New-generation Devices Research Articles

Radioactivity induced in new-generation cardiac implantable electronic devices during high-energy X-ray irradiation

This study provides the first insight into the problem of the induced radioactivity of the construction materials of the new-generation cardiac implantable electronic devices (CIEDs). Its aim was to identify nuclear reactions and the resulting radioisotopes induced in the CIEDs by high-energy X-ray therapeutic beams generated by medical linear accelerators. The presented results allow to verify the rightness of choice of materials for investigated CIEDs. Such analysis is currently available only for the older types of the CIEDs, but not for those of the new generation. Gamma spectrometry measurements have been performed using a high-purity germanium detector (HPGe). The identification and activities of the generated radioisotopes were obtained from the measured spectra of gamma - rays from decays of the produced unstable radioisotopes. 21 radioisotopes originating from 24 nuclear reactions were identified. For all considered models of CIEDs the highest activities are from the tin isomer 117mSn. The induced activities were relatively small, not exceeding 3.1 Bq per a 1 Gy X-ray dose to a target volume.

Epitaxial fabrication of 2D materials of group IV elements

Experimental fabrication and investigation of unique properties of two-dimensional monoatomic layers of carbon, silicon, germanium, and tin on different surfaces have opened bright perspectives for development of devices of new generation. Wide opportunities to control their exotic electronic and optical properties via appropriate choice of substrate, content and geometry of two-dimensional layer, combined with elastic strain engineering, made them the central theme of research in the field of nanotechnology and materials science. In this work we review epitaxial methods of synthesis of two-dimensional materials of group IV elements: silicene, germanene, and stanene. General structural properties of these materials are also briefly considered. Special attention is paid to the technological growth modes, providing fabrication of high-quality large-area two-dimensional structures necessary for emerging device application.

Holographic 3-D control devices of the new generation

The types of new-generation devices designed for non-destructive control over the formation of the topography of a micro relief and the external geometry of a complex surface are determined. Passive control devices: a holographic Profiler operating in the visible range of electromagnetic waves. Active monitoring devices: a holographic Profiler operating in the x-ray range. A tool for structuring a three-dimensional geometric model of a complex shape surface is specified. This tool is a modular geometric approach. The modular-geometric approach allows you to restore the natural curvature of the surface in the local area of the point. The connection between the design of the control device and the method of surface modeling is established.

Italian Society of Arterial Hypertension (SIIA) Position Paper on the Role of Renal Denervation in the Management of the Difficult-to-Treat Hypertensive Patient.

Renal denervation is a device-based procedure for hypertension for which safety and efficacy has been demonstrated. At present, its clinical use is still matter of debate, despite the most recent clinical trials have shown promising results with new-generation devices in various hypertensive populations. This position paper was deemed necessary by the Italian Society of Arterial Hypertension, in order to provide indications about the applications of renal denervation in the clinical setting. A state-of-the art review of the literature, focusing on safety and efficacy data, is provided. Furthermore, based on current evidence and expert consensus, clinical profiles of possible candidates for renal denervation are proposed. The selection process should take into account not only blood pressure values, global cardiovascular risk profile, but also drug adherence and tolerability and patient preferences. This position paper also defines minimum requirements for renal denervation selection centers and a flowchart for the difficult-to-treat hypertensive patient. Further studies are needed to support these preliminary indications, which are based on expert-consensus only.

"Top-down" Arsenene Production by Low-Potential Electrochemical Exfoliation.

Arsenene, as an exotic representative of two-dimensional (2D) materials, has received great interest, yet the interest is mainly based on theoretical study. The reason for this is a restricted ability to operate the material from its synthesis to implementation. Beginning with the production, electrochemical exfoliation has been found as an extremely effective method for the preparation of 2D materials from bulk materials. Here, for the first time, we demonstrate the electrochemical exfoliation of bulk black arsenic in the anhydrous electrolyte medium. Spectro- and microscopic analyses evidence micrometer lateral size few-layer arsenene in a netlike porous shape formed of 2D flakes. We demonstrate that the surfactant-free exfoliation successfully resulted in a stable dispersion for which only washing with the corresponding solvent was sufficient. This electrochemistry route for the black arsenic exfoliation toward few-layer arsenene will broaden the materials' scope applications in new-generation devices.

