Heart, lung and vessels最新文献

Idiopathic ascending aortitis as a rare cause of supravalvular aortic stenosis. 特发性升主动脉炎是一种罕见的导致瓣上主动脉狭窄的原因。

Heart, lung and vessels Pub Date : 2015-01-01

Amedeo Pergolini, Giordano Zampi, Maria Denitza Tinti, Andrea Vallone, Paolo Giuseppe Pino, Francesco Musumeci, Giampaolo Luzi

引用次数: 0

Novel therapeutic and diagnostic management of heart transplant patients. 心脏移植患者的新型治疗和诊断管理。

Heart, lung and vessels Pub Date : 2015-01-01

Francesca D'Addio, Davide Margonato, Umberto Pensato, Laura Borgese, Luciano Potena, Paolo Fiorina

{"title":"Novel therapeutic and diagnostic management of heart transplant patients.","authors":"Francesca D'Addio, Davide Margonato, Umberto Pensato, Laura Borgese, Luciano Potena, Paolo Fiorina","doi":"","DOIUrl":"","url":null,"abstract":"Heart transplantation was performed for the first time 40 years ago and it is now universally considered the \"gold standard\" treatment for individuals suffering from end-stage heart failure. The increased understanding of the molecular mechanisms and of the role of the immune system in allograft rejection led to an overall improvement of graft survival, which is now around 10 years. The introduction of novel immunosuppressive drugs reduced the rate of acute allograft rejection but did not improve significantly the long-term graft survival. In addition, adverse effects (e.g. infections, cancer and renal failure) associated with immunosuppressive drugs are increasing over time and may affect post-transplantation outcomes. An immunosuppression-free protocol based on tolerance induction is the Holy Grail for heart transplant recipients, but it is still far beyond our reach. In this review, we discuss the landscape of immunological challenges that heart transplanted individuals face and we critically review the novel immunological approaches available to overcome these remaining issues. Some of the novel approaches, successfully tested in preclinical and clinical models, may lead to a prolongation of patient's and heart allograft survival. ","PeriodicalId":89932,"journal":{"name":"Heart, lung and vessels","volume":"7 3","pages":"198-207"},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ee/d8/hlv-07-198.PMC4593017.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34112338","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

Novel airway management in a child with Goldenhar Syndrome at a remote location. 偏远地区儿童高氏综合征的新型气道管理。

Heart, lung and vessels Pub Date : 2015-01-01

Sujatha P Bhandary, Allen Keebler, Sudha Balan, Thomas J Papadimos

引用次数: 0

Beneficial impact of levosimendan in critically ill patients with or at risk for acute renal failure: a meta-analysis of randomized clinical trials. 左西孟旦对急性肾功能衰竭危重患者的有益影响:一项随机临床试验的荟萃分析

Heart, lung and vessels Pub Date : 2015-01-01

Tiziana Bove, Andrea Matteazzi, Alessandro Belletti, Gianluca Paternoster, Omar Saleh, Daiana Taddeo, Roberto Dossi, Teresa Greco, Nikola Bradic, Ino Husedzinovic, Caetano Nigro Neto, Vladimir V Lomivorotov, Maria Grazia Calabrò

{"title":"Beneficial impact of levosimendan in critically ill patients with or at risk for acute renal failure: a meta-analysis of randomized clinical trials.","authors":"Tiziana Bove, Andrea Matteazzi, Alessandro Belletti, Gianluca Paternoster, Omar Saleh, Daiana Taddeo, Roberto Dossi, Teresa Greco, Nikola Bradic, Ino Husedzinovic, Caetano Nigro Neto, Vladimir V Lomivorotov, Maria Grazia Calabrò","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: The incidence of Acute Kidney Injury is nowadays high in critically ill patients. Its etiology is multifactorial and a primary role is played by low cardiac output syndrome. Everything targeted to normalize cardiac output should increase the renal perfusion and abolish the secondary vasoconstriction. Levosimendan is a calcium sensitizer drug with inotropic properties that improves cardiac output and seems to increase renal blood flow. The aim of this meta-analysis was to evaluate the role of levosimendan in critically ill patients with or at risk of Acute Kidney Injury.Methods: We performed a meta-analysis of randomized controlled trials searching for trials that compared levosimendan with any comparator. The endpoints were the number of patients receiving Renal Replacement Therapy after randomization and the number of patients developing Acute Kidney Injury.Results: Final analysis included 33 trials and 3,879 patients (2,024 levosimendan and 1,855 control). The overall analysis showed that the use of levosimendan was associated with a significant reduction in the risk of Renal Replacement Therapy (17 of 492 [3.5%] in the levosimendan group versus 37 of 427 [8.7%] in the control group, relative risk =0.52 [0.32 to 0.86], p for effect =0.01) and of Acute Kidney Injury (114 of 1,598 [7.1%] in the levosimendan group versus 143 of 1,529 [9.4%] in the control arm, relative risk =0.79 [0.63 to 0.99], p for effect =0.048).Conclusions: This meta-analysis suggests that the use of levosimendan is associated with a significant reduction of Renal Replacement Therapy in critically ill patients.","PeriodicalId":89932,"journal":{"name":"Heart, lung and vessels","volume":"7 1","pages":"35-46"},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c0/9b/hlv-07-035.PMC4381821.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33206348","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

