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https://www.readbyqxmd.com/read/29344382/advanced-therapies-for-the-management-of-adults-with-pulmonary-arterial-hypertension-due-to-congenital-heart-disease-a-systematic-review
#1
Daniel L Varela, Mohamed Teleb, Wael El-Mallah
Pulmonary arterial hypertension (PAH) secondary to congenital heart disease (CHD) is the third most common cause of PAH, and it is becoming increasingly common as improvements in the management of CHD have led to increased life expectancy for these patients. The medical management of PAH due to CHD (PAH-CHD) is largely the same as what has been used for the treatment of idiopathic PAH, though the body of literature supporting this management decision is very small. There are currently few studies available which specifically focus on the treatment of PAH-CHD...
2018: Open Heart
https://www.readbyqxmd.com/read/29295699/aortic-stenosis-aortic-regurgitation-and-arterial-hypertension
#2
V Katsi, G Georgiopoulos, D Oikonomou, C Aggeli, C Grassos, D P Papadopoulos, C Thomopoulos, M Marketou, K Dimitriadis, K Toutouzas, P Nihoyannopoulos, C Tsioufis, D Tousoulis
BACKGROUND: Hypertension (HT) is an important risk factor for cardiovascular disease and might precipitate pathology of the aortic valve. OBJECTIVE: To investigate the association of HT with aortic dysfunction (including both aortic regurgitation and stenosis) and the impact of antihypertensive treatment on the natural course of underlying aortic disease. METHODS: We performed a systematic review of the literature for all relevant articles assessing the correlation between HT and phenotype of aortic disease...
January 1, 2018: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/29260464/veno-arterial-extracorporeal-membrane-oxygenation-in-addition-to-primary-pci-in-patients-presenting-with-st-elevation-myocardial-infarction
#3
F S van den Brink, A D Magan, P G Noordzij, C Zivelonghi, P Agostoni, F D Eefting, J M Ten Berg, M J Suttorp, B R Rensing, J P van Kuijk, P Klein, E Scholten, J A S van der Heyden
INTRODUCTION: Primary percutaneous coronary intervention (pPCI) in ST-elevation myocardial infarction (STEMI) can cause great haemodynamic instability. Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) can provide haemodynamic support in patients with STEMI but data on outcome and complications are scarce. METHODS: An in-hospital registry was conducted enrolling all patients receiving VA-ECMO. Patients were analysed for medical history, mortality, neurological outcome, complications and coronary artery disease...
December 19, 2017: Netherlands Heart Journal
https://www.readbyqxmd.com/read/29248881/three-vessel-coronary-artery-aneurysmal-disease-complicated-by-multivessel-thrombosis-and-cardiogenic-shock-the-saving-role-of-intracoronary-thrombolysis
#4
Luis Pablo Roldan, Chris Rowan, Mark Sheldon, Carlos A Roldan
The benefit of intracoronary thrombolytics in ST-elevation myocardial infarction (STEMI) is not well established. Mainstays of STEMI management include intravenous thrombolytics, percutaneous coronary interventions and surgical revascularisation. However, in cases of STEMI secondary to coronary artery aneurysmal disease (CAAD), standard treatment options may not be suitable due to high thrombus burden, perioperative risk and factors unique to each patient. Thus, STEMI management in CAAD can represent a therapeutically challenging clinical scenario...
December 15, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29186485/indications-and-practical-approach-to-non-invasive-ventilation-in-acute-heart-failure
#5
Josep Masip, W Frank Peacock, Susanna Price, Louise Cullen, F Javier Martin-Sanchez, Petar Seferovic, Alan S Maisel, Oscar Miro, Gerasimos Filippatos, Christiaan Vrints, Michael Christ, Martin Cowie, Elke Platz, John McMurray, Salvatore DiSomma, Uwe Zeymer, Hector Bueno, Chris P Gale, Maddalena Lettino, Mucio Tavares, Frank Ruschitzka, Alexandre Mebazaa, Veli-Pekka Harjola, Christian Mueller
In acute heart failure (AHF) syndromes significant respiratory failure (RF) is essentially seen in patients with acute cardiogenic pulmonary oedema (ACPE) or cardiogenic shock (CS). Non-invasive ventilation (NIV), the application of positive intrathoracic pressure through an interface, has shown to be useful in the treatment of moderate to severe RF in several scenarios. There are two main modalities of NIV: continuous positive airway pressure (CPAP) and pressure support ventilation (NIPSV) with positive end expiratory pressure...