Comparative Study Between Medical Treatment and Intervention in Acute Iliofemoral DVT

Abstract Background The cornerstone of current management of deep vein thrombosis (DVT) are the routine use of anticoagulant therapy, graduated elastic compression stockings (ECS), and early ambulation. Thrombolytic therapy was previously reserved only for patients with life-, limb-, or organ-threatening complications. However, the Post-Thrombotic Syndrome (PTS) has been increasingly recognized as a frequent and serious long-term complication of DVT. In this study I will use systematic review techniques to compare between the medical and intervention management outcome and possible complications and I will try to find out if although of high expenses of the new techniques especially catheter directed thrombolysis CDT it worth it as regarding the post-operative care and complications. Objective To review the literature comparing between medical treatment of acute iliofemoral DVT and intervention in the form of endovenous or surgical management of acute iliofemoral DVT as regards short and long term benefits. Methodology A systematic Review of published English literature from their date of inception till 2018. Only published English literature will be included in the study. All studies from their inception date till 2018 will be included. Results The literature search from the specified electronic databases identified 179 articles. After application of the inclusion and exclusion criteria, 7 comparative studies were finally included in this systematic review. There were 5 randomized trials and 2 observational studies. 1 prospective and 1 was retrospective. Various other approaches were used in combination with conservative/pharmacological thrombolysis according to the underlying pathology A total of 631 patients underwent CDT compared to 675 patients who underwent conservative strategy for management of acute iliofemoral DVT Conclusion Pharmacological and pharmacomechanical thrombolysis offers significant benefits to proximal dvt patients in the long term period. However, it does not show an advantage over conservative management in short -term outcome. Furthermore, CDT carries more risk of bleeding and recurrent VTE in the shortterm. More randomized control studies focused on quality of life after conservative and endovasculat intervention in proximal dvt patients as well as on studies on newer generation devices is needed to provide more information for clinical decisions.

Strong coupling of excitons in 2D MoSe2/hBN heterostructure with optical bound states in the continuum

We experimentally demonstrate strong exciton-photon coupling in a MoSe2/hBN heterostructure interfaced with an all-dielectric metasurface supporting high-Q bound states in the continuum. The resulting exciton-polaritons are probed by means of temperature- and angle-resolved reflectivity and photoluminescence. Our findings pave the way towards new-generation nonlinear planar polaritonic devices.

Outcomes of Transcatheter Aortic Valve Replacement in Patients With Bicuspid Aortic Valve Disease: A Report From the Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy Registry.

Patients with bicuspid aortic valve (AV) stenosis were excluded from the pivotal evaluations of transcatheter AV replacement (TAVR) devices. We sought to evaluate the outcomes of TAVR in patients with bicuspid AV stenosis in comparison with those with tricuspid AV stenosis. We used data from the Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy Registry (November 2011 through November 2018) to determine device success, procedural outcomes, post-TAVR valve performance, and in-hospital clinical outcomes (mortality, stroke, and major bleeding) according to valve morphology (bicuspid versus tricuspid). Results were stratified by older and current (Sapien 3 and Evolut R) generation valve prostheses. Medicare administrative claims were used to evaluate mortality and stroke to 1 year among eligible individuals (≥65 years). After exclusions, there were 170 959 eligible procedures at 593 sites during the specified interval. Of these, 5412 TAVR procedures (3.2%) were performed in patients with bicuspid AV, including 3705 with current-generation devices. In comparison with patients with tricuspid valves, patients with bicuspid AV were younger and had a lower Society of Thoracic Surgeons Predicted Risk of Operative Mortality score. When current-generation devices were used to treat patients with bicuspid AV, device success increased (93.5 versus 96.3; P=0.001) and the incidence of 2+ aortic insufficiency declined (14.0% versus 2.7%; P<0.001) in comparison with older-generation devices. With current-generation devices, device success was slightly lower in the bicuspid (versus tricuspid) AV group (96.3% in bicuspid versus 97.4% in tricuspid, P=0.07), with a slightly higher incidence of residual moderate or severe aortic insufficiency among patients with bicuspid AV (2.7% versus 2.1%; P<0.001). A lower 1-year adjusted risk of mortality (hazard ratio, 0.88 [95% CI, 0.78-0.99]) was observed for patients with bicuspid AV versus patients with tricuspid AV in the Medicare-linked cohort, whereas no difference was observed in the 1-year adjusted risk of stroke (hazard ratio, 1.14 [95% CI, 0.94-1.39]). Using current-generation devices, procedural, postprocedural, and 1-year outcomes were comparable following TAVR for bicuspid AV versus tricuspid AV disease. With newer-generation devices, TAVR is a viable treatment option for patients with bicuspid AV disease.

