28 research outputs found
Intramyocardial administration of autologous bone marrow mononuclear cells in a critically ill child with dilated cardiomyopathy
No full textAbstractAlmost half of the children with symptomatic dilated cardiomyopathy receive a transplant or die within 2 years; however, cardiac stem cell transplantation has become a promising therapeutic option. The present case demonstrates for the first time, to our knowledge, the intramyocardial administration of autologous bone marrow mononuclear cells in a critically ill 4-month-old child with severe dilated cardiomyopathy. Left ventricular ejection fraction increased from 20% before stem cell transplantation to 41% at 4 months of follow-up.</jats:p
Stem cell therapy as one of temporary measures for management of heart failure and pulmonary hypertension in children
No full textFavourable results of experimental studies on animals and several conditions in adult population indicate that bone marrow derived progenitor stem cell (BMPSC) transplantation may play a crucial role. Nevertheless, little is known about possible implementation of the BMPSC transplantation in children, dilated cardiomyopathy and pulmonary hypertension in particular. An increasing understanding of the nature and processes of idiopathic dilated cardiomyopathy and pulmonary arterial hypertension in children, as well as the limited treatment options have led our research towards the use of stem cell transplantation in the management of these patients. We performed intramyocardial BMPSC transplantation in 6 patients (4 months to 17 years) with dilated cardiomyopathy. All patients underwent complete detailed examination before and after the procedure. All patients demonstrated an increase in LVEF and degree of shortening of the left ventricular diameter between end-diastole and end-systole after the procedure. A decreased concentration of natriuretic peptide or LVDd on 2D and 3D echocardiography was observed in 5 and 3 of the 6 patients respectively. Intrapulmonary BMPSC transplantation was performed in two patients (9 and 15 years old) with severe pulmonary hypertension due to uncorrected large ventricular septal defects. Both patients showed improvement in lungs’ vascularization. No serious periprocedural side effects were observed. If applied wisely, the stem cell therapy appears to be a safe and effective way for stabilization of critically ill patients with both severe pulmonary hypertension and idiopathic cardiomyopathy
Stem cell therapy as one of temporary measures for management of heart failure and pulmonary hypertension in children
No full textFavourable results of experimental studies on animals and several conditions in adult population indicate that bone marrow derived progenitor stem cell (BMPSC) transplantation may play a crucial role. Nevertheless, little is known about possible implementation of the BMPSC transplantation in children, dilated cardiomyopathy and pulmonary hypertension in particular. An increasing understanding of the nature and processes of idiopathic dilated cardiomyopathy and pulmonary arterial hypertension in children, as well as the limited treatment options have led our research towards the use of stem cell transplantation in the management of these patients. We performed intramyocardial BMPSC transplantation in 6 patients (4 months to 17 years) with dilated cardiomyopathy. All patients underwent complete detailed examination before and after the procedure. All patients demonstrated an increase in LVEF and degree of shortening of the left ventricular diameter between end-diastole and end-systole after the procedure. A decreased concentration of natriuretic peptide or LVDd on 2D and 3D echocardiography was observed in 5 and 3 of the 6 patients respectively. Intrapulmonary BMPSC transplantation was performed in two patients (9 and 15 years old) with severe pulmonary hypertension due to uncorrected large ventricular septal defects. Both patients showed improvement in lungs’ vascularization. No serious periprocedural side effects were observed. If applied wisely, the stem cell therapy appears to be a safe and effective way for stabilization of critically ill patients with both severe pulmonary hypertension and idiopathic cardiomyopathy.</p
Primary Cardiac Tumours in Infancy and Youth in the Small Population: a Seven Year Review
No full textPrimary Cardiac Tumours in Infancy and Youth in the Small Population: a Seven Year Review
