Treatment of pulmonary Hypertension in patients with mitral valve stenosis: A randomized,prospective,double blinf study

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Background: Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods: This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, r…

Cardioprotective effects of C1 esteresa inhibitor in patients with acute coronary syndrome undergoing CABG

L’aula in classi multiculturali: approcci di Trasposizione Culturale tra pratica quotidiana e prospettive future sulla formazione matematica

Il fenomeno didattico della multiculturalità è un tema in molti casi discusso, vissuto però sovente in ambito scolastico come problema, non come risorsa. Parecchi sono infatti gli insegnanti che, sperimentando quotidianamente la realtà multiculturale nelle loro classi, manifestano un disagio, spesso associato ad una successiva richiesta di formazione; in molti casi disattesa o non adeguata ai loro bisogni. La ricerca nazionale in campo educativo, rivolta allo studio di questi fenomeni, è infatti a uno stadio quasi embrionale: non molte sono le riflessioni pedagogico-didattiche dirette ad insegnanti e formatori che operano in contesti complessi come quelli qui presi in esame, ancor meno le i…

Inhaled Prostacyclin, Nitric Oxide, and Nitroprusside in Pulmonary Hypertension After Mitral Valve Replacement

Abstract Objective: Pulmonary hypertension increases morbidity and mortality in patients undergoing heart surgery. Mitral valve stenosis is frequently associated with an increase in pulmonary vascular resistance (PVR). Cardiopulmonary bypass exacerbates pulmonary hypertension in patients undergoing cardiac surgery. The aim of this study was to compare the hemodynamic effects of inhaled prostacyclin and nitric oxide and the administration of i.v. nitroprusside during cardiac surgery with a clinical, pharmacodynamic dose-response, prospective, randomized, and double-blind study (Group A: inhaled prostacyclin; Group B: inhaled nitric oxide; Group C: nitroprusside). Materials and Methods: Fifty…

Long-term results after Bentall techique using St Jude tube graft

Photon Pressure Force on Space Debris TOPEX/Poseidon Measured by Satellite Laser Ranging

The TOPEX/Poseidon (T/P) altimetry mission operated for 13 years before the satellite was decommissioned in January 2006, becoming a large space debris object at an altitude of 1,340 km. Since the end of the mission, the interaction of T/P with the space environment has driven the satellite's spin dynamics. Satellite Laser Ranging (SLR) measurements collected from June 2014 until October 2016 allow for the satellite spin axis orientation to be determined with an accuracy of 1.7°. The spin axis coincides with the platform yaw axis (formerly pointing in the nadir direction) about which the body rotates in a counterclockwise direction. The combined photometric and SLR data collected over the 1…

Valve prosthesis-patient mismatch: hemodynamic, echocardiographic and clinical consequences

OBJECTIVES: The purpose is to evaluate in vivo at rest and under stress conditions hemodynamic performance of the small size St. Jude Medical Regent (SJMR) prosthetic valve in patients with a body surface area (BSA) of 1.8 ± 0.11 m(2) and to define the role of valve prosthesis- patient mismatch on left ventricular mass regression following aortic valve replacement. METHODS: We evaluated 25 cases (12 males and 13 females, mean age 65.2 ± 8 years) of aortic valve replacement (17 mm SJMR in three cases and 19 mm SJMR in 22 cases). All the patients underwent at rest Doppler echocardiography before and after surgery and both basal and dobutamine stress echocardiography (DSE) at follow-up. The me…

Effect of nornothermic and hypothermic CPB on coronary arteries grafts flow

Histological and genetic studies in patients with bicuspid aortic valve and ascending aorta complications.

OBJECTIVES: Aneurysm diameter and growing rate does not represent a definite parameter for operation in bicuspid aortic valve (BAV), ascending aortic aneurysm and normal root patients. Thus, we investigated histological and immunohistochemical aspects of different segments of ascending aorta (precisely, aortic root without dilatation, aneurysmatic tubular portion, dissected ascending aorta) and genetic features of patients with BAV and ascending aorta complication (aneurysm or dissection). METHODS: Aorta tissue samples of 24 BAV patients were examined. The patients comprised of 18 men and 6 women; the mean age was 54.2 ± 14.3 years. All patients underwent composite aortic root replacement (…

Dalle classi multiculturali ad una didattica interculturale della matematica: verso una Smart Community di insegnanti in formazione