Food and Drug Administration Malfunction Recalls of Left Ventricular Assist Devices.

Left ventricular assist devices (LVADs) are being increasingly implanted given the increasing prevalence of patients with advanced heart failure stages. However, they are not exempt from device malfunctions. A PubMed search for the key words (left ventricular assist device malfunction) (ventricular assist system malfunction) was performed. We identified 28 publications in the US Food and Drug Administration (FDA) website database that addressed LVAD malfunction. Twenty-nine FDA recalls were identified regarding LVAD malfunctions: 17 regarding HeartWare ventricular assist device, six for HeartMate II, three for HeartMate 3, and three for total artificial heart. Mechanisms involved in LVAD malfunction include battery malfunction, loose driveline connector, malfunction of the system controller, loose power supply connector ports, malfunction of the driveline splice kit, problems with the percutaneous lead connection, disconnection of the bend relief and outflow graft and outflow graft occlusion among others. Multiple mechanisms could be linked to LVAD malfunction. However, multiple device modifications have been developed over the past decade to avoid recurrent malfunctions. Constant improvements and research in biotechnology are needed to prevent these complications. It remains to be seen if newer generation devices will lead to improved patient outcomes over the long term.

Long-Term Follow-Up of Transcatheter Aortic Valve Implantation With Portico Versus Evolut Devices

New-generation devices such as Evolut and Portico have provided favorable results in patients who underwent transcatheter aortic valve implantation (TAVI) for aortic stenosis, but their comparative effectiveness remains debated, despite its relevance when envisioning TAVI in low-risk patients. We evaluated the safety and efficacy of 2 leading TAVI devices (Evolut and Portico) used by the same team of experienced TAVI operators, focusing on long-term outcomes, including major adverse events (i.e., the composite of death, stroke, myocardial infarction, major vascular complication, or major bleeding). Unadjusted and propensity score-adjusted analyses were carried out. A total of 233 patients were included, 119 (51.1%) receiving Evolut and 114 (49%) Portico. Baseline and procedural data showed significant between-device differences, including functional class, surgical risk, chronic obstructive pulmonary disease, renal function, transesophageal guidance, device size, postdilation, and procedural time (all p <0.05). Yet, acute and in-hospital outcomes were not significantly different (all p >0.05). Follow-up status was ascertained in 228 (98%) patients after 15.0 ± 7.6 months. Unadjusted analysis showed similar rates of major adverse events, as well as the individual risk of death, stroke, myocardial infarction, major vascular complication, major bleeding, and pacemaker implantation (all p >0.05). Even at propensity score-adjusted analysis outcomes were not significantly different with Evolut and Portico (all p >0.05). In conclusion, Evolut and Portico devices yield similarly favorable results at long-term follow-up when used by experienced TAVI operators.

Tuning the “O” vacancies density in SnO2 nanocrystals during and after humid air plasma synthesis: implications on the photocatalytic performances under UV light

Tin(IV) oxide is a very attractive material with promising applications in new-generation devices. In this work, we reported a powerful but cheap and sustainable approach for preparing SnO2 nanocrystals based on the use of a non-thermal plasma burning in humid air. Physicochemical characterizations by Raman, Infrared and X-ray photoelectron spectroscopies revealed the presence of few hydroxyl groups and few oxygen vacancy (Ov) defects in the material obtained after 30 min under plasma (hereafter called NC-Sn30). By increasing the synthesis duration up to 120 min, the number of Ov decreased while the material became more hydroxylated. Furthermore, the material obtained after 120 min under plasma (i.e. NC-Sn120) was more crystallized. When tested as photocatalyst in iodide oxidation, NC-Sn120 showed lowest activity compared to NC-Sn30. After further calcination under air or nitrogen atmosphere at 550 °C, the crystallites size of pristine materials increased and their specific surface area values which were 190 and 206 m2 g−1 for NC-Sn30 and NC-Sn120, respectively, dropped to about 30 m2 g−1. Meanwhile, the Ov density increased leading to the rise of the valence band maximum and the decrease of the band gap energy of materials. The calcined samples with higher Ov density showed better photocatalytic performances, as the rate of formation of reactive iodine species (i.e. I3−, I2) normalized with the surface area of calcined photocatalysts was about 4 times higher than that of their corresponding pristine SnO2. These results open the door to a new route synthesis of SnO2 nanocrystals with tunable “O” vacancies density and photocatalytic performances.

