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Heart surgery

Mehrdad Namdari, Ali Eatemadi
Heart valves are currently under thorough investigation in tissue engineering (TE) research. Mechanical and biological heart valve prostheses which are recently used have several shortcomings. While allogenic and xenogenic biological prostheses are related to graft rejection, degeneration and thrombosis, resulting in a high rate of reoperation. Mechanical prostheses on the other hand are based on metallic, carbon, and polymeric components, and require continuous treatment with anticoagulant, which result in adverse reactions, e...
October 22, 2016: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
Xiang-Yang Fang, Zhe Chen, Guo-Bin Miao, Lin Zhang
β-adrenergic receptors (β-ARs) and anti-β1-AR autoantibodies play important roles in heart failure. This study was designed to investigate the expression of β1- and β2-ARs in the lungs, and their relevance to the corresponding autoantibodies in an aged rat model of heart failure. In addition, we investigated the association between anti-β-AR autoantibody and soluble Fas (sFas) and soluble Fas ligand (sFasL). Aged male Wistar rats were divided into the sham-operated control group and the heart failure group...
October 24, 2016: International Journal of Molecular Medicine
Pierre Bou-Khalil, Salah Zeineldine, Robert Chatburn, Chakib Ayyoub, Farouk Elkhatib, Imad Bou-Akl, Mohamad El-Khatib
Simple and accurate expressions describing the PaO2-FiO2 relationship in mechanically ventilated patients are lacking. The current study aims to validate a novel mathematical expression for accurate prediction of the fraction of inspired oxygen that will result in a targeted arterial oxygen tension in non-smoking and smoking patients receiving mechanical ventilation following open heart surgeries. One hundred PaO2-FiO2 data pairs were obtained from 25 non-smoking patients mechanically ventilated following open heart surgeries...
October 24, 2016: Journal of Clinical Monitoring and Computing
Bobby Yanagawa, Gosta B Pettersson, Gilbert Habib, Marc Ruel, Gustavo Saposnik, David A Latter, Subodh Verma
There has been an overall improvement in surgical mortality for patients with infective endocarditis (IE), presumably because of improved diagnosis and management, centered around a more aggressive early surgical approach. Surgery is currently performed in approximately half of all cases of IE. Improved survival in surgery-treated patients is correlated with a reduction in heart failure and the prevention of embolic sequelae. It is reported that between 20% and 40% of patients with IE present with stroke or other neurological conditions...
October 25, 2016: Circulation
Richard G Ohye, Dietmar Schranz, Yves D'Udekem
Universally fatal only 4 decades ago, the progress in the 3-stage palliation of hypoplastic left heart syndrome and related single right ventricular lesions has drastically improved the outlook for these patients. Although the stage II operation (hemi-Fontan or bidirectional Glenn) and stage III Fontan procedure have evolved into relatively low-risk operations, the stage I Norwood procedure remains one of the highest-risk and costliest common operations performed in congenital heart surgery. Yet, despite this fact, experienced centers now report hospital survivals of >90% for the Norwood procedure...
October 25, 2016: Circulation
Ruggero De Paulis, Salvatore D'Aleo, Alessandro Bellisario, Andrea Salica, Luca P Weltert, Raffaele Scaffa, Lorenzo Guerrieri Wolf, Daniele Maselli, Michele Di Mauro
BACKGROUND: Structural valve deterioration (SVD) is the Achilles' heel of bioprostheses. Its correlation with younger age is well known. In recent years we exclusively reserved use of small-size Mitroflow valve prostheses (LivaNova, London, United Kingdom) to an older patient population with small aortic annuli. This study aimed to assess the incidence of SVD and its effect on patient survival and need for reoperation. MATERIALS AND METHODS: Two hundred five patients (aged 75...
September 28, 2016: Journal of Thoracic and Cardiovascular Surgery
Martin Eisenberger, Alan Bulava, Josef Kautzner, Petr Neuzil, Ales Mokracek, Jiri Hanis, Ladislav Dusek
BACKGROUND: Atrial fibrillation is common in patients with structural heart disease who are undergoing cardiac surgery. Surgical CryoMaze has been shown to be an effective treatment in several trials, but success rates have varied considerably, between 47-95 %. The sequential hybrid approach, combining surgical CryoMaze followed by radiofrequency catheter ablation, can achieve high freedom from atrial arrhythmias, even when rigorous methods to detect arrhythmias after the procedure are used...