November 26, 2017: European Heart Journal
https://www.readbyqxmd.com/read/29156619/standard-vs-calorie-dense-immune-nutrition-in-haemodynamically-compromised-cardiac-patients-a-prospective-randomized-controlled-pilot-study
#6
Sergey Efremov, Vladimir Lomivorotov, Christian Stoppe, Anna Shilova, Vladimir Shmyrev, Michail Deryagin, Alexander Karaskov
BACKGROUND: The aim of study was to test the hypothesis that early enteral nutrition (EN) with calorie-dense and protein rich enteral formula improves enteral energy and protein delivery in critically ill cardiac patients. METHODS: Prospective randomized pilot study of 40 ventilated adult patients undergoing elective cardiac surgery with use of cardiopulmonary bypass receiving inotropic support postoperatively. Patients were to receive either standard isocaloric (1000 Kcal/L and 38 g/L protein) early EN (n = 20) or calorie-dense and protein-rich (1300 Kcal/L and 66...
November 20, 2017: Nutrients
https://www.readbyqxmd.com/read/29155934/controlled-flow-diversion-in-hybrid-venoarterial-venous-extracorporeal-membrane-oxygenation
#7
Mehmet Cakici, Fatih Gumus, Evren Ozcinar, Cagdas Baran, Onat Bermede, Mustafa Bahadir Inan, Mustafa Serkan Durdu, Mustafa Sirlak, Ahmet Ruchan Akar
OBJECTIVES: Patients on venoarterial or venovenous extracorporeal membrane oxygenation (ECMO) support may require venoarterial-venous (VAV-ECMO) configuration during follow-up. We report 12 cases of VAV-ECMO with significant outflow steal. METHODS: Between October 2014 and November 2016, a total of 97 patients (56.6 ± 12.0 years; 59 men/38 women; body surface area 1.84 ± 0.36 m 2 ) were supported with venoarterial ECMO ( n  = 85) or venovenous ECMO ( n  = 12)...
August 16, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29150237/-maternal-deaths-due-to-amniotic-fluid-embolism-results-from-the-french-confidential-enquiry-into-maternal-deaths-2010-2012
#8
E Morau, A Proust, J-C Ducloy
Amniotic fluid embolism (AFE) is an unpredictable, dreadful complication of pregnancy or childbirth. EA typically includes in the same lapse of time respiratory, haemodynamic, neurological and hemorrhagic symptoms (from early and severe coagulopathy). Immediate supportive treatment by a multidisciplinary team is the cornerstone of the management. Between 2010 an 2012 in France, 24 deaths were related to AFE giving a maternal mortality ratio of 1/100,000 live births (CI 95% 0.6-1.4). AFE ranks as the second leading cause of direct maternal death...
November 14, 2017: Gynecologie, Obstetrique, Fertilite & Senologie
https://www.readbyqxmd.com/read/29138449/haemodynamic-recovery-properties-of-the-torsioned-testicular-artery-lumen
#9
Selda Goktas, Ozlem Yalcin, Erhan Ermek, Senol Piskin, Can T Capraz, Yusuf O Cakmak, Kerem Pekkan
Testicular artery torsion (twisting) is one such severe vascular condition that leads spermatic cord injury. In this study, we investigate the recovery response of a torsioned ram testicular artery in an isolated organ-culture flow loop with clinically relevant twisting modes (90°, 180°, 270° and 360° angles). Quantitative optical coherence tomography technique was employed to track changes in the lumen diameter, wall thickness and the three-dimensional shape of the vessel in the physiological pressure range (10-50 mmHg)...
November 14, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29128166/right-ventricle-dysfunction-and-pre-implantation-vasopressors-in-refractory-ards-supported-by-vv-ecmo
#10
Chiara Lazzeri, Manuela Bonizzoli, Giovanni Cianchi, Stefano Batacchi, Cristiana Guetti, Morena Cozzolino, Pasquale Bernardo, Adriano Peris
BACKGROUND: Acute respiratory distress syndrome (ARDS) has been shown to be frequently associated with haemodynamic instability requiring the use of vasopressors. To date, there is still some uncertainty in the use of veno-venous Extracorporeal Membrane Oxygenation (VV-ECMO) in haemodynamically unstable ARDS patients. METHODS: We therefore assessed whether patients receiving pre ECMO vasopressors had a worse prognosis and, furthermore, we reviewed the factors associated with the use of pre ECMO vasopressors in 92 consecutive patients with refractory ARDS treated with VV-ECMO...