Pulmonary capillary wedge pressure and natriuretic peptide levels in patients with sinus rhythm and severe left atrial enlargement following mitral valve surgery: early and late changes. 二尖瓣手术后窦性心律和严重左房扩大患者的肺毛细血管楔压和利钠肽水平:早期和晚期的变化。

Heart, lung and vessels Pub Date : 2015-01-01

S Hyllén, S Nozohoor, C Meurling, P Wierup, J Sjögren

{"title":"Pulmonary capillary wedge pressure and natriuretic peptide levels in patients with sinus rhythm and severe left atrial enlargement following mitral valve surgery: early and late changes.","authors":"S Hyllén, S Nozohoor, C Meurling, P Wierup, J Sjögren","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: Chronic mitral regurgitation is often accompanied by left atrial and ventricular remodeling and elevated natriuretic peptide levels. Our aim was to examine the relation between severe preoperative left atrial enlargement and changes in hemodynamics and natriuretic peptide levels after mitral valve surgery.Methods: A prospective study was conducted including 40 consecutive patients in sinus rhythm, with severe degenerative mitral regurgitation. N-terminal protype-B natriuretic peptide levels and hemodynamics were measured at predefined time points. An echocardiographic evaluation was performed the day before valve surgery and six months postoperatively.Results: Patients with left atrial volume index ≥60 mL/m(2), n=26, had higher baseline mean pulmonary capillary wedge pressure (17±9 mmHg vs 9±4 mmHg, p=0.010) and N-terminal protype-B natriuretic peptide (1326±2573 ng/L vs 233±221 ng/L, p=0.002) than patients with left atrial volume index <60 mL/m(2). The mean pulmonary capillary wedge pressure decreased to normal in patients with severe left atrial enlargement early after surgery, while it remained normal in patients without severe left atrial enlargement. The natriuretic peptide levels increased during the early postoperative period and decreased in both groups at 6-month follow-up.Conclusions: A severe left atrial enlargement in patients with chronic degenerative mitral regurgitation and sinus rhythm indicates higher pulmonary capillary wedge pressure and natriuretic peptide levels than in those without. These findings may support early referral to surgery and may facilitate perioperative management. The potential reversibility of left atrial enlargement after surgery may be associated with postoperative reductions in pulmonary capillary wedge pressure and natriuretic peptide levels.","PeriodicalId":89932,"journal":{"name":"Heart, lung and vessels","volume":"7 1","pages":"7-17"},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/bd/1b/hlv-07-007.PMC4381818.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33206345","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

Peripheral diagnostic and interventional procedures using an automated injection system for carbon dioxide (CO2): case series and learning curve. 使用二氧化碳自动注射系统的外围诊断和介入程序:病例系列和学习曲线。

Heart, lung and vessels Pub Date : 2015-01-01

Arturo Giordano, Stefano Messina, Michele Polimeno, Nicola Corcione, Paolo Ferraro, Giuseppe Biondi-Zoccai, Gabriele Giordano

{"title":"Peripheral diagnostic and interventional procedures using an automated injection system for carbon dioxide (CO2): case series and learning curve.","authors":"Arturo Giordano, Stefano Messina, Michele Polimeno, Nicola Corcione, Paolo Ferraro, Giuseppe Biondi-Zoccai, Gabriele Giordano","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: The administration of iodinated contrast media in doses sufficient for diagnosis and procedural guidance, when coincident with renal insufficiency, presents a considerable risk of exacerbating and hastening renal failure. Carbon dioxide has been proposed in the past as an alternative, but only recently dedicated injection systems have become available. We aimed to review our ongoing experience with an automated carbon dioxide injector for peripheral diagnostic and interventional procedures.Methods: Details on 21 patients undergoing peripheral procedures with carbon dioxide angiography were systematically collected. An automated injector enabling customized and repeated carbon dioxide injections was used in all cases, with iodinated contrast media used only as bailout.Results: No major or minor complications occurred in these patients, either during the procedure or up to discharge. Comparison according to phase of the learning curve showed that with accruing experience operators relied progressively more on carbon dioxide only, as there was a significantly reduced need for additional iodinated contrast media injections per procedure (from 2.5±2.1 to 0.6±2.1 injections per patient, p=0.005). Accordingly, in the second phase of our learning curve, iodinated contrast media were avoided in 91% of cases in comparison to 20% of procedures performed in the beginning of our experience (p=0.002). Concomitantly, no significant change in the duration of the procedure occurred.Conclusions: Carbon dioxide-based angiography using an automated injection system is feasible and safe in patients undergoing diagnostic or interventional procedures for infra-diaphragmatic conditions, especially for transcatheter renal sympathetic denervation.","PeriodicalId":89932,"journal":{"name":"Heart, lung and vessels","volume":"7 1","pages":"18-26"},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b7/e5/hlv-07-018.PMC4381819.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33206346","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

