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Exchangeable heart valve

Gregory S Matte, Thomas J Sandora, Robert J Howe, William L Regan, Gail Potter-Bynoe, James R Neal, Pedro J Del Nido
OBJECTIVE: Oxygenators for cardiopulmonary bypass require water flow for their integral heat exchanger. Heater-cooler units are nearly universally used for this requirement. Heater-cooler units pose the risk of aerosolized infection. The Centers for Disease Control and Prevention recommended discontinuing use of Stöckert 3T heater-cooler units (LivaNova PLC, London, United Kingdom) in October 2016 because of this risk. We aimed to reduce the risk of aerosolized infection posed by heater-cooler units by eliminating those devices from our operating rooms...
March 7, 2018: Journal of Thoracic and Cardiovascular Surgery
Roland Hetzer, Mariano Francisco Del Maria Javier, Eva Maria Delmo Walter
Background: While heart transplantation has gained recognition as the gold standard therapy for advanced heart failure, the scarcity of donor organs has become an important concern. The evolution of surgical alternatives such as ventricular assist devices (VADs), allow for recovery of the myocardium and ensure patient survival until heart transplantation becomes possible. This report elaborates the role of VADs as a bridge to heart transplantation in infants and children (≤18 years old) with end-stage heart failure...
January 2018: Annals of Cardiothoracic Surgery
Cíntia Yukie Shoji, Luciana Castilho de Figuereido, Eveline Maria Calixtre, Cristiane Delgado Alves Rodrigues, Antonio Luis Eiras Falcão, Pedro Paulo Martins, Ana Paula Ragonete Dos Anjos, Desanka Dragosavac
OBJECTIVES: To analyze patients after cardiac surgery that needed endotracheal reintubation and identify factors associated with death and its relation with the severity scores. METHODS: Retrospective analysis of information of 1,640 patients in the postoperative period of cardiac surgery between 2007 and 2015. RESULTS: The reintubation rate was 7.26%. Of those who were reintubated, 36 (30.3%) underwent coronary artery bypass surgery, 27 (22...
April 2017: Revista Brasileira de Terapia Intensiva
Nihat Pekel, Ertuğrul Ercan, Mehmet Emre Özpelit, Ferhat Özyurtlu, Akar Yılmaz, Caner Topaloğlu, Serkan Saygı, Serkan Yakan, İstemihan Tengiz
OBJECTIVE: The standard transcatheter ventricular septal defects (VSD) closure procedure is established with arteriovenous (AV) loop and is called as antegrade approach. The directly retrograde transarterial VSD closure without using AV loop might be better option as shortens the procedure time and decreases radiation exposure. METHODS: Our series consist of twelve sequential adult cases with congenital VSDs (seven with perimembranous, four with muscular, one with postoperative residuel VSD)...
June 2017: Anatolian Journal of Cardiology
Cristina Beltrami, Marie Besnier, Saran Shantikumar, Andrew I U Shearn, Cha Rajakaruna, Abas Laftah, Fausto Sessa, Gaia Spinetti, Enrico Petretto, Gianni D Angelini, Costanza Emanueli
The pericardial fluid (PF) is contained in the pericardial sac surrounding the heart. MicroRNA (miRNA) exchange via exosomes (endogenous nanoparticles) contributes to cell-to-cell communication. We investigated the hypotheses that the PF is enriched with miRNAs secreted by the heart and that it mediates vascular responses through exosome exchange of miRNAs. The study was developed using leftover material from aortic valve surgery. We found that in comparison with peripheral plasma, the PF contains exosomes enriched with miRNAs co-expressed in patients' myocardium and vasculature...
March 1, 2017: Molecular Therapy: the Journal of the American Society of Gene Therapy
Per M Arvidsson, Johannes Töger, Marcus Carlsson, Katarina Steding-Ehrenborg, Gianni Pedrizzetti, Einar Heiberg, Håkan Arheden
Intracardiac blood flow is driven by hemodynamic forces that are exchanged between the blood and myocardium. Previous studies have been limited to 2D measurements or investigated only left ventricular (LV) forces. Right ventricular (RV) forces and their mechanistic contribution to asymmetric redirection of flow in the RV have not been measured. We therefore aimed to quantify 3D hemodynamic forces in both ventricles in a cohort of healthy subjects, using magnetic resonance imaging 4D flow measurements. Twenty five controls, 14 elite endurance athletes, and 2 patients with LV dyssynchrony were included...
