HSR proceedings in intensive care & cardiovascular anesthesia最新文献_第5页

Selective decontamination of the digestive tract: an update of the evidence. 消化道选择性净化：最新证据。

HSR proceedings in intensive care & cardiovascular anesthesia Pub Date : 2012-01-01

L Silvestri, H K F van Saene

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The future of heart valve banking and of homografts: perspective from the Deutsches Herzzentrum Berlin. 心脏瓣膜库和同种移植的未来：柏林德国心脏中心的观点。

HSR proceedings in intensive care & cardiovascular anesthesia Pub Date : 2012-01-01

E M Delmo Walter, T M M H de By, R Meyer, R Hetzer

{"title":"The future of heart valve banking and of homografts: perspective from the Deutsches Herzzentrum Berlin.","authors":"E M Delmo Walter, T M M H de By, R Meyer, R Hetzer","doi":"","DOIUrl":"","url":null,"abstract":"Ever since the early days of homograft implantation in 1956, and the introduction into clinical practice by Ross and Barrat Boyes, homograft heart valves have proven to have many advantages. Its disadvantages became evident during long-term follow up. Factors, such as donor and recipient morbidity, tissue banking techniques, and the often complex surgical technique required to implant, are of great influence on the long term results. Because of European Directives, legally binding quality assurance regulations have been introduced in homograft banks. However, still not all processing methods have been scientifically sub-structured on their effects on the final product and its durability. The donor shortage has stimulated researchers and industries to develop and improve mechanical and biological valve substitutes such as the stentless bioprostheses. In general, candidates for homograft valve implantation include patients with: endocarditis, congenital defects and women who wish to become pregnant. For each category of patients different implantation techniques are required. The results of homograft banking and homograft transplantation in the German Heart Institute Berlin are satisfactory. Freedom of re-infection rate after homograft implantation is 91.9% +/- 3.6% after 15 years. Current developments show an increased interest in tissue engineered as well as in de- and re-cellularization of heart valve homografts. The advantages and disadvantages of the several processing techniques have not yet been proven in long term clinical results. For homograft bankers these developments pose as a challenge to join forces and to initiate cooperate projects aimed at scientific and organizational development.","PeriodicalId":89769,"journal":{"name":"HSR proceedings in intensive care & cardiovascular anesthesia","volume":"4 2","pages":"97-108"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ea/e4/hsrp-04-097.PMC3484936.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31263862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Cardiovascular tissue banking in Europe. 欧洲心血管组织库。

HSR proceedings in intensive care & cardiovascular anesthesia Pub Date : 2012-01-01

T M M H de By, R Parker, E M Delmo Walter, R Hetzer

{"title":"Cardiovascular tissue banking in Europe.","authors":"T M M H de By, R Parker, E M Delmo Walter, R Hetzer","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: In the past 50 years, human cardiovascular tissue allografts, also called homografts, have been implanted into patients with different valvular diseases. The use of these allografts and the number of cardiovascular tissue banks and their respective techniques increased. We conducted a survey to establish the quantity of allografts processed, and issued by, European tissue banks. The survey also included the collection of other relevant statistics.Methods: In 2011, the Foundation of European Tissue Banks collected data from 19 different cardiovascular tissue banks in 11 European countries.Results: From 2007 to 2010 the data show a decrease in the number of hearts received, from 1700 to 1640 in 18 tissue banks; the average number of hearts received for cardiovascular tissue processing decreased from 113 to 91. The number of heart valves issued for transplantation increased from 1272 in 2007 to 1486 in 2010. The average rate of discard because of microbiological contamination was 20.7%, while 4.2% of the grafts were not used because of positive serology. Half of the tissue banks issued arterial grafts, while 3 banks also issued veins and pericardium. An overview of decontamination methods shows considerable methodological differencesbetween 17 cardiovascular tissue banks.Conclusions: From the experience in Europe, it can be concluded that cardiovascular tissue banks have an established place in the domain of cardiovascular surgery. The statistics show fluctuating data concerning the demand for human cardiovascular allografts and methodological questions. There is room for growth and improvement with respect to validation of decontamination methods.","PeriodicalId":89769,"journal":{"name":"HSR proceedings in intensive care & cardiovascular anesthesia","volume":"4 4","pages":"251-60"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d4/09/hsrp-04-251.PMC3563559.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31263420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Wish you were here! 真希望你在这里!