Observation of Shubnikov-de Haas Oscillations in Large-Scale Weyl Semimetal WTe2 Films**Supported by the National Key R&D Program of China (Grant Nos. 2017YFA0206304 and 2016YFA0300803), the National Natural Science Foundation of China (Grant Nos 61822403, 11874203, 11774160, 61427812 and U1732159), the Fundamental Research Funds for the Central Universities (Grant Nos 021014380080 and 021014380113), the Natural Science Foundation of Jiangsu Province of

Topological Weyl semimetal WTe2 with large-scale film form has a promising prospect for new-generation spintronic devices. However, it remains a hard task to suppress the defect states in large-scale WTe2 films due to the chemical nature. Here we significantly improve the crystalline quality and remove the Te vacancies in WTe2 films by post annealing. We observe the distinct Shubnikov-de Haas quantum oscillations in WTe2 films. The nontrivial Berry phase can be revealed by Landau fan diagram analysis. The Hall mobility of WTe2 films can reach 1245 cm2V−1s−1 and 1423 cm2V−1s−1 for holes and electrons with the carrier density of 5 × 1019 cm−3 and 2 × 1019 cm−3, respectively. Our work provides a feasible route to obtain high-quality Weyl semimetal films for the future topological quantum device applications.

Research progress and device applications of multifunctional materials based on two-dimensional film/ferroelectrics heterostructures

With the rapid development of microelectronic integration technology, the miniaturization, integration and multifunction of electronic devices are becoming a general trend. Two-dimensional materials are a class of layered material with atomic layer thickness, and have unique electrical, magnetic, optical and mechanical properties. The co-existence of the weak van der Waals force between layers and the strong covalent bonding within layers makes the two-dimensional material very suitable for the miniature design of new-generation multifunctional electronic devices. Two-dimensional materials, represented by graphene and transition metal chalcogenides, exhibit high mobility, adjustable energy band and high visible light transmittance, and thus having become the frontier hotspots in the field of micro-nanoscience in recent years. Synergy between two-dimensional materials and various functional materials such as SiO&lt;sub&gt;2&lt;/sub&gt; insulator, semiconductor, metal and organic compound may lead to new properties and device applications, thus can deepen and expand the basic research and application of two-dimensional materials. Among them, ferroelectric materials have received much attention because of their spontaneous polarizations, high dielectric constants, and high piezoelectric coefficients. The two-dimensional ferroelectric composites well have the advantages of the two, i.e. they not only contain a variety of rich phenomena such as the magnetoelectric coupling effect, ferroelectric field effect and lattice strain effect, tunneling effect, photoelectric effect, and photoluminescence effect, but also have broad applications in devices such as multi-state memories, tunneling transistors, photoelectric diodes, solar cells, super capacitors, and pyroelectric infrared detectors, which have attracted wide concern from academia and industry. To better understand the combination of two-dimensional thin films with ferroelectric substrates and provide a holistic view, we review the researches of several typical two-dimensional film/ferroelectrics heterostructures in this article. First, two-dimensional materials and ferroelectric materials are introduced. Then, the physical mechanism at the interface is briefly illustrated. After that, several typical two-dimensional film/ferroelectrics heterostructures are mainly introduced. The ferroelectric materials including Pb(Zr&lt;sub&gt;1–&lt;i&gt;x&lt;/i&gt;&lt;/sub&gt;Ti&lt;i&gt;&lt;sub&gt;x&lt;/sub&gt;&lt;/i&gt;)O&lt;sub&gt;3&lt;/sub&gt;, (1–&lt;i&gt;x&lt;/i&gt;)PbMg&lt;sub&gt;1/3&lt;/sub&gt;Nb&lt;sub&gt;2/3&lt;/sub&gt;O&lt;sub&gt;3&lt;/sub&gt;–&lt;i&gt;x&lt;/i&gt;PbTiO&lt;sub&gt;3&lt;/sub&gt;, P(VDF-TrFE), are mainly summarized, and other ferroelectric materials such as P(VDF-TrFE-CFE), BaTiO&lt;sub&gt;3&lt;/sub&gt;, BiFeO&lt;sub&gt;3&lt;/sub&gt;, PbTiO&lt;sub&gt;3&lt;/sub&gt;, CuInP&lt;sub&gt;2&lt;/sub&gt;S&lt;sub&gt;6&lt;/sub&gt;, HfO&lt;sub&gt;2&lt;/sub&gt; are briefly involved. The future research emphasis of the two-dimensional materials/ferroelectrics composites is also suggested at the end of the article. This review will present a significant reference to the future design of miniature and multifunctional devices.