October 24, 2016: Trials
R-C Zhao, W Han, J Han, J Yu, J Guo, J-L Fu, Z Li, R-Z Zhao
OBJECTIVE: To study the efficacy and safety of radiofrequency catheter ablation (RFCA) in patients with different forms of atrial fibrillation. PATIENTS AND METHODS: By retrospective analysis, we summarize 720 cases, where patients diagnosed with atrial fibrillation in our hospital were treated with RFCA from February 2010 to October 2014. Among the cases, 425 were diagnosed with paroxysmal atrial fibrillation and 295 with non-paroxysmal atrial fibrillation (including persistent atrial fibrillation and permanent atrial fibrillation)...
October 2016: European Review for Medical and Pharmacological Sciences
Alexander J Sweidan, Navneet K Singh, Natasha Dang, Vinh Lam, Jyoti Datta
INTRODUCTION: Amiodarone is often used in the suppression of tachyarrhythmias. One of the more serious adverse effects includes amiodarone pulmonary toxicity (APT). Several pulmonary diseases can manifest including interstitial pneumonitis, organizing pneumonia, acute respiratory distress syndrome, diffuse alveolar hemorrhage, pulmonary nodules or masses, and pleural effusion. Incidence of APT varies from 5-15% and is correlated to dosage, age of the patient, and preexisting lung disease...
2016: Clinical Medicine Insights. Case Reports
Francesco Nappi, Cristiano Spadaccio, Antonio Nenna, Mario Lusini, Massimiliano Fraldi, Christophe Acar, Massimo Chello
OBJECTIVE: The symmetry of mitral valve tethering and regional left ventricle wall dysfunction are reported to play a fundamental role in the outcomes and long-term durability of surgical repair in ischemic mitral regurgitation (IMR). We recently demonstrated in a randomized clinical trial (the Papillary Muscle Approximation trial) the superiority of papillary muscle approximation (PMA) in combination with standard restrictive annuloplasty (RA) in severe IMR over annuloplasty alone in terms of adverse left ventricular remodeling and mitral regurgitation (MR) recurrence...
September 24, 2016: Journal of Thoracic and Cardiovascular Surgery
Suresh V Joshi, Abhijeet V Naik, Parag S Bhalgat, Bhushan Chavan, Prasanna Salvi
BACKGROUND: Anomalous origin of left coronary artery from pulmonary artery is a very rare disease with incidence of one every 300,000 live births. It has a high mortality of 80% in the first year of life. This observational study summarized our experience using the technique of subclavian arterial bypass without the use of cardiopulmonary bypass (CPB) for treatment of this coronary anomaly in pediatric population. The study aims to revive an earlier technique, with modifications, as an alternative to the existing coronary translocation...
September 2016: Indian Heart Journal
Akshay Gupta, Rajat Kalra, Reena Khantwal Joshi, Neeraj Aggarwal, Mridul Aggarwal, Rakesh Pandey, Raja Joshi
Parachute valve is the malformation of an atrioventricular valve in which the tension apparatus springs from a single papillary muscle or group of muscles. Parachute tricuspid valve is a rare anomaly with no surgically repaired case to date. We describe a case of parachute deformity of the tricuspid valve leading to hemodynamically significant severe tricuspid stenosis. The present case was successfully repaired surgically along with atrial septal defect (ASD) and ventricular septal defect (VSD) closure.
November 2016: Annals of Thoracic Surgery
Robert Kramer, Reed Quinn, Agneta Odera, Robert Groom, Nancy Boulanger, Eric Gunnoe, Russell White
Cardiac surgeons traveling to East Africa on humanitarian surgical missions treat a large number of people of all ages with rheumatic heart disease. A patient with severe mitral stenosis with pulmonary edema in the second trimester of pregnancy was treated successfully with closed mitral commissurotomy in a hospital in rural Kenya. An operation from the late 1940s may regain prominence more than 70 years later in areas of the world with a high incidence of rheumatic heart disease and limited cardiology and cardiac surgery resources...
November 2016: Annals of Thoracic Surgery
John-Peder Escobar Kvitting, Odd R Geiran
In 1977, Karl Viktor Hall implanted a novel tilting disc heart valve prosthesis at Rikshospitalet in Oslo, Norway. The Medtronic-Hall valve was known for its excellent durability and low thrombogenicity. Hall popularized the use of the great saphenous vein in situ as an arterial shunt in the 1960s, made a metal stripper to lyse vein valves, and introduced electromagnetic flowmeters in vascular surgery. He performed the first coronary artery bypass graft in Scandinavia in 1969. Under his leadership the first heart transplantation and the first heart-lung transplantation were performed in Scandinavia by his successor Tor Frøysaker in 1983 and 1986, respectively...