February 1, 2017: American Journal of Physiology. Heart and Circulatory Physiology
Jitin Narula, Usha Kiran, Poonam Malhotra Kapoor, Minati Choudhury, Palleti Rajashekar, Ujjwal Kumar Chowdhary
OBJECTIVE: To evaluate the effect of autologous blood harvest (ABH)-induced volume shifts using electrical cardiometry (EC) in patients with pulmonary artery hypertension secondary to left heart disease. DESIGN: Prospective, randomized, controlled trial. SETTING: A tertiary care hospital. PARTICIPANTS: The study comprised 50 patients scheduled to undergo heart valve replacement. INTERVENTIONS: Patients were divided randomly into 2 experimental groups that were distinguished by whether ABH was performed...
February 2017: Journal of Cardiothoracic and Vascular Anesthesia
Laura Brown, Lowell Tilzer, Fred Plapp
A 33-year-old male was admitted to the hospital for a repeat mitral valve replacement. The original surgery, performed in India in 2008 due to rheumatic heart disease, required massive amounts of plasma replacement during and after the surgery. The patient was admitted to our hospital with extremely low Factor V and Factor VIII activities due to a rare combined Factor V and Factor VIII deficiency. His clinical condition on admission was grave due to severe pulmonary hypertension. It was decided to replace the patient's Factor V using therapeutic plasma exchange (TPE) with fresh frozen plasma (FFP) just prior to surgery, and his Factor VIII with Factor VIII concentrate...
June 2017: Journal of Clinical Apheresis
Marzieh Nikparvar, Mohammad Reza Evazi, Tasnim Eftekhari, Farzaneh Moosavi
In patients with sickle cell disease, thrombotic microangiopathy is a rare complication. Also in sickle cell disease, intracardiac thrombus formation without structural heart diseases or atrial arrhythmias is a rare phenomenon. We herein describe a 22-year-old woman, who was a known case of sickle cell-βthalassemia, had a history of recent missed abortion, and was admitted with a vaso-occlusive crisis. The patient had manifestations of microangiopathic hemolytic anemia, including laboratory evidence of hemolytic anemia, thrombocytopenia, respiratory distress, fever, jaundice, and abnormal liver function and coagulation tests, accompanied by clot formation on the Eustachian valve of the inferior vena cava in the right atrium and also a long and worm-like thrombus in the right ventricle...
March 2016: Iranian Journal of Medical Sciences
Amjad Shalabi, Ehud Raanani, Amihai Shinfeld, Rafael Kuperstein, Alexander Kogan, Alexander Lipey, Eyal Nachum, Dan Spiegelstein
UNLABELLED: Background: Prolonged life expectancy has increased the number of elderly high risk patients referred for surgical aortic valve replacement (AVR). These referred high risk patients may benefit from sutureless bioprosthesis procedures which reduce mortality and morbidity. OBJECTIVES: To present our initial experience with sutureless aortic bioprotheses, including clinical and echocardiographic results, in elderly high risk patients referred for AVR. METHODS: Forty patients (15 males, mean age 78 ± 7 years) with symptomatic severe aortic stenosis underwent AVR with the 3F Enable or Perceval sutureless bioprosthesis during the period December 2012 to May 2014...
February 2016: Israel Medical Association Journal: IMAJ
Ying Lei, Zannatul Ferdous
With the increase in average life expectancy and growing aging population, lack of functional grafts for replacement surgeries has become a severe problem. Engineered tissues are a promising alternative to this problem because they can mimic the physiological function of the native tissues and be cultured on demand. Cyclic stretch is important for developing many engineered tissues such as hearts, heart valves, muscles, and bones. Thus a variety of stretch bioreactors and corresponding scaffolds have been designed and tested to study the underlying mechanism of tissue formation and to optimize the mechanical conditions applied to the engineered tissues...
May 2016: Biotechnology Progress
Roland Hetzer, Friedrich Kaufmann, Eva Maria Delmo Walter
This paper reviews the development and establishment of the Berlin Heart EXCOR® (BHE®) as a paediatric mechanical circulatory support and reports our entire experience with regard to indications, timing of implantation and explantation and outcome. The Berlin group reported the first successful paediatric bridge to transplantation using a pulsatile pneumatic paracorporeal biventricular assist device, the BHE®, in 1990 in an 8-year-old boy with end-stage heart failure and coarctation of the aorta. This experience prompted them to develop miniaturized pump systems for children through the company Berlin Heart Mediproduct GmbH...
August 2016: European Journal of Cardio-thoracic Surgery
Luis Rodriguez-Ospina, Juan Garcia-Morell, Carla P Rodriguez-Monserrate, Julio Valentin-Nieves
Valve replacement is the standard surgical treatment of diseased valves that cannot be repaired. The main goal of replacement is to exchange the diseased valve with one that has the engineering and hemodynamics as close as possible to the disease free native valve. However due to mechanical and fluid dynamic constraints all prosthetic heart valves (PHVs) are smaller than normal and thus are inherently stenotic. This represents a challenge when it comes time to replace a valve. The correct valve with the correct and matching profile has to be selected before the procedure to avoid possible complications...
