Search results for "IAC"
showing 10 items of 4189 documents
Surgical treatment of chronic thromboembolic pulmonary hypertension
1999
Background: Chronic thromboembolic pulmonary artery obstruction from unresolved pulmonary emboli is characterized by persistent elevation of pulmonary vascular resistance and progressive right heart dysfunction and failure. The diagnosis of chronic thromboembolic pulmonary hypertension is difficult and often missed. Medical therapy is ineffective in these patients. The prognosis is poor and depends on the degree of pulmonary hypertension. Pulmonary thromboendarterectomy has proven to be an effective and potentially curative surgical therapy for this clinical entity although less than 1000 cases have been reported in the surgical literature. Methods: The current principles of diagnosis, pati…
Serum markers for early detection of patients with mesenteric ischemia after cardiac surgery
2018
AbstractObjectiveMesenteric ischemia (MESI) is a rare but often fatal complication in patients after cardiac surgery. Non-specific clinical symptoms and lack of specific laboratory parameters complicate the diagnosis. We evaluated potential serum markers for MESI in cardiac surgery patients.MethodsBetween March and October 2012, serial serum samples of 567 elective cardiac surgery patients were collected 1, 24, and 48 h after the operation, and concentrations of potential markers for MESI [α-glutathione-S-transferase (αGST), intestinal fatty-acid-binding protein (iFABP), and D-lactate] were measured retrospectively. In patients requiring laparotomy, blood samples obtained 72, 48, 24, and 12…
Modifications in Ventricular Fibrillation and Capture Capacity Induced by a Linear Radiofrequency Lesion
2012
[EN] Introduction and objectives: An analysis was made of the effects of a radiofrequency-induced linear lesion during ventricular fibrillation and the capacity to capture myocardium through high-frequency pacing. Methods: Using multiple epicardial electrodes, ventricular fibrillation was recorded in 22 isolated perfused rabbit hearts, analyzing the activation maps upon applying trains of stimuli at 3 different frequencies close to that of the arrhythmia: a) at baseline; b) after radio-frequency ablation to induce a lesion of the left ventricular free wall (length=10 [1] mm), and c) after lengthening the lesion (length=23 [2] mm). Results: Following lesion induction, the regularity of the r…
Simplified Electrophysiology Modeling Framework to Assess Ventricular Arrhythmia Risk in Infarcted Patients
2021
Patients that have suffered a myocardial infarction are at lifetime high risk for sudden cardiac death (SCD). Personalized 3D computational modeling and simulation can help to find non-invasively arrhythmogenic features of patients’ infarcts, and to provide additional information for stratification and planning of radiofrequency ablation (RFA). Currently, multiscale biophysical models require high computational resources and long simulations times, which make them impractical for clinical environments. In this paper, we develop a phenomenological solver based on cellular automata to simulate cardiac electrophysiology, with results comparable to those of biophysical models. The solver can ru…
A hybrid stimulation strategy for suppression of spiral waves in cardiac tissue
2011
International audience; Atrial fibrillation (AF) is the most common cardiac arrhythmia whose mechanisms are thought to be mainly due to the self perpetuation of spiral waves (SW). To date, available treatment strategies (antiarrhythmic drugs, radiofrequency ablation of the substrate, electrical cardioversion) to restore and to maintain a normal sinus rhythm have limitations and are associated with AF recurrences. The aim of this study was to assess a way of suppressing SW by applying multifocal electrical stimulations in a simulated cardiac tissue using a 2D FitzHugh-Nagumo model specially convenient for AF investigations. We identified stimulation parameters for successful termination of S…
Personalized Cardiac Computational Models: From Clinical Data to Simulation of Infarct-Related Ventricular Tachycardia.
2019
In the chronic stage of myocardial infarction, a significant number of patients develop life-threatening ventricular tachycardias (VT) due to the arrhythmogenic nature of the remodeled myocardium. Radiofrequency ablation (RFA) is a common procedure to isolate reentry pathways across the infarct scar that are responsible for VT. Unfortunately, this strategy show relatively low success rates; up to 50% of patients experience recurrent VT after the procedure. In the last decade, intensive research in the field of computational cardiac electrophysiology (EP) has demonstrated the ability of three-dimensional (3D) cardiac computational models to perform in-silico EP studies. However, the personal…
Classification of Chimney EVAR-Related Endoleaks: Insights from the PERICLES Registry
2017
Juxtarenal aortic aneurysms (JAAs) pose significant challenges for endovascular aneurysm repair (EVAR). A short or absent infrarenal neck typically excludes standard EVAR as a viable or reasonable treatment option. In this context, the use of chimney grafts (chEVAR) is gaining in popularity and applicability. These grafts are designed to course in the aortic lumen outside the main stent-graft to maintain normal perfusion to the involved target branches. As such, they may represent a promising and less resource-intensive option for management of JAAs. However, this technical strategy is not without challenges of its own, particularly the inevitable creation of “gutters” that result from the …
Transesophageal Echocardiography - Dysphagia Risk in Acute Stroke (TEDRAS): a prospective, blind, randomized and controlled clinical trial.
2020
BACKGROUND AND PURPOSE Dysphagia is common in acute stroke and leads to worse overall outcome. Transesophageal echocardiography (TEE) is used in the diagnostic evaluation of stroke with regard to its etiology and is a known cause of postoperative dysphagia in cardiac surgery. The prevalence of dysphagia in acute stroke patients undergoing TEE remains unknown. The aim of the Transesophageal Echocardiography - Dysphagia Risk in Acute Stroke (TEDRAS) study was to assess the influence of TEE on swallowing among patients who have experienced acute stroke. METHODS The TEDRAS study was a prospective, blind, randomized, controlled trial that included two groups of patients with acute stroke. Simple…
Duodenogastrischer Reflux nach Vagotomie und Pyloroplastik
1976
Bei 27 Patienten mit selektiver oder trunkularer Vagotomie und Pyloroplastik wurde gepruft, ob ein duodenogastrischer Reflux vorliegt. Die Untersuchung erfolgte rontgenologisch durch Instillation von verdunntem Bariumbrei in das Duodenum und durch Nachweis von i.v. appliziertem Bromsulphalein im Magensaft. Es konnte bei 20 von 23 Patienten rontgenologisch und bei 18 von 27 Patienten durch den Bromsulphalein-Nachweis ein duodenogastrischer Reflux festgestellt werden. In Zusammenhang mit Reflux standen postoperative Beschwerden wie Vollegefuhl, Brechreiz und Oberbauchschmerzen, sowie der Nachweis morphologischer Veranderungen der Magenschleimhaut im Sinne von Gastritiden verschiedener Stadien.
Early urinary sodium trajectory and risk of adverse outcomes in acute heart failure and renal dysfunction.
2021
Introduction and objectives: Urinary sodium (UNa+) has emerged as a useful biomarker of poor clinical outcomes in acute heart failure (AHF). Here, we sought to evaluate: a) the usefulness of a single early determination of UNa+ for predicting adverse outcomes in patients with AHF and renal dysfunction, and b) whether the change in UNa+ at 24 hours (Delta UNa24 h) adds any additional prognostic information over baseline values. Methods: This is a post-hoc analysis of a multicenter, open-label, randomized clinical trial (IMPROVE-HF) (ClinicalTrials.gov NCT02643147) that randomized 160 patients with AHF and renal dysfunction on admission to a) the standard diuretic strategy, or b) a carbohydra…