November 2016: Annals of Thoracic Surgery
G Fenna van Breda, Lennart G Bongartz, Wenqing Zhuang, Rachel P L van Swelm, Jeanne Pertijs, Branko Braam, Maarten-Jan Cramer, Dorine W Swinkels, Pieter A Doevendans, Marianne C Verhaar, Roos Masereeuw, Jaap A Joles, Carlo A J M Gaillard
BACKGROUND: Hepcidin regulates systemic iron homeostasis by downregulating the iron exporter ferroportin. Circulating hepcidin is mainly derived from the liver but hepcidin is also produced in the heart. We studied the differential and local regulation of hepcidin gene expression in response to myocardial infarction (MI) and/or chronic kidney disease (CKD). We hypothesized that cardiac hepcidin gene expression is induced by and regulated to severity of cardiac injury, either through direct (MI) or remote (CKD) stimuli, as well as through increased local iron content...
October 22, 2016: American Journal of Nephrology
YeongHo Choi, Yu Jin Lee, Sang Do Shin, Kyoung Jun Song, KyungWon Lee, Eui Jung Lee, Yu Jin Kim, Ki Ok Ahn, Ki Jeong Hong, Young Sun Ro
BACKGROUND: Timely transfer and percutaneous coronary intervention (PCI) with or without thrombolysis are recommended by the American Heart Association (AHA) to care for ST-segment elevation myocardial infarction (STEMI) patients who present first to a non-PCI-capable hospital. This study was to evaluate the impact on in-hospital mortality of the compliance with guidelines regarding to the time of PCI for patients with STEMI who were transferred to a capable PCI hospital. METHODS: We used the CArdioVAscular disease Surveillance data from November 2007 to December 2012 for this study...
September 16, 2016: American Journal of Emergency Medicine
Péter Farkas, Dorottya Csuka, Bálint Mikes, György Sinkovits, Marienn Réti, Endre Németh, Kristóf Rácz, Krisztina Madách, Mihály Gergely, Judit Demeter, Zoltán Prohászka
BACKGROUND: The secondary forms of hemolytic uremic syndrome/thrombotic thrombocytopenic purpura (secondary TMA) emerge as complications of coexisting diseases. OBJECTIVES: We hypothesized that secondary TMA could be characterized by the presence of relative ADAMTS13 deficiency and complement activation, and this relationship may have a prognostic value for outcome. PATIENTS AND METHODS: Fifty-three patients with thrombotic microangiopathy (TMA) and coexisting disease (such as malignancies, sepsis, heart surgery with extracorporeal circulation, solid organ transplantation, systemic autoimmune disorders), 41 patient controls, and 34 healthy controls were enrolled in our case-control study with 30days follow-up...
October 18, 2016: Immunobiology
S Pscherer, A Nüssler, C Bahrs, M Reumann, C Ihle, U Stöckle, S Ehnert, T Freude, B G Ochs, I Flesch, P Ziegler
Background: The increasing incidence of diabetes mellitus is also reflected in the patient population of a trauma and orthopaedic centre. Diabetics also exhibit more comorbidities than non-diabetics. In addition to surgical problems in these patients, hospitalisation is often accompanied by complications, which can prolong treatment and increase costs. The aim of this retrospective study is to analyse hospitalisation of diabetics compared to non-diabetics, as well as differences in treatment costs, depending on associated age and comorbidities...
October 21, 2016: Zeitschrift Für Orthopädie und Unfallchirurgie
Daniel Verdini, Daniel Vargas, Anderson Kuo, Brian Ghoshhajra, Phillip Kim, Horacio Murillo, Jacobo Kirsch, Michael Lane, Carlos Restrepo
PURPOSE: Coronary-pulmonary arterial fistulas (CPAFs) are rare coronary artery anomalies that have been described only in limited case reports. This study aims to evaluate the clinical presentation and imaging findings of CPAFs collected from 6 participating medical centers along with CPAFs reported in the literature, to discern any general trends present in CPAFs. MATERIALS AND METHODS: A total of 25 cases of CPAF diagnosed by coronary computed tomography angiography were collected across 6 participating institutions...
November 2016: Journal of Thoracic Imaging
Walter H Reinhart
The hematocrit (Hct) determines the oxygen carrying capacity of blood, but also increases blood viscosity and thus flow resistance. From this dual role the concept of an optimum Hct for tissue oxygenation has been derived. Viscometric studies using the ratio Hct/blood viscosity at high shear rate showed an optimum Hct of 50-60% for red blood cell (RBC) suspensions in plasma. For the perfusion of an artificial microvascular network with 5-70μm channels the optimum Hct was 60-70% for high driving pressures. With lower shear rates or driving pressures the optimum Hct shifted towards lower values...
October 21, 2016: Clinical Hemorheology and Microcirculation
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