April 2015: Boletín de la Asociación Médica de Puerto Rico
B Steinlechner, Daniel Zimpfer, Arno Schiferer, Nikolaus Heinrich, Thomas Schlöglhofer, Angela Rajek, Martin Dworschak, Michael Hiesmayr
Apart from heart transplantation, implantation of a left ventricular assist device (LVAD) is the only established surgical treatment for therapy-refractory terminal left heart failure, The specific intensive care unit (ICU) management of these patients depends on the reason for the ICU admission and requires understanding of the characteristic hemodynamics of non-pulsatile LVADs as well as of the inherent problems. Knowledge about the specific features in hemodynamic monitoring, understanding of pump characteristics, management of anticoagulation and hemostasis and the handling of problems, such as right heart failure, aortic valve insufficiency and infections is essential...
September 2015: Medizinische Klinik, Intensivmedizin und Notfallmedizin
El Mehdi Moutaouekkil, Abdelmalek Najib, Rida Ajaja, Moha Arji, Anas Slaoui
BACKGROUND: Patients with the homozygous sickle cell disease have increased perioperative mortality. Some indications like heart valve surgery, may justify an exchange blood transfusion to reduce the proportion of hemoglobin S (HbS) and complications. SUBJECTS AND METHODS: We report two female cases aged 20 and 27, of African origin with homozygous sickle cell anemia who underwent heart valve surgery to treat mitral valve regurgitation. This presentation describes the perioperative considerations including anesthesia and postoperative care...
July 2015: Annals of Cardiac Anaesthesia
Johanna Larsson, Sofia Sutherland, Åsa Söderström, Christine Roman-Emanuel, Anders Jeppsson, Elisabeth Hansson Olofsson, Per-Arne Svensson
BACKGROUND: Bacterial mediastinitis is a severe complication after open heart surgery. The infection causes prolonged hospitalization and an increased mortality risk. Observations from orthopaedic surgery showed that the suction catheter used during surgery is commonly contaminated with bacteria. The aim of this study was to describe the prevalence of suction catheter contamination in cardiac surgery and to study if suction time influences the contamination risk. METHODS: Fifty suction catheter tips were collected during 25 aortic valve replacement operations...
2015: Patient Safety in Surgery
Frank Nestler, Andrew P Bradley, Stephen J Wilson, Daniel L Timms, O Howard Frazier, William E Cohn
Rotary blood pumps are emerging as a viable technology for total artificial hearts, and the development of physiological control algorithms is accelerated with new evaluation environments. In this article, we present a novel hybrid mock circulation loop (HMCL) designed specifically for evaluation of rotary total artificial hearts (rTAH). The rTAH is operated in the physical domain while all vasculature elements are embedded in the numerical domain, thus combining the strengths of both approaches: fast and easy exchange of the vasculature model together with improved controllability of the pump...
September 2014: Artificial Organs
Reinhold Hustert, Matthias Frisch, Alexander Böhm, Günther Pass
INTRODUCTION: In insects, the pumping of the dorsal heart causes circulation of hemolymph throughout the central body cavity, but not within the interior of long body appendages. Hemolymph exchange in these dead-end structures is accomplished by special flow-guiding structures and/or autonomous pulsatile organs ("auxiliary hearts"). In this paper accessory pulsatile organs for an insect ovipositor are described for the first time. We studied these organs in females of the cricket Acheta domesticus by analyzing their functional morphology, neuroanatomy and physiological control...
2014: Frontiers in Zoology
Kristaps Klavins, Dinh Binh Chu, Stephan Hann, Gunda Koellensperger
A mass spectrometric quantitative assay was developed for the analysis of 10 sugar phosphates in the yeast Pichia pastoris. As a novelty, two-dimensional chromatography based on a fully automated heart-cutting LC-LC technique was introduced. Using a ten-port valve, ten fractions of the first chromatographic dimension, i.e. anion exchange chromatography (AEC), were transferred and separated by the orthogonal second dimension, i.e. separation on porous graphitized carbon. The chromatographic separation on the second dimension was optimized for each transferred fraction minimizing the separation time and ensuring complete removal of the salt constituents of the AEC eluents...
March 21, 2014: Analyst
Lutz T Wasserthal
Respiration in insects is thought to be independent of the circulatory system because insects typically lack respiratory pigments and because oxygen transport occurs in the gaseous phase through a ramified tracheal system by diffusion and convection directly to the tissues. In the blowfly, as in other insects with periodic heartbeat reversal, the haemolymph is periodically shifted between the anterior body and abdomen, exerting alternating pressure changes on the compliant tracheae in the thorax and in the abdomen...
May 1, 2014: Journal of Experimental Biology
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