Trends in Endovascular Reperfusion Therapy for Acute Stroke after Introduction of Mechanical Thrombectomy Devices: Japanese Registry of NeuroEndovascular Therapy (JR-NET)3.

In Japan, the era of thrombectomy for acute stroke started when the Merci retriever was approved in 2010 and the Penumbra system in 2011. New-generation Penumbra catheters (MAX series) and stent retrievers were introduced in 2013 and 2014, respectively. The aim of this study was to clarify the general status and trends in endovascular reperfusion therapy for stroke in Japan from 2010 to 2014. We extracted a total of 3705 patients (72.1 ± 12.2 years, 1482 women) from a nationwide study of patients receiving any neuroendovascular treatment, the Japanese Registry of NeuroEndovascular Therapy 3. Reperfusion therapy resulted in a successful reperfusion rate of 59%, and 31% of patients achieved a favorable outcome at 30 days of onset. The frequency of Merci-including procedures increased to 52% in the first half of 2011, but conversely decreased to 1% in the second half of 2014. The frequency of Penumbra-including procedures increased from 18% in the second half of 2011 to 67% in the first half of 2014, decreasing to 38% in the second half of 2014. The reperfusion rate and 30-day clinical outcomes remained almost unchanged until June 2013, and started to improve thereafter, coincident with the introduction and spread of newer-generation devices. The rate of successful reperfusion reached 71–76%, and 36–38% of patients achieved a favorable outcome in 2014. After multivariate adjustment for preprocedure variables, the calendar period from 2013 to 2014 was significantly associated with improvement in reperfusion rates and clinical outcomes.

Evaluation of Peripheral Retinal Changes on Ultra-Widefield Fundus Autofluorescence Images of Patients with Age-Related Macular Degeneration

Objectives:Age-related macular degeneration (AMD) is the most common cause of central vision loss in individuals aged 65 years and older in developed countries. Earlier imaging systems did not enable visualization of the peripheral retina in diseases affecting the macula. With the introduction of new-generation devices, the peripheral retina is easily visualized. In our study, we aimed to evaluate the incidence of peripheral retinal changes in the color and autofluorescence fundus images of patients with AMD.Materials and Methods:In the study group, 550 eyes of 277 patients who were diagnosed with AMD and 90 eyes of 45 healthy patients in the control group were evaluated. An ultra-wide-angle imaging device was used to record standard 200° color and autofluorescence fovea-centered fundus images followed by superior and inferior fundus images obtained using the device’s fixation light. The fundus images were examined in 3 sections: zone 1, zone 2, and zone 3.Results:Evaluation of color fundus images revealed peripheral retinal changes in 67.8% of the 550 AMD eyes and 47.8% of the healthy eyes. Drusen was the most common peripheral retinal change. Evaluation of autofluorescence images revealed peripheral autofluorescence changes in 39.6% of the AMD eyes and 28.9% of the healthy eyes. Hypoautofluorescence was the most common autofluorescence change.Conclusion:Peripheral retinal changes were more common in AMD patients than the control group, indicating that AMD is not only a macular disease, but can affect the entire retina. Future prospective studies will elucidate the relationship between these peripheral retinal changes and patients’ genetic features and their importance in prognosis, diagnosis, and treatment.

Ethics and governance is becoming unethical: time for some common sense?

