425 research outputs found
Urgent/emergent surgical revascularization in unstable angina: influence of different type of conduits
No full textAbstract
AIM:
In patients with unstable angina (UA) undergoing nonelective myocardial revascularization we compare the outcomes of skeletonized bilateral internal mammary arteries (BIMA) vs left internal mammary artery (LIMA) and saphenous vein grafts (SVGs) vs SVGs only.
METHODS:
Between January 1997 and December 2003, 758 patients: 612 (80.7%) males, mean age 62+/-12 years, underwent nonelective coronary artery bypass grafting (CABG) for unstable angina; 205 (27%) were operated emergently and 553 (73%) urgently. BIMA were employed in 320 (42%) patients (Group B) , isolated LIMA and/or SVGs in 332 (44%) patients (Group M) and only SVGs in 106 (14%) (Group S).
RESULTS:
In-hospital mortality (B=5.9%, M=4.5% and S=7.5%), and perioperative myocardial infarction (B=2.2%; M=1.9%, S=3.7%) were similar between the 3 groups (P=NS). Actuarial survival at 1, 3 and 7 years was 98.7%, 97.5% and 96.2% in group B, 99.3%, 94.8% and 89.4% in group M (P65 years (P= 0.02), left ventricular ejection fraction (LVEF) 1 ischemic irreversible area (P= 0.03) as independent predictors for late deaths, while the use of the LIMA (P= 0.006) and both mammary arteries (P= 0.001) decreased the risk of late deaths.
CONCLUSIONS:
The use of BIMA in nonelective CABG for UA is safe and effective. There is a trend, however, toward a survival benefit with improved freedom from late cardiac events (recurrence of angina, freedom from reoperation and infarction)
An agglomerative hierarchical clustering method for text in Albanian
No full textNowadays, big data is available in many areas of science, so the need to summarize data sets into groups and extract information is important. Using the cluster analysis technique, we can explore such data based on their similarity. The degree of similarity in the data is quantitatively represented by distance functions.
In this paper, using Ward’s method of cosine distance in a database with 100 Albanian texts into 16 different clusters based on the frequency of words, with 87 percent of texts well classified by author
Undergoing cardiopulmonary bypass using enoxaparin only during a cardiac transplantation procedure
No full textThe use of enoxaparin as a replacement drug to standard heparin, for anticoagulation during extracorporeal circulation, in patients with heparin-induced thrombocytopenia, is still very limited. Enoxaparin significantly reduces thrombin formation and activity during cardiopulmonary bypass. The prolonged circulating rate, slow elimination rate and non-total reversion of enoxaparin by protamine can induce important postoperative bleeding. We are describing the first case of cardiac transplantation where enoxaparin was used as a replacement drug to standard heparin. (C) 2000 Elsevier Science B.V. All rights reserved
Accessory mitral valve leaflet in an adult with coronary artery disease
No full textAccessory mitral valve leaflet is a very rare cause of left ventricular outflow tract obstruction. We report a patient presenting this cardiac abnormality who undergone cardiac surgery. A 60-year-old man, presented coronary artery disease and moderate left ventricular tract obstruction due to accessory mitral valve leaflet. The accessory mitral valve leaflet had the typical morphology of a parachute-shaped attached partially to the anterior mitral valve leaflet, with chordae tendinae attached to: 1) an accessory papillary muscle inserted at the free-wall closed to the apex; 2) interconnected with the chordae tendinae of the anterior mitral valve leaflet; 3) a second accessory papillary muscle inserted to the interventricular septum. He underwent successful coronary revascularization of 2 vessels and accessory leaflet excision. A review of 21 cases with accessory mitral valve leaflet is reported
Comparing the climate impact of methanol production in Europe: Steam methane reforming vs. Plastic waste gasification processes
No full textThis study compares the climate change impacts of three methanol production processes: the conventional method via steam methane reforming, and two alternatives – gasiforming and electriforming – which utilize plastic waste as feedstock. A gate-to-gate LCA approach is employed, considering credits and substitution impacts for avoiding traditional end-of-life treatment of plastic waste. Influential local parameters for GWP reduction are identified to include electricity carbon footprint, waste treatment infrastructure, incinerator efficiency, and the utilization of captured CO2 streams. Regional conditions are found to be crucial, as demonstrated by a case study comparing technology choices among EU27+3 countries. The study concludes that the novel plastic waste treatment and methanol production processes, have the potential to mitigate climate change impact, particularly when diverting plastic waste from incineration. With carbon-neutral electricity and avoided incineration, the specific impact reduction in methanol production can reach 2 kg CO2e per kg methanol
Reoperative revascularization of an occluded left subclavian artery and left internal mammary artery ostial stenosis
No full textAn ostial stenosis of the left internal mammary artery graft anastomosed to the left anterior descending artery was responsible for unstable angina in a patient with a previous coronary artery bypass graft. A T-shape arterectomy was performed between the left subclavian artery and left internal mammary artery. Successful revascularization of the lesion was achieved with a carotid-to-subclavian bypass and surgical ostial plasty extending to the proximal left internal mammary graft using a Hemashild a graft. This procedure was performed through a transverse supraclavicular incision to avoid potential hazards of a redo median sternotomy. © 2002 Elsevier Science B.V. All rights reserved
A Capex Opex Simultaneous Robust Optimizer: Process Simulation-based Generalized Framework for Reliable Economic Estimations
No full textDuring the design of a process, the most economically impactful choices are often taken with limited data and details available on the specifics of unit operations. Despite this fact, the effect some of these choices have on the final economic performance of the plant can be dramatic and far more influential than later decisions. The availability of fast and reliable preliminary cost estimations based on few key design parameters for the most common units can go a long way in improving flowsheet design. Due to the early design stage, these estimates don't need to be very accurate since errors in the range of 50% are admissible as long as the estimation requires few input data. Automating the costs computation process and making the interface with the most common simulation packages standardized and easily accessible for users not accustomed to programming languages is very important in speeding up the cost evaluation of the plant and reducing the human resources tied to this task. These concepts stand at the core design of the CAPEX OPEX Robust Optimizer (CORO) developed in this work. Aspen HYSYS serves as the commercial simulation package to estimate the input variable of the economic libraries. Excel is used both as a GUI and as a data extraction tool from Aspen HYSYS due to its widespread diffusion in industry and versatility provided by Visual Basic for Applications. The CORO code is detached both from Excel and HYSYS and interacts only with a standardized xml data sheet to allow for in-house expansions to other simulation packages. The long-term development goal is a generalized CAPE-OPEN interface working with every commercial software that supports the interface. In the current CORO release, the interface can interact only with Aspen HYSYS. This paper will showcase the economic libraries implemented in CORO, the mathematical C ++ optimization libraries, the overall structure of the tool, planned future expansions, and customization options
Development of augmented BIM models for built environment management
No full textTraditional surveys in the built environment are time-consuming and usually result in enormous amounts of data, that are difficult to manage and contains bias. Therefore, BIM modeling of both geometries and related information leads to inconsistent, incomplete, or the other way around highly detailed models that need to be reworked afterwards, slowing the design process. The proposed methodology combines point cloud surveying technique, photogrammetry, and BIM within a game engine platform to define a workflow for an incremental model semantic enrichment that leads to an augmented BIM environment. The case study prototype allows stepwise accurate integration of detailed BIM objects by easing positioning them in the scene in accordance with the overlapped aligned images, giving the possibility of model enrichment only when it is required
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