1,721,155 research outputs found
Commentary: Left ventricular assist device infection: Welcome to Babel!
No full textHeart failure affects 6.5 million adults in the United States. Since heart transplantation is limited by an organ shortage, durable mechanical circulatory support has rapidly evolved, Although we have made technological improvements to mechanical circulatory support over the years, providing today a 1-year survival at of 81%,1 infection remains the cation, contributing to major morbidity and mortality postLVAD. Infections may occur in 19% to 39% of recipients, resulting in more than 10% of LVAD-related deaths.2 Driveline infection is confirmed to be the most common However, these numbers have to be managed with care, and any comparison in terms of prevalence, outcome, and management may be inapplicable, given that there is a sues of the research in this field
Cor-Knot automated fastener to facilitate Corex aortic valve bypass implantation
No full textHerein we describe the use of an automated suture fastener (Cor-Knot), recently proposed for valvular surgery, in cases of aortic valve bypass with a Correx apical connector. This surgical option aims to control suture tension, avoid muscular tears, and standardize and simplify the implantation technique. We report the first 5 cases operated on using the new suturing technique
Intraoperative graft verification in coronary surgery
No full textTransit-time flow measurement (TTFM) is a reliable method to check the graft function intraoperatively in coronary surgery. The given parameters are: Mean Graft Flow (MGF); Pulsatility Index (PI) and Insufficiency Ratio (%BF). Some cutoffs of these parameters have been identified as predictors for unfair 1-y clinical outcome: mean graft flow (MGF) less than 20 ml/min and high pulsatility index greater than 5. Other cutoffs have been found as related to postoperative angiography: MGF 15 ml/min or less and pulsatility index at least 3 (sensitivity 94%; specificity 61%); MGF less than 15 ml/min and pulsatility index greater than 3 for left coronary artery or pulsatility index greater than 5 for right coronary artery (sensitivity 96%; specificity 77%); MGF 15 ml/min or less and pulsatility index at least 5.1 left coronary artery (sensitivity 98%; specificity 26%). Hence, with the need to improve the diagnostic accuracy of TTFM, a high-resolution epicardic coronary ultrasound module has been added to graft flow evaluation providing 2D ultrasound imaging (either in short-axis or long-axis) and color-flow mapping, allowing an accurate morphological evaluation of body graft and anastomosis. An intraoperative method aimed to verify coronary grafts should be easy to handle, not time consuming, minimally invasive, easily meaningful and relatively cheap; in addition, it should offer objective parameters more than qualitative criteria. We herein report the results of our experience with intraoperative graft verification with TTFM and high-resolution imaging along with a systematic review of the literature in this field with the aim to provide a road map to be followed
A Novel Technique to Reconstruct Tricuspid Valve Anterior Leaflet in Massive Endocarditis
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Development of a Miniaturized and Selective Impedance Sensor for Real-Time Slime Monitoring in Pipes and Tanks
No full textA novel impedance sensor for monitoring the thickness of undesired micrometric deposits on the surfaces of water pipes and tanks is presented. Coplanar 10 μm-spaced gold microelectrodes were fouled in controlled laboratory conditions and the influence of slime on impedance response was measured. Two different sets of experiments were conducted to form slime on the electrodes surface, addressing biofilm growth and calcium carbonate precipitation, respectively. Following the formation, the thickness of the slime was characterized by Atomic Force Microscopy. Experimental tests highlighted that the impedance response is linear with to the thickness of the slime in both cases, in a 2 μm to 10 μm range. Interestingly, the slope of the response (i.e. of the ionic resistance change vs. thickness) is opposite: a decrease in the case of biofilm (-0.6 Ω/μm where the conductivity of the extracellular matrix becomes dominant) and an increase (+1.4 Ω/μm) in the case of inorganic deposits. In conclusion, this simple and robust sensor provides an accurate and selective determination of slime, while fouling and cleaning up cycles have demonstrated the possibility of regeneration. The final goal for the microsensor, once coupled to an electronic system for data processing and transmission, is the installation along the inner surface of pipes and tanks for real-time remote monitoring of long-term formation of slime with sub-micrometric thickness resolution
The role of bariatric surgery for improvement of hypertension in obese patients: A retrospective study
No full textObjective: Evaluate if bariatric surgery can improve hypertension (HPT) control leading to both reduction of blood pressure values and antihypertensive therapy withdrawal. Methods: Eight-hundred and sixty-four consecutive patients who referred to our hospital, from March 2001 to February 2011, because of morbid obesity were initially enrolled in this retrospective study. To obtain two comparable groups, propensity-matching was applied. Finally, the study included 444 (51% out of initial 864 patients), 222 on diet (group D) and 222 patients undergoing surgery (group S). Results: In group D, sistolic blook pressure (SBP) showed a significant increase (135 ± 14 vs 138 ± 11mmHg; P = 0.006); conversely in group S, SBP decreased (130 ± 14 vs 124 ± 9mmHg; P=0.001). In group D, diastolic blood pressure (DBP) showed a significant increase (80 ± 6 vs 82 ± 6mmHg; P = 0.004); conversely in group S, DBP decreased (81 ± 9 vs 79 ± 8mmHg; P = 0.015). Among 136 patients with HPT, 73 (53%) withdrew antihypertensive therapy: significantly more in group S (55/63, 87%) than in group D (17/56, 23%), P<0.001. The median weight loss was significantly higher in group S than in group D at 6 months [4 (3-7) vs 15 (10-20)], 12 months [6 (4-9) vs 19 (12-28)] and 18 months [6 (2-10) vs 20 (13-32)]. Loss of weight is greater in the subgroup with HPT having surgery. Conclusion: Bariatric surgery is effective to improve SBP and DBP and leads to therapy withdrawal in obese patients; these changes are directly related to the amount of weight loss
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