Ventricular assist devices (VADs) are an important part of the management of patients with end stage heart disease either as a bridge to cardiac transplantation or as definitive therapy in patients who for one reason or another are not eligible for transplantation. Survival after VAD implantation has progressively improved as newer generation devices have been developed.1 VADs require a driveline which exits through the skin of the abdominal wall and conducts power to the pump and monitors parameters from the pump. Not surprisingly a driveline infection is a serious complication resulting in substantial morbidity and even mortality.2 In order to develop a better understanding of the mechanisms underpinning driveline infection, a study was initiated involving three hospitals in Australia implanting VADs. When a patient with a VAD undergoes heart transplantation, the driveline is removed from the patient and thrown in the contaminated waste. Two of the three hospitals had a total of three patients on their waiting lists for cardiac transplantation with infected drivelines. The information that could be gleaned from these three drivelines (which would become clinical waste on explantation) was of significant interest to our team and could open several doors of investigation towards improved outcomes through assessing their biofilm formation and degree of tissue integration. The clinicians involved in the cardiac transplant/mechanical circulatory support programmes at both hospitals were very helpful and understood the need for obtaining these infected drivelines at the time of cardiac transplantation. The only variation in practice in this study required that, at the time of VAD explantation the driveline was to be placed in a sterile container and sent to our laboratory as opposed to disposing of it in the clinical waste bin.

Comparative one-month safety and effectiveness of five leading new-generation devices for transcatheter aortic valve implantation

Transcatheter aortic valve implantation (TAVI) for aortic stenosis is becoming an appealing alternative to surgical aortic valve replacement in high-risk patients and to medical therapy for inoperable ones. Several new-generation TAVI devices have been recently introduced, but comparative analyses are lacking. We aimed to compare 1-month outcomes associated with such five leading new-generation TAVI devices exploiting data collected in the prospective observational RISPEVA (Registro Italiano GISE sull’impianto di Valvola Aortica Percutanea) Study. We queried the dataset of the ongoing RISPEVA study to retrieve baseline, procedural and 1-month outcome details of patients undergoing TAVI with Acurate, Evolut, Portico, Lotus, and Sapien3. Analysis was based on unadjusted and propensity score-adjusted methods. We included 1976 patients, 234 (11.8%) treated with Acurate, 703 (35.6%) with Evolut, 151 (7.6%) with Lotus, 347 (17.6%) with Portico, and 541 (27.4%) with Sapien3. Unadjusted analysis for baseline features highlighted several significant differences, and other discrepancies were found for procedural features. Despite these differences, device and procedural success were similarly high (ranging from 98.0% to 99.4%, p > 0.05). However, procedural valve migration appeared more common with Acurate (p = 0.007), and major bleeding with Sapien3 (p = 0.002). Unadjusted analysis for 1-month outcomes also highlighted significant differences in the composite of death, stroke, myocardial infarction, major vascular complication, major bleeding, or renal failure (favoring Portico, p < 0.001), major vascular complications (favoring Lotus, p < 0.001), renal failure (favoring Portico, p = 0.035), and permanent pacemaker implantation (favoring Acurate, p < 0.001). Propensity score-adjusted analyses showed lower rates of major adverse events with Evolut and Portico (p < 0.05), major vascular complications with Lotus and Portico (p < 0.05), renal failure with Sapien3 (p < 0.05) and permanent pacemaker implantation with Acurate (p < 0.05). In conclusion, new-generation TAVI devices have different profiles of early comparative safety and efficacy. These findings should be taken into account for individualized decision making and patient management.

Van der Waals Integration of Bismuth Quantum Dots-Decorated Tellurium Nanotubes (Te@Bi) Heterojunctions and Plasma-Enhanced Optoelectronic Applications.

Van der Waals (vdW)-integrated heterojunctions have been widely investigated in optoelectronics due to their superior photoelectric conversion capability. In this work, 0D bismuth quantum dots (Bi QDs)-decorated 1D tellurium nanotubes (Te NTs) vdW heterojunctions (Te@Bi vdWHs) are constructed by a facile bottom-up assembly process. Transient absorption spectroscopy suggests that Te@Bi vdWH is a promising candidate for new-generation optoelectronic devices with fast response properties. The subsequent experiments and density functional theory calculations demonstrate the vdW interaction between Te NTs and Bi QDs, as well as the enhanced optoelectronic characteristics owing to the plasma effects at the interface between Te NTs and Bi QDs. Moreover, Te@Bi vdWHs-based photodetectors show significantly improved photoresponse behavior in the ultraviolet region compared to pristine Te NTs or Bi QDs-based photodetectors. The proposed integration of vdWHs is expected to pave the way for constructing new nanoscale heterodevices.