La presenza di alunni stranieri nelle nostre classi è ormai una realtà con cui i nostri insegnanti si devono confrontare ogni giorno. A partire dagli ’90 il Ministero ha cominciato a fornire indicazioni molto ampie, spesso volte a normare, gestire e sistematizzare l’iter scolastico, e non, degli studenti stranieri; per quel che riguarda gli insegnanti sovente si sono suggeriti atteggiamenti volti all’inclusione, poi integrati nelle proposte di educazione civica. Sono però insufficienti i richiami specificatamente disciplinari (in particolare sulla matematica) e più generalmente didattici (dal design alla trasposizione didattica), necessari ad intercettare, interpretare e rielaborare le diff…

Longterm results of surgical treatment of acute type A aortic dissection

ischemica mitral regurgitation:mitral valve repair with cabg vs cabg alone

Flow capacities of the descending branch of lateral femoral circunflex artery in composite arterial coronary bypass

SARS-CoV-2 infection and venous thromboembolism after surgery: an international prospective cohort study

SARS-CoV-2 has been associated with an increased rate of venous thromboembolism in critically ill patients. Since surgical patients are already at higher risk of venous thromboembolism than general populations, this study aimed to determine if patients with peri-operative or prior SARS-CoV-2 were at further increased risk of venous thromboembolism. We conducted a planned sub-study and analysis from an international, multicentre, prospective cohort study of elective and emergency patients undergoing surgery during October 2020. Patients from all surgical specialties were included. The primary outcome measure was venous thromboembolism (pulmonary embolism or deep vein thrombosis) within 30 da…

UNUSUAL CASE OF PULMONARY TRUNK ANEURYSM ASSOCIATED WITH AORTIC ROOT DILATATION

treatment of pulmonary hypertension in patients undergoing cardiac surgery with cardiopulmonary bypass: a randomized,prospective, double-bind study.

Objective Pulmonary hypertension can already be present in patients undergoing cardiac surgery or can be exacerbated by cardiopulmonary bypass. Postoperative treatment is still a challenge for physicians. The aim of this study was to evaluate the effects of inhaled prostacyclin (iPGI(2)) and nitric oxide (iNO) compared with those of intravenous vasodilators. Methods This prospective, randomized, double-blind study included 58 patients affected by severe mitral valve stenosis and pulmonary hypertension with high pulmonary vascular resistance (> 250 dynes.s.cm(-5)) and a mean pulmonary artery pressure > 25 mmHg. All patients were monitored by central venous, radial arterial and Swan-Ganz cath…

Treatment of pulmonary hypertension in patients undergoing cardiac surgery with cardiopulmonary bypass: a randomized, prospective, double-blind study

Pulmonary hypertension can already be present in patients undergoing cardiac surgery or can be exacerbated by cardiopulmonary bypass. Postoperative treatment is still a challenge for physicians. The aim of this study was to evaluate the effects of inhaled prostacyclin (iPGI2) and nitric oxide (iNO) compared with those of intravenous vasodilators.This prospective, randomized, double-blind study included 58 patients affected by severe mitral valve stenosis and pulmonary hypertension with high pulmonary vascular resistance (250 dynes x s x cm(-5)) and a mean pulmonary artery pressure25 mmHg. All patients were monitored by central venous, radial arterial and Swan-Ganz catheters. Data were recor…

valve prosthesis-patient mismatch: hemodynamic, echocardiografic and clinical evidences

predictors factors for early mortality in patients with acute myocardial infarction undergone surgical revascularization

Functional annulus remodelling using a prosthetic ring in tricuspid aortic valve repair: mid-term results

OBJECTIVES: The functional aortic valve annulus (FAVA) is a complex unit with proximal (aorto-ventricular junction) and distal (sinotubular junction) components. The aim of our study was to evaluate the impact of the total FAVA remodelling, using a prosthetic ring, on mid-term clinical and echocardiographic-RESULTS:-after aortic valve repair. METHODS: Since February 2003, 250 patients with tricuspid aortic valve insufficiency (AI) underwent aortic valve repair. FAVA dilatation was treated by prosthetic ring in 52 patients, by isolated subcommissural plasty in 62, by subcommissural plasty plus ascending aortic replacement in 57 and by David's reimplantation procedure in 79. Survival rate and…

inhaled prostacyclin,nitric oxyde and nitroprusside in pulmonary hypertension after mitral valve replacement

