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Current experiences with one of the two CE Marked devices, the CoreValve ReValving® System for Percutaneous Aortic Valve Replacement (PAVR) have proved to be an overall success. This device consists of a porcine pericardial valve prosthesis mounted on a self-expanding Nitonol frame, which is delivered by means of an 18 French size (6mm) catheter.

Transapical access is based on decades of clinical experience with de-airing the heart, through the tip (apex) of the left ventricle, during routine cardiac surgical interventions. Insertion of a catheter and later-on closure through the apex is possible in a relatively uncomplicated manner. An anterolateral minithoracotomy is a simple and standardized access to the apex. It is applicable in almost all patients and they can be extubated soon afterwards. This procedure can even be performed without intubation under regional anaesthesia in some patients.

In recent years, much attention has been given to depression following heart attack and its effects on prognosis. Several large scale studies have been undertaken (ENRICHD, SADHART, MIND-IT, CREATE) in which depression was targeted. Although we hoped that treating depression would result in an improved prognosis, these studies have not provided much evidence to support this position: effects on depression itself have been minor and did not translate into cardiovascular benefits.

Conversely, lifestyle, diabetes, dyslipidemia, cigarette smoking and hypertension contribute to most of the population-attributable risk in the large, international INTERHEART study of acute myocardial infarction (heart attacks). The identification of single gene disorders may pave the way to a better understanding of complex metabolic pathways. Understanding the genes that regulate high density lipoprotein (HDL) metabolism may lead to novel therapeutic approaches. This has been emphasized by two therapeutic approaches for the treatment of CAD:

According to recent evidence school-based intervention programmes provide the best results for reducing prevalence of childhood overweight and obesity if they are performed with involvement of stakeholders and political support. In this context physical activity education in schools, reducing television viewing and nutritional education are examples of interventions that have been successful. Reducing the consumption of sugar-added drinks has significant beneficial effects on weight development.

One in three people with a high risk of developing cardiovascular disease (CVD) over the next 10 years have not been diagnosed, according to a major UK study in the September issue of IJCP, the International Journal of Clinical Practice.

The shortfall in identifying people at high risk is greatest when it comes to middle-aged men, says the study of more than 71,000 men and women, which was carried out by Oxford University and funded by Unilever.

The best place to seek novel compounds for pharmaceutical drugs, alternative energy sources, and a host of industrial applications, is within natural systems that have evolved over millions of years. Scientists now realise that the precise molecular arrangements within natural pathways in organisms have been highly tuned for specific processes and provide both compounds that can be exploited directly and vital information over how to synthesise new products by mimicking biochemical processes.

Importantly, the Food and Drug Administration recently summarized a statement that in various controlled clinical trials the cardiovascular risks of COX-2 selective drugs have been indistinguishable from non-selective NSAIDs, thus also raising serious questions about the safety of the latter. As such, the FDA mandated a "boxed warning" for COX-2 selective inhibitors and traditional NSAIDs alike in view of the potential of these agents to increase adverse cardiovascular outcomes.

Long procedures require long fluoroscopy times with a serious amount of radiation for physician and personnel. The idea is that both the performance of procedures can be improved by robotic navigation systems and that the amount of complications can be reduced. At present two systems are extensively tested in cardiology: a robotic system that allows manipulating conventional catheters directly in the heart (Sensei, Hansen) and the Niobe (Stereotaxis) system that allows steering special magnetic catheters with the help of two large external magnets.

When patients present with symptoms, or when there are objective signs of poor tolerance in patients without symptoms, surgery should be performed using as often as possible surgical mitral valve repair, as this treatment has shown safety, efficacy and good long-term results.

A study of Crohn's disease and ulcerative colitis in children has identified a gene that influences whether children get these diseases early in life, and points to a potential new target for treatment.

The findings of the international team that performed the study were published online this week by the journal Nature Genetics.

In his PhD, Jesús López Taberna put forward two protection techniques so that wind generators continue to be operative despite breaks in electricity supply

Cardiac ultrasound imaging, also known as echocardiography, has been recently challenged by several new imaging methods. However, echocardiography has unique characteristics that make it very attractive: it is cheap, can be done bedside and without ionizing radiation. Recently devices have also become very small.

Actually, in echocardiography there are two diverse and ongoing trends: the development of handheld miniature echo devices and even more advanced systems for more quantitative analyses.

Cardiac computed tomography has revolutionized cardiac imaging in recent years by providing exquisitely detailed cardiac anatomy, including, but not limited to, coronary anatomy. Non-invasive coronary angiography by computed tomography (CTA) is performed in ever increasing numbers, over 150 000 per year in the United States. However, the specific role of CTA in the diagnostic pathways of cardiology remains to be defined, and practice patterns of the technique often neglect established insights into coronary artery disease. The following characteristics of CTA need to be understood:

Imaging has gained attention in many areas of medicine but its relevance and importance in clinical cardiology cannot be underestimated. While chest X-ray and heart radioscopy have been used for many decades, it is the maturation of echocardiography which has propelled non-invasive imaging to the foreground of our diagnostic arsenal in cardiology. More recently, cardiovascular magnetic resonance and computed tomography have joined this club.