October 31, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29118115/computational-tools-for-clinical-support-a-multi-scale-compliant-model-for-haemodynamic-simulations-in-an-aortic-dissection-based-on-multi-modal-imaging-data
#11
Mirko Bonfanti, Stavroula Balabani, John P Greenwood, Sapna Puppala, Shervanthi Homer-Vanniasinkam, Vanessa Díaz-Zuccarini
Aortic dissection (AD) is a vascular condition with high morbidity and mortality rates. Computational fluid dynamics (CFD) can provide insight into the progression of AD and aid clinical decisions; however, oversimplified modelling assumptions and high computational cost compromise the accuracy of the information and impede clinical translation. To overcome these limitations, a patient-specific CFD multi-scale approach coupled to Windkessel boundary conditions and accounting for wall compliance was developed and used to study a patient with AD...
November 2017: Journal of the Royal Society, Interface
https://www.readbyqxmd.com/read/29101108/transthoracic-echocardiography-is-adequate-for-intraprocedural-guidance-of-transcatheter-aortic-valve-implantation
#12
Renuka Jain, Daniel P O'Hair, Tanvir K Bajwa, Denise Ignatowski, Daniel Harland, Amanda M Kirby, Tracy Hammonds, Suhail Q Allaqaband, Jonathan Kay, Bijoy K Khandheria
BACKGROUND: While transcatheter aortic valve implantation (TAVI) has traditionally been supported intraprocedurally by transoesophageal echocardiography (TOE), transthoracic echocardiography (TTE) is increasingly being used. We evaluated echocardiographic imaging characteristics and clinical outcomes in patients who underwent TTE during TAVI (TTE-TAVI). METHODS AND RESULTS: A select team of dedicated sonographers and interventional echocardiographers performed TTE-TAVI in 278 patients, all of whom underwent TAVI through transfemoral access...
December 2017: Echo Research and Practice
https://www.readbyqxmd.com/read/29084009/microvascular-reactivity-assessed-by-near-infrared-spectroscopy-and-a-vascular-occlusion-test-is-associated-with-patient-outcomes-following-cardiac-surgery-a-prospective-observational-study
#13
Ethan Butler, Sajeev Mahendran, John Nguyen, Anders Aneman
BACKGROUND: Microvascular dysfunction in patients admitted to the ICU following cardiac surgery may be related to perioperative complications and increased resource utilisation even in the presence of acceptable systemic haemodynamic variables. OBJECTIVES: To assess the relationship between microvascular impairment using peripheral near-infrared spectroscopy at ICU admission and 6 h postadmission and the duration of mechanical ventilatory support, length of stay in ICU and in hospital...
October 27, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29060624/sensitivity-study-on-modelling-a-flow-diverting-stent-as-a-porous-medium-using-computational-fluid-dynamics
#14
Yujie Li, Mingzi Zhang, David I Verrelli, William Yang, Winston Chong, Makoto Ohta, Yi Qian
The flow-diverting (FD) stent has become a commonly used endovascular device to treat cerebral aneurysms. This discourages blood from entering the aneurysm, thereby reducing the likelihood of aneurysm rupture. Using computational fluid dynamics (CFD) to simulate the aneurysmal haemodynamics after FD treatment could help clinicians predict the stent effectiveness prior to the real procedure in the patient. As an alternative to modelling the stent as a fine wire mesh, modelling the FD stent as a porous medium was established to save computational time, and has also been proved capable of predicting the same haemodynamics as obtained using the real FD stent geometry...
July 2017: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/29056259/relationship-between-left-ventricle-position-and-haemodynamic-parameters-during-cardiopulmonary-resuscitation-in-a-pig-model
#15
Yong Hun Jung, Kyung Woon Jeung, Dong Hun Lee, Young Won Jeong, Sung Min Lee, Byung Kook Lee, In Seok Jeong, Sang-Kwon Lee, Jihye Choi
BACKGROUND: From the viewpoint of cardiac pump theory, the area of the left ventricle (LV) subjected to compression increases as the LV lies closer to the sternum, possibly resulting in higher blood flow in patients with LV closer to the sternum. However, no study has evaluated LV position during cardiac arrest or its relationship with haemodynamic parameters during cardiopulmonary resuscitation (CPR). The objectives of this study were to determine whether the position of the LV relative to the anterior-posterior axis representing the direction of chest compression shifts during cardiac arrest and to examine the relationship between LV position and haemodynamic parameters during CPR...
