[Current status for interventional and surgical aortic valve implantation]

[Aortic stenosis-which diagnostic algorithms and which treatment?]

The progress in cardiology during the last 50 years can best be studied by looking at the diagnostics and treatment of patients with aortic valve stenosis. Previously, the clinical examination, electrocardiography (ECG) and chest X‑ray were used before heart catheterization, which included a transseptal puncture to complete the indications for surgery in young patients. Nowadays, echocardiography, often combined with a dobutamine stress test, is the primary diagnostic tool to which computed tomography for quantification of valve calcification and cardiac magnetic resonance imaging can be of additive value. The treatment of severe aortic valve stenosis is no longer only treated by aortic valve replacement but transluminal aortic valve implantation also represents a new therapeutic option. The change in the age groups of treated patients is also noteworthy. Surgery is recommended for patients under 75 years old but for older patients, especially those with a high risk, interventional catheter-assisted treatment is preferred.

Snake venom thrombin-like enzymes: from reptilase to now

The snake venom thrombin-like enzymes (SVTLEs) comprise a number of serine proteases functionally and structurally related to thrombin. Until recently, only nine complete sequences of this subgroup of the serine protease family were known. Over the past 5 years, the primary structure of several SVTLEs has been characterized, and now this family includes several members. Of particular interest is their possible use in pathologies such as thrombosis. The aim of the present review is to summarize the state of the art concerning the evolutionary, structural and biological features of the SVTLEs.