OBJECTIVE: Pulmonary hypertension increases morbidity and mortality in patients undergoing heart surgery. Mitral valve stenosis is frequently associated with an increase in pulmonary vascular resistance (PVR). Cardiopulmonary bypass exacerbates pulmonary hypertension in patients undergoing cardiac surgery. The aim of this study was to compare the hemodynamic effects of inhaled prostacyclin and nitric oxide and the administration of i.v. nitroprusside during cardiac surgery with a clinical, pharmacodynamic dose-response, prospective, randomized, and double-blind study (Group A: inhaled prostacyclin; Group B: inhaled nitric oxide; Group C: nitroprusside). MATERIALS AND METHODS: Fifty-eight pa…

Relocation of Papillary Muscles for Ischemic Mitral Valve Regurgitation

Objective The assessment of the mitral valve apparatus (MVA) and its modifications during ischemic mitral regurgitation (IMR) is better performed by three-dimensional (3D) transesophageal echocardiography (TEE). The aim of our study was to carry out nonrestrictive mitral annuloplasty in addition to relocation of papillary muscles (PPMs) oriented by preoperative real-time 3D TEE through the mitral valve quantification dedicated software. Methods Since January 2008, a total of 70 patients with severe IMR were examined both before and after mitral valve repair. The mean (SD) coaptation depth and the mean (SD) tenting area were 1.4 (0.4) cm and 3.2 (0.5) cm2, respectively. Intraoperative 3D TEE…

results of small aortic bioprosthesis in elderly patients with severe aortic stenosis

Implantation of Gore-Tex chordae on aortic valve leaflet to treat prolapse using "the chordae technique": surgical aspects and clinical results.

Background Repair of prolapsed aortic valve leaflets has been considered a challenging technique for cardiac surgeons. In this paper we describe our surgical approach, "the chordae technique." It consists of the correction of aortic cusp prolapse by shortening the free margin length and of an adjustment of the leaflets coaptation height by anchoring the prolapsing cusp to the aortic wall at the sinotubular junction level. Methods Between February 2003 and December 2006, 26 patients with one or more prolapsed aortic leaflets underwent surgical repair using the new approach. The mean age of patients was 55 ± 10 years. There were 10 (38.5%) patients with grade II aortic valve regurgitation, 4 …

SIMPLE, SAFE AND EASY TECHNIQUE TO ENSURE THE CORRECT LENGTH OF ARTIFICIAL CHORDAE IN MITRAL VALVE REPAIR.

Replacement of diseased chordae with Gore-Tex sutures (W. L. Gore & Assoc, Flagstaff, AZ) in patients with degenerative mitral valve insufficiency has become a standard technique used by surgeons in mitral valve repair with good long-term results. Nevertheless, determining the correct length of the artificial chordae has remained problematic. Although various procedures have been previously published, in this article we describe our approach used to achieve an accurate chordal height adjustment.

Beneficial effects of C1 esterase inhibitor in ST-elevation myocardial infarction in patients who underwentsurgical reperfusion: a randomized double-blind study.

Background: The inflammatory cascade has been hypothesized to be an important mechanism of post-ischaemic myocardial reperfusion injury and several studies demonstrated that C1 esterase inhibitor (C1 -INH) is effective in post-ischaemia myocardial protection. Therefore, we aimed to investigate prospectively in a randomised double-blind study the cardioprotective effects of C1-INH in ST segment elevation myocardial infarction (STEMI) in patients who underwent emergent reperfusion with coronary artery bypass grafting (CABG). Methods: In this study, we enrolled 80 patients affected with STEMI who underwent emergent CABG. Patients were assigned in two groups (C1-INH group: receive 1000 Ul of C1…

Calculus Artefacts in Chinese Textbooks: Variational Approaches with Prospective Primary Teachers

The first part of the paper presents some theoretical reflections and some methodological notes about a Professional Development (PD) path worked out during the last two years by Italian researchers for prospective primary teachers. The theoretical construct of Cultural Transposition defines the framework of the PD path’s activities and the related research. It was used to define an interesting cultural lens to delineate possible new approaches for effective pre-service teacher education programs in particular for the primary level. The defined methodology was based on the possibility to reflect on the he decentralization of didactic practices based on a specific cultural context through on…