September 24, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29049673/incidence-and-echocardiographic-predictors-of-early-postoperative-right-ventricular-dysfunction-following-left-ventricular-assist-implantation-in-paediatric-patients
#16
Mathias Redlin, Oliver Miera, Helmut Habazettl, Joachim Photiadis, María Irene Carísimo-Cresta, Mathias Hommel, Benjamin O'Brien, Marian Kukucka
OBJECTIVES: Left ventricular assist device implantation is an established therapy for paediatric patients with end-stage heart failure. Early right ventricular dysfunction (RVD) after implantation still remains a challenge in the postoperative period. This study sought to determine the incidence of RVD and to identify echocardiographic predictors of RVD in paediatric patients, as well describing associated clinical outcome. METHODS: Prospectively collected preoperative echocardiographic, haemodynamic, demographic and biochemical data from 48 patients scheduled for left ventricular assist device implantation were evaluated...
July 31, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29045747/extracorporeal-membrane-oxygenation-support-for-right-ventricular-failure-after-left-ventricular-assist-device-implantation
#17
Julia Riebandt, Thomas Haberl, Dominik Wiedemann, R Moayedifar, Thomas Schloeglhofer, Stéphane Mahr, Kamen Dimitrov, Philipp Angleitner, Guenther Laufer, Daniel Zimpfer
OBJECTIVES: Right ventricular (RV) failure complicating left ventricular assist device implantation is associated with increased mortality. Despite a lack of supporting evidence, venoarterial extracorporeal membrane oxygenation (ECMO) support is increasingly being used as an alternative to traditional temporary RV support. We report our institutional experience with ECMO-facilitated RV support after left ventricular assist device implantation. METHODS: We retrospectively reviewed the concept of temporary ECMO support for perioperative RV failure in 32 consecutive left ventricular assist device (mean age 52 ± 14 years; male 84...
October 16, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29016778/comparison-between-endocardial-and-epicardial-cardiac-resynchronization-in-an-experimental-model-of-non-ischaemic-cardiomyopathy
#18
Gerard Amorós-Figueras, Esther Jorge, Silvia Raga, Concepcion Alonso-Martin, Enrique Rodríguez-Font, Victor Bazan, Xavier Viñolas, Juan Cinca, Jose M Guerra
Aims: Pacing from the left ventricular (LV) endocardium might increase the likelihood of response to cardiac resynchronization therapy. However, experimental and clinical data supporting this assumption are limited and controversial. The aim of this study was to compare the acute response of biventricular pacing from the LV epicardium and endocardium in a swine non-ischaemic cardiomyopathy (NICM) model of dyssynchrony. Methods and results: A NICM was induced in six swine by 3 weeks of rapid ventricular pacing...
July 17, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28962495/is-there-a-role-for-upper-extremity-intra-aortic-balloon-counterpulsation-as-a-bridge-to-recovery-or-a-bridge-to-transplant-in-the-treatment-of-end-stage-heart-failure
#19
Nnamdi Nwaejike, Andre Y Son, Carmelo A Milano, Mani A Daneshmand
A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was: Is there a role for upper-extremity intra-aortic balloon pump counterpulsation (UE-IABP) in the treatment of end-stage heart failure? Altogether 230 papers were found using the reported search, of which 6 papers represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated...
October 1, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28959494/arterial-stiffness-and-stroke-de-stiffening-strategy-a-therapeutic-target-for-stroke
#20
Yajing Chen, Fanxia Shen, Jianrong Liu, Guo-Yuan Yang
Stroke is the second leading cause of mortality and morbidity worldwide. Early intervention is of great importance in reducing disease burden. Since the conventional risk factors cannot fully account for the pathogenesis of stroke, it is extremely important to detect useful biomarkers of the vascular disorder for appropriate intervention. Arterial stiffness, a newly recognised reliable feature of arterial structure and function, is demonstrated to be associated with stroke onset and serve as an independent predictor of stroke incidence and poststroke functional outcomes...
June 2017: Stroke and Vascular Neurology
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