McConnell's echocardiographic sign in acute pulmonary embolism: still a useful pearl. 急性肺栓塞的麦康奈尔超声心动图征象:仍是一颗有用的明珠。

Heart, lung and vessels Pub Date : 2015-01-01

Jorge A Brenes-Salazar

引用次数: 0

No coronary artery occlusion in septic shock: Isoproterenol infusion should not be discouraged. 感染性休克无冠状动脉闭塞:不应阻止异丙肾上腺素输注。

Heart, lung and vessels Pub Date : 2015-01-01

Marc Leone, Claude Martin

引用次数: 0

Major themes for 2014 in cardiothoracic and vascular anaesthesia and intensive care. 2014 年心胸和血管麻醉及重症监护领域的重大主题。

Heart, lung and vessels Pub Date : 2015-01-01

Jacob T Gutsche, Hynek Riha, Prakash Pate, Lance Atchley, Elizabeth Valentine, Ronak Shah, Sophia T Cisler, Stuart J Weiss, George Silvay, John G T Augoustides

{"title":"Major themes for 2014 in cardiothoracic and vascular anaesthesia and intensive care.","authors":"Jacob T Gutsche, Hynek Riha, Prakash Pate, Lance Atchley, Elizabeth Valentine, Ronak Shah, Sophia T Cisler, Stuart J Weiss, George Silvay, John G T Augoustides","doi":"","DOIUrl":"","url":null,"abstract":"There has been significant progress throughout 2014 in cardiothoracic and vascular anaesthesia and intensive care. There has been a revolution in the clinical approach to acute and chronic adult aortic diseases. Contemporary management of adult aortic disease is based on etiology, clinical presentation, extent, and integrated intervention with medical, endovascular and/or surgical measures. Further European guidelines have explored in depth the cardiovascular management in non-cardiac surgery with a thematic focus to reduce perioperative mortality from the leading offender, namely myocardial ischemia. Integrated guidelines address the management of myocardial revascularization including the percutaneous and surgical options. Despite 50 years since the first coronary artery bypass grafting procedure and impressive advances in interventional cardiology, surgical revascularization remains a gold standard for many patients with coronary artery disease. These advances in 2014 will likely further improve perioperative outcomes for our patients. ","PeriodicalId":89932,"journal":{"name":"Heart, lung and vessels","volume":"7 2","pages":"101-9"},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e7/ef/hlv-07-101.PMC4476764.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33890014","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

Tricuspid annular plane systolic excursion (TAPSE) predicts poor outcome in patients undergoing acute pulmonary embolectomy. 三尖瓣环平面收缩漂移(TAPSE)预测急性肺栓塞切除术患者的不良预后。

Heart, lung and vessels Pub Date : 2015-01-01

Eckhard Schmid, Jan N Hilberath, Gunnar Blumenstock, Prem S Shekar, Steffen Kling, Stanton K Shernan, Peter Rosenberger, Martina Nowak-Machen

{"title":"Tricuspid annular plane systolic excursion (TAPSE) predicts poor outcome in patients undergoing acute pulmonary embolectomy.","authors":"Eckhard Schmid, Jan N Hilberath, Gunnar Blumenstock, Prem S Shekar, Steffen Kling, Stanton K Shernan, Peter Rosenberger, Martina Nowak-Machen","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: Right ventricular failure remains a major cause of mortality during acute pulmonary embolism. Right ventricular function can be assessed with transesophageal echocardiography. However, due to the complex right ventricular anatomy, only a few echocardiographic parameters are reliable and easily obtainable intraoperatively. Tricuspid annular plane systolic excursion is a validated parameter of global right ventricular function.Methods: Data from 81 patients with acute pulmonary embolus undergoing pulmonary embolectomy were evaluated. Transesophageal echocardiography derived parameters of right ventricular function were obtained and compared to tricuspid annular plane systolic excursion measurements. Patients were then divided into two groups (TAPSE < 18 mm and ≥18 mm).Results: The patient population consisted of 46 males and 35 females, mean age 61.0 ± 12.9 years. Patients in the TAPSE <18 mm group had significantly larger diastolic (p=0.0015) and systolic (p=0.0031) right ventricular diameters, lower right ventricular fractional area change (p=0.0065) and greater degrees of tricuspid regurgitation (p=0.0001) compared to patients with TAPSE ≥18 mm. In addition, all patients who needed intraoperative cardiopulmonary resuscitation (11/81) or died intraoperatively (8/81) belonged to the TAPSE <18 mm group. Logistic regression analysis confirmed TAPSE <18 mm as an independent risk factor for intraoperative cardiopulmonary resuscitation and death.Conclusions: Transesophageal echocardiography derived TAPSE is easily obtainable and correlates well with other standardized parameters of right ventricular function. TAPSE <18 mm is an independent predictor of intraoperative cardiopulmonary resuscitation and death in patients undergoing emergent pulmonary embolectomy.","PeriodicalId":89932,"journal":{"name":"Heart, lung and vessels","volume":"7 2","pages":"151-158"},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/66/0f/hlv-07-151.PMC4476769.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33890019","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