HSR proceedings in intensive care & cardiovascular anesthesia Pub Date : 2012-01-01

M John

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Ross procedure. 罗斯的过程。

HSR proceedings in intensive care & cardiovascular anesthesia Pub Date : 2012-01-01

H H Sievers

{"title":"Ross procedure.","authors":"H H Sievers","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: In 1967 Donald Ross introduced the subcoronary Ross procedure consisting of transplantation of the autologous pulmonary valve into aortic position. We describe our 15-year experience in Ross procedures.Methods: 576 subcoronary operations have been performed (436 male and 140 female patients); the mean age was 45±11.9 years. (range, 13 to 70 years). The mean follow-up was 7±4.2 years (range, 0 to 16 years). There were 4597 patient years at follow-up with a clinical completeness of 95% and echo completeness of 91%.Results: There were two operative deaths (0.3%) and 31 patients with reoperation. The survival is similar to that of the normal population and the freedom from allo- and autograft reoperation is 87% at 15 years. Autograft regurgitation at last examination was grade 0 in 40%, trace in 54%, grade I in 19%, grade II in 4% and grade III in 0.4%; the pressure gradient was smaller than 5 mmHg in 57% and between 5 and 10 mmHg in 24%. Only 6% had a transvalvular pressure gradient of more than 10 mmHg.Discussion: After 15 years of experience it can be concluded that the subcoronary technique provides near normal survival in adult patients, with excellent hemodynamics and acceptable rate of reoperations.","PeriodicalId":89769,"journal":{"name":"HSR proceedings in intensive care & cardiovascular anesthesia","volume":"4 2","pages":"119-23"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5f/07/hsrp-04-119.PMC3484939.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31355882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Multiple causes for an ischemic stroke: myxoma, papillary fibroelastomas and patent foramen ovale. 缺血性中风的多种原因:黏液瘤、乳头状纤维弹性瘤和卵圆孔未闭。

HSR proceedings in intensive care & cardiovascular anesthesia Pub Date : 2012-01-01

J Roque, F Silva, R Arruda Pereira, J Cravino

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A quantitative evaluation of fluid leakage around a polyvinyl chloride tapered endotracheal tube cuff using an in-vitro model. 使用体外模型定量评价聚氯乙烯锥形气管内管袖口周围的液体泄漏。

HSR proceedings in intensive care & cardiovascular anesthesia Pub Date : 2012-01-01

J Shiotsuka, A T Lefor, M Sanui, O Nagata, A Horiguchi, Y Sasabuchi

{"title":"A quantitative evaluation of fluid leakage around a polyvinyl chloride tapered endotracheal tube cuff using an in-vitro model.","authors":"J Shiotsuka, A T Lefor, M Sanui, O Nagata, A Horiguchi, Y Sasabuchi","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: This study was designed to quantitatively evaluate the sealing effect of a polyvinyl chloride tapered endotracheal tube cuff and to compare the tapered cuff with cylindrical endotracheal tube cuffs using an in vitro viscous fluid model.Methods: Five types of 8.0 mm inner diameter endotracheal tubes (TaperGuard, PortexSacett, PortexSoftseal, Sheridan HVT, Sheridan CF) were fixed in vertically placed 20mm internal diameter acrylic tubes. The cuffs were inflated to 25 mmHg pressure and water was added to the top of the cuff. The amount of water leaking around the cuff at five minutes was measured. Afterwards a viscous fluid was poured above the cuff and the amount of fluid passing around the cuff at five minutes and four hours was measured. Each determination was repeated five times and the data analyzed.Results: The median (range) amount (ml) of dyed water passing around the cuff at 5 minutes was TaperGuard tube 0 (0-0.2), PortexSacett 81.1 (44.6-107.9), PortexSoftseal 95.4 (91.4-113.7), Sheridan HVT 46.5 (32.7-74.6) and Sheridan CF 52.6 (31.9-62.2), suggesting that TaperGuard significantly (P<0.05) reduced fluid leakage. The viscous fluid leakage at 5 minutes was not significantly different among the groups while the amount of leaked viscous fluid at 4 hours was 0.2 (0-1.1) for the TaperGuard, 57.6 (11.9-117.4) for the PortexSacett, 23.2 (13.8-33.0) for the PortexSoftseal, 5.5 (2.7-15.4) for the Sheridan HVT and 5.6 (1.8-7.9) for the Sheridan CF.Conclusion: An endotracheal tube with a tapered polyvinyl chloride cuff had significantly less fluid leakage compared to four tubes with cylindrical cuffs.","PeriodicalId":89769,"journal":{"name":"HSR proceedings in intensive care & cardiovascular anesthesia","volume":"4 3","pages":"169-75"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/85/7f/hsrp-04-169.PMC3485387.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31264361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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Because good enough is never good enough. 因为足够好永远不会足够好。

HSR proceedings in intensive care & cardiovascular anesthesia Pub Date : 2012-01-01

M John

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Clinical results of implanted tissue engineered heart valves. 组织工程化心脏瓣膜植入的临床效果。

HSR proceedings in intensive care & cardiovascular anesthesia Pub Date : 2012-01-01

P M Dohmen

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State of the art in cardiothoracic surgery: now and the next decade. 心胸外科技术的现状:现在和下一个十年。

HSR proceedings in intensive care & cardiovascular anesthesia Pub Date : 2012-01-01

E M Delmo Walter, R Hetzer

引用次数: 0