For the effective reduction of global CO 2 emissions, it is essential to develop and deploy efficient and cost-effective technologies for CO 2 capture, especially from large point sources. We recently developed an electrochemically mediated amine regeneration (EMAR) system to replace traditional thermal desorption for the capture of CO 2 from post-combustion flue gases. Despite EMAR effectiveness on a laboratory scale, concerns regarding the high gas-to-liquid ratio in the electrochemical cell and longterm instability of the electrodes need to be addressed before further scale-up of the process to a pilot plant and beyond can be entertained. Accordingly, we investigated the effect of using sodium dodecyl sulfate (SDS) as an anionic surfactant and dodecyltrimethylammonium bromide (DTAB) as a cationic surfactant on the process operation. It was found that it is advantageous to use an anionic surfactant for a system such as EMAR that contains hydrophilic electrodes and a positively charged electrochemically active species. The overall cell resistance was notably reduced when SDS anionic surfactant was used. The precipitation of copper particles observed in the anode outlet when no surfactant was used was effectively avoided when SDS was added to the electrolyte, resulting in electrode stability. In addition, smaller gas bubbles were produced in the presence of the SDS surfactant, which resulted in less blockage of the electrode by the gas with a resultant lower cell potential under constant current conditions, driving more efficient CO 2 desorption. This led to an ∼25% reduction in the electrochemical energy requirement, the lowest ever achieved experimentally for the EMAR process. Overall, the addition of a very low concentration of SDS resulted in the successful circumvention of the important problems faced by the EMAR system regarding further scale-up.

Aim: The aim of our study is to assess the predictors and the prognostic role of left ventricle ejection fraction (LVEF) recovery after Impella-supported percutaneous coronary intervention (PCI) in patients presenting with acute myocardial infarction (AMI). Methods: This retrospective, observational study included patients admitted for AMI who underwent Impella-supported PCI in two Italian high-volume cardiac catheterization laboratories. Only patients who underwent an echocardiographic assessment of left ventricle ejection fraction (LVEF) before the procedure (acute LVEF) and during follow-up (follow-up LVEF) were included in the present analysis. Patients with a baseline LVEF ≥40% were excluded from the present analysis. LVEF recovery was calculated as the difference between follow-up LVEF and acute LVEF. A delta ≥5% was considered significant and was used to define the responder group. Results: From April 2007 to December 2020, 64 consecutive patients were included in our study. A total of 55 patients (86%) received hemodynamic support with Impella 2.5, and 9 patients (14%) with Impella CP. Median LVEF at follow-up was significantly higher compared to baseline (36% (30–42) vs. 30% (24–33), p < 0.001). Based on LVEF recovery, 37 patients (57.8%) were deemed responders. According to multivariate analysis, complete functional revascularization was an independent predictor of a significant EF recovery (OR: 0.159; 95% CI: 0.038–0.668; p = 0.012). At three-year follow-up, lack of LVEF recovery was the only predictor of mortality (HR: 5.315; 95% CI: 1.100–25.676; p = 0.038). Conclusions: Functional complete revascularization is an independent predictor of the recovery of LVEF in patients presenting with AMI who underwent Impella-supported PCI. The recovery of LV function is associated with improved prognosis and could be used to stratify the risk of future events at long-term follow-up.

Drug coated balloons (DCBs) are currently indicated in guidelines as a first choice option in the management of instant restenosis, whereas their use in de novo lesions is still debated. The concerns raised after the contrasting results of the initial trials with DCBs in de novo lesions have been more recently overcome by a larger amount of data confirming their safety and effectiveness as compared to drug-eluting stents (DES), with potentially greater benefits being achieved, especially in particular anatomical settings, as in very small or large vessels and bifurcations, but also in selected subsets of higher-risk patients, where a ‘leave nothing behind’ strategy could offer a reduction of the inflammatory stimulus and thrombotic risk. The present review aims at providing an overview of current available DCB devices and their indications of use based on the results of data achieved so far.

Background The use of mechanical circulatory support in high-risk percutaneous coronary intervention (HRPCI) has grown over the past decade. We aimed to evaluate the impact of coronary revascularization extent on one-year outcomes of Impella-supported HRPCI in the setting of acute coronary syndrome (ACS). Methods We performed a single-center retrospective study including all patients who underwent coronary angiography supported by Impella at our institution. Patients undergoing HRPCI in the setting of ACS with Impella-assistance were identified for the analysis. Revascularization extent was assessed using the British Cardiovascular Intervention Society (BCIS) jeopardy score revascularization index (RI). Patients were classified into two groups according to the completeness of revascularization in high RI (RI&gt;0.75) and low RI (RI&lt;0.75). The primary study endpoint was survival free from major adverse cardiac and cerebrovascular events (MACCE: all-cause death, myocardial infarction, stroke, heart failure hospitalization) at one-year follow-up. Results Among fifty patients enrolled in the study, forty ACS patients (mean age 69.2±9 years) were identified for the analysis. At coronary angiography, 76.3% had multivessel disease, and the mean BCIS-JSPRE-PCI score was 10.2±2.1. After Impella-supported PCI, BCIS-JSPOST-PCI score was 2.1±2.0 (p&lt;0.01) and RI&gt;0.75 was reached in 89.2% of cases (mean RI 0.8±0.2). In-hospital mortality was 20.5% without a statistical difference between high and low RI (p=0.1). Within 12 months, time-to-MACCE was statistically higher in patients with high RI as compared to low RI (288.2 vs. 189.8 days, p&lt;0.05) (Figure). Conclusions Our single-center experience suggests a more extensive revascularization, aiming for a positive impact on outcomes, when a Impella-protected strategy is performed in the setting of acute coronary syndromes.