Introduction. Primary tumours of the heart are rare in fetuses, neonates and children; the incidence varies from 0.003% - 0.08% (4, 6, 9, 10) up to 0.2% in children referred for cardiac examination (3, 15). Rhabdomyoma is the most common cardiac tumour during fetal life (60-75%). Teratoma is less common (14 to 19%) with fibroma, myxoma, hemangioma also being described (3, 4, 6, 10, 16, and 18). Multiple rhabdomyomas are associated with tuberous sclerosis in up to 90-95% of cases (3, 4, 5, 6, 10, 12, and 16). No previous study was done on this topic in Latvia so our aim was to determine the incidence, the course and the outcome of primary cardiac tumours in children in our small population. Aim of the study. The aim of our study was to determine the incidence of primary cardiac tumours in our paediatric population, to investigate the nature of the pathology, the course and the outcome of the disease in childhood in Latvia and to compare our results with data from the international literature. Materials and methods. We reviewed retrospectively the clinical, echocardiographic, operative, histological and follow-up data on 17 cases of a primary heart tumours detected within the period of January 1, 2000 till December 31, 2006 in the Clinic for Pediatric Cardiology and Cardiac Surgery of the University Children's Hospital in Riga, Latvia. Results. the incidence of primary heart tumours in the paediatric population in Latvia is 2.4+/-1.4 cases per year. 94% (16) of the primary cardiac tumours in children were benign and 6% (1) malignant. Radical excision performed in all 7 cases of surgical treatment. Rhabdomyomas comprise 47% (n=8) of all the benign tumours with tuberous sclerosis present in 88% of the cases. Conclusions. Most primary cardiac fetal tumours tend to appear in the third trimester of pregnancy, a normal early fetal scan might not rule out cardiac tumours. Relatively often (29% of the cases) the cardiac tumours were an incidental finding. The localization, number and visual appearance of the tumours in echocardiography was indicative of the type of tumour. 41% of the patients with primary cardiac tumours were in need of urgent surgical treatment. Almost all benign primary cardiac tumours were not the cause of death and with the exception of tuberous sclerosis there is good overall prognosis, in the case of malignant primary cardiac tumour the prognosis is poor.</jats:p
Comparision of Biomechanical Properties of Two Synthetic Biomaterials for VSD Closure
No full textVentricular septal defect (VSD) is most common
congenital heart disease (15-20%) [Hoffman, 2002]
and about 70% of these are perimembranous
(PmVSD). The traditional treatment, if necessary, is
surgical repair - VSD closure using the autologous
pericardium or synthetic material such as
polytetrafluorethylene (PTFE). There are two types
that are commonly in use - GORE TEX
Cardiovascular patch (GRTX) and BARD Edwards
Outflow Tract Fabric knitted PTFE (BARD).
Polytetrafluorethylene (PTFE) polymers are
successfully used to repair as large diameter VSD
and small VSD as well.
For surgical operation there are usually used
synthetic patch, uninterrupted (continuous) and
interrupted suture technique, and transatrial access
with cardiopulmonary bypass, cardioplegia in aortic
root and local myocardial hypothermia
Most patients undergo the operation in the first year
of life6, therefore the structure of the myocardial
tissues is more soft in contrast with age two or more
years old child tissues characteristics, concerning
the used material for VSD closure. At the moment
of exposure of VSD, considering localization, size
and shape of the VSD, we make a decision, which
material is more suitable in certain case. We
suspect that knitted material (BARD) would be
more appropriate to be with greater accordance to
myocardial tissues and it has the advantage of
making less myocardial and conduction tissue
trauma and being more fitted for good shaping of
VSD patch to avoid residual defects. [Stark, 1986].
The goal of this research was to investigate the
biomechanical properties of two synthetic
materials, such as the PTFE material patches -
GRTX and BARD in vitro, and compare the main
biomechanical parameter of these materials
Biomechanical Properties and Resistens to Proteolytic Degradation of Glutaraldehyde Treated Human Pericardium
No full textPericardium is commonly used for repair of
congenital heart defects [Paez, 1999]. Autologous
pericardium can be used in its fresh non-treated
state, or after chemical fixation with glutaraldehyde
solution as a biomaterial for surgical repair of
congenital heart anomalies. However, there are not
many studies about changes of biomechanical
properties of human pericardium after treating with
glutaraldehyde. Influence of different concentration
and exposition time of glutaraldehyde on resistance
of human pericardium to proteolytic degradation
needs further investigations. [Vincentelli, 1998,
Stacchino, 1998] The aim of this experimental
study is to investigate changes of biomechanical
properties and resistance to proteolytic degradation
of human pericardium, which was used as patch
material for congenital heart surgery, after
harvesting and treatment with glutaraldehyde
solution
Comparison of Solar and Other Influences on Long-term Climate
No full textExamples are shown of climate variability, and unforced climate fluctuations are discussed, as evidenced in both model simulations and observations. Then the author compares different global climate forcings, a comparison which by itself has significant implications. Finally, the author discusses a new climate simulation for the 1980s and 1990s which incorporates the principal known global climate forcings. The results indicate a likelihood of rapid global warming in the early 1990s