Prediction of One-Year Mortality Based upon A New Staged Mortality Risk Model in Patients with Aortic Stenosis Undergoing Transcatheter Valve Replacement.

Background: In-depth knowledge about potential predictors of mortality in transcatheter aortic valve replacement (TAVR) is still warranted. Currently used risk stratification models for TAVR often fail to reach a holistic approach. We, therefore, aimed to create a new staged risk model for 1-year mortality including several new categories including (a) AS-entities (b) cardiopulmonary hemodynamics (c) comorbidities, and (d) different access routes. Methods: 737 transfemoral (TF) TAVR (84.3%) and 137 transapical (TA) TAVR (15.7%) patients were included. Predictors of 1-year mortality were assessed according to the aforementioned categories. Results: Over-all 1-year mortality (n = 100, 11.4%) was significantly higher in the TA TAVR group (TF vs. TA TAVR: 10.0% vs. 18.9 %; p = 0.0050*). By multivariate cox-regression analysis, a three-staged model was created in patients with fulfilled categories (TF TAVR: n = 655, 88,9%; TA TAVR: n = 117, 85.4%). Patients in “stage 2” showed 1.7-fold (HR 1.67; CI 1.07–2.60; p = 0.024*) and patients in “stage 3” 3.5-fold (HR 3.45; CI 1.97–6.05; p < 0.0001*) enhanced risk to die within 1 year. Mortality increased with every stage and reached the highest rates of 42.5% in “stage 3” (plogrank < 0.0001*), even when old- and new-generation devices (plogrank = n.s) were sub-specified. Conclusions: This new staged mortality risk model had incremental value for prediction of 1-year mortality after TAVR independently from the TAVR-era.

P3745Differences in short-term outcome between early- and new-generation TAVR devices

Abstract Background For transcatheter aortic valve replacement (TAVR) morbidity- and outcome relevant factors like paravalvular aortic regurgitation, vascular access complications and the need for permanent pacemaker implantation remain key challenges. New-generation devices for TAVR have been optimized to improve clinical outcome. Purpose We aimed to address safety and effectiveness of new-generation TAVR devices compared with earlier generations in a single centre study. Methods We compared 30 days outcome of the new-generation repositionable MER (n=614) and MEP (n=90) and the balloon-expandable ES3 (n=414) valve with the last-generation self-expandable MCV (n=270) and the balloon-expandable SXT (n=103) in patients treated with TAVR between 2009 and 2018. TAVR endpoints and adverse events were defined according to the Valve Academic Research Consortium-2. Results Logistic EuroSCORE I as predictor for risk stratification and 30-day mortality was comparable between both cohorts (27.3%±2.9 new vs 23.0%±1.4 early; p=n.s.). Compared to early-generation devices (MCV/SXT), new-generation devices (MER/MEP/ES3) had significantly higher primary device success (98.9% new vs 96.8% early; p=0.0089), lower incidence of new renal replacement therapy (2.6% new vs 6.2% early; p=0.0028), new permanent pacemaker therapy for conduction disturbances (12.8% new vs 17.0% early; p=0.0394), and disabling bleeding (1.4% new vs 4.0% early; p=0.0040). No difference could be observed concerning incidence of moderate-to-severe paravalvular leakage (4.2% new vs 5.0% early; p=n.s.), stroke (3.3% new vs 2.1% early; p=n.s.), major vascular complications (2.8% new vs 3.5% early; p=n.s.) and 30-day mortality (2.7% new vs 4.4% early; p=n.s). Conclusion Data from the retrospective analysis indicate higher primary device success and lower incidence of renal replacement, pacemaker therapy and disabling bleeding events in new-generation devices, although praised “hot-item” advantages like paravalvular leackage/aortic regurgitation, vascular complications and mortality remain unacknowledged.