, Giovanni Esposito, Raffaele Izzo, Jan Belohlavek, Marko Noc and Tomaz Goslar
Medicina 2024, 60(11), 1883; https://doi.org/10.3390/medicina60111883 - 17 Nov 2024
Viewed by 1242
Abstract
Background and Objectives: This study aimed to investigate the risk and mechanisms of air entry into the extracorporeal membrane oxygenation (ECMO) circuit through the central venous catheter (CVC) in a veno-venous configuration. The primary goal was to assess the impact of different air [...] Read more.
Background and Objectives: This study aimed to investigate the risk and mechanisms of air entry into the extracorporeal membrane oxygenation (ECMO) circuit through the central venous catheter (CVC) in a veno-venous configuration. The primary goal was to assess the impact of different air volumes on ECMO circuit performance at varying pump speeds. Material and Methods: The study utilized a circuit model to simulate ECMO conditions and evaluate the potential entry points of air, specifically through the unprotected lumen of the CVC. Various interventions, such as the use of a closed three-way stopcock or clave, were implemented to assess their efficacy in preventing air entry. Results: The unprotected lumen of the central venous catheter posed a significant risk for air entry into the ECMO circuit. The introduction of a closed three-way stopcock or clave proved effective in preventing air ingress through the central venous catheter. Auditory cues, such as a distinct hissing sound, served as an early warning sign of air presence in the circuit. The study demonstrated that even small volumes of air, as minimal as 1 mL, could pass through the oxygenator at specific pump speeds, and larger volumes could lead to pump dysfunction. Conclusions: The study identified the unprotected lumen of the central venous catheter as a potential entry point for air into the ECMO circuit. The use of a closed three-way stopcock or one-way valve was found to be a reliable protective measure against air infiltration. Early detection through the observation of a hissing sound in the circuit provided a valuable warning sign. These findings contribute to enhancing the safety and performance of ECMO systems by minimizing the risk of air embolism. Full article
(This article belongs to the Special Issue Advancements in Cardiovascular Medicine and Interventional Radiology)
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8 pages, 2753 KiB  
Case Report
The Role of Intravascular Ultrasound in the Evaluation and Treatment of Free-Floating Stent Struts Following Inadequate Ostial Circumflex Stenting: A Case Report
by Milorad Tesic, Djordje Mladenovic, Vladan Vukcevic, Dario Jelic and Dejan Milasinovic
Medicina 2024, 60(10), 1563; https://doi.org/10.3390/medicina60101563 - 24 Sep 2024
Viewed by 1234
Abstract
Introduction: Excessive stent strut protrusion in the distal left main (LM) from either the left anterior descending (LAD) or circumflex (Cx) artery following inadequate ostial stenting may complicate any later procedure involving the left coronary artery. In such case scenarios, intravascular ultrasound (IVUS) [...] Read more.
Introduction: Excessive stent strut protrusion in the distal left main (LM) from either the left anterior descending (LAD) or circumflex (Cx) artery following inadequate ostial stenting may complicate any later procedure involving the left coronary artery. In such case scenarios, intravascular ultrasound (IVUS) guidance provides accurate assessment of the ostial stent position and may facilitate subsequent management strategies and treatment. Case summary: We present a complex percutaneous coronary intervention (PCI) of LM bifurcation in a 49-year-old man following inadequate ostial Cx stenting that resulted in excessive stent protrusion in the distal LM segment, accompanied by a subsequent short 80–90% ostial LAD stenosis. Initially, IVUS was performed to confirm “floating struts” from a previous Cx ostial stenting and to ensure complete intraluminal placement of the wire within the stent leading to the Cx, precluding any side passage through the stent struts. Then, a second wire was inserted into the LAD through the most distal stent strut under live IVUS guidance. Further PCI was completed according to the principles of the double kissing mini-culotte technique. Final IVUS runs confirmed correct stent apposition and expansion in the LM, LAD and Cx segments. Conclusions: In cases involving the treatment of “free-floating” struts in the distal LM artery, intravascular imaging is essential to ensure optimal PCI outcomes. Full article
(This article belongs to the Special Issue Advancements in Cardiovascular Medicine and Interventional Radiology)
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