ARCHIVES OF THE RUSSIAN FEDERATION CONCERNING HISTORY OF THE MOSCOW INSTITUTE OF NATIONAL ECONOMY
No full textOn the basis of source analysis of archive documents the author studies work of the Moscow Plekhanov Institute of National Economy during the most difficult period of institution history and history of Russian higher education in general, i. e. the pre-war time from mid- late- 1930s of the 20th century. He raises the question of the faculty and employees functioning as well as the institution management, its directors M. I. Lacis, A. K. Abolin, A. V. Morozov. The author points out the necessity to highlight contribution of the Plekhanov Russian University of Economics academics to the process of establishing and developing the Russian state system, public, political and cultural life of the country at various stages of its history
The Metabolic Changes in Fresh Versus Old Stored Blood Used in Priming of Extracorporeal Circuit in Cardiopulmonary Bypass for Pediatric Patients - First Results
No full textThe Metabolic Changes in Fresh Versus Old Stored Blood Used in Priming of Extracorporeal Circuit in Cardiopulmonary Bypass for Pediatric Patients - First Results
Introduction. One of the main goal in modern pediatric bypass equipment is to reduce the size of the extracorporeal circuit in order to minimize the prime volume. High priming volume can produce a low hematocrit on CPB in small infants, which results in electrolyte imbalance and decreased tissue oxygenation, therefore the donor blood should be used in the prime. The use of donor blood itself has several disadvantages, including complement activation, induction of a transfusion reaction, infusion of lactate, glucose and potassium, therefore this should be avoided as much as possible. When blood is stored, many alterations occur in its constinuents, in particular an increase in potassium and lactate levels, and decrease in pH, which have been associated with severe complications. Aim of the study. To evaluate the effect of length of storage of packed red blood cells (PRBC) on the concentration of potassium, sodium, lactate, glucose and pH in PRBC used in pediatric cardiac surgery. Materials and methods. From October, 2006 until June, 2009 blood samples were drawn from 78 PRBC used in cardiopulmonary bypass before they were added to the priming solution. All PRBC were splited in two groups depending on the age of blood: 5 days ≥ (Group 1), n=44 and 5 days< (Group 2), n=34. Blood samples were analyzed by GEM PREMIER 3000. Results. Seventy eight PRBC used in pediatric cardiac surgery were included in the study. In 44 blood samples the age of PRBC was under 5 days (Group 1) and in 34 blood samples the age of PRBC was over 5 days (Group 2). The mean storage time of PRBC in Group 1 was 4 +/- 1 days and in Group 2 - 8 +/- 3. The pH value in Group 1 was higher than in Group 2 (6.7 +/- 0.1 vs 6.5 +/- 0.2, P=0.000859). There was a significant difference between both groups in terms of potassium level (6.1 +/- 1.8 vs 9.4 +/- 2.6, P <0.0001) and lactate level (7.2 +/- 1.4 vs 10.1 +/- 1.7, P <0.0001), but no significant difference in terms of sodium level (138.3 +/- 3.9 vs 135.6 +/- 4.7, P=0.056688) and glucose level (346.5 +/- 36.1 vs 336.3 +/- 50.7, P=0.509321). There was an intermediate correlation in both groups in terms of storage time and level of potassium, storage time and level of lactate, pH and level of potassium, pH and level of lactate, and the levels of potassium and lactate. There was a linear increase in the levels of potassium and lactate depending on the storage age of PRBC. Conclusions. It is absolutely crucial to use as fresh packed red blood cells as possible in pediatric cardiac surgery to avoid such unexpected complications as transfusion-induced cardiac arrest due to hyperkalaemia. There are also other metabolic changes such as hyperlactemia and low pH, should be avoided, when performing pediatric cardiopulmonary bypass. The research is going to be continued, possibly starting to evaluate the levels of potassium and acid-base balance, when circulating the priming solution for some time before the initiation of cardiopulmonary bypass.</jats:p
Modified Senning Operation in the Treatment of Transposition of The Great Arteries
No full textModified Senning Operation in the Treatment of Transposition of The Great Arteries
The arterial switch operation has become the procedure of choice for patients with transposition of the great arteries(TGA) in most medical centres. Although atrial switching may occasionally be employed in some centres in cases with delayed diagnosis, pulmonary hypertension and some other unusual entities. We preferred to use the atrial switch operation - modified Senning procedure for 6 years 6 months old boy with TGA, small atrial septal defect (ASD) and patent ductus arteriosus (PDA).</jats:p
