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Systemic Pressure (systemic + pressure)
Selected AbstractsLate Presenters with Dextro-transposition of Great Arteries and Intact Ventricular Septum: To Train or Not to Train the Left Ventricle for Arterial Switch Operation?CONGENITAL HEART DISEASE, Issue 6 2009Noor Mohamed Parker MBChB ABSTRACT Objective., We report our experience in managing late presenters (older than 4 weeks) with dextro-transposition of great arteries and intact ventricular septum (d-TGA/IVS) in an effort to achieve successful arterial switch operation (ASO) in a third world setting. Design., We retrospectively reviewed the charts of all late presenters with d-TGA/IVS. Patients were divided into two groups: left ventricular training (LVT) group and non-left ventricular training (non-LVT) group. LVT group underwent pulmonary artery banding and Blalock-Taussig Shunt prior to ASO. Results., Twenty-one late presenters were included in the study. In LVT group, 11 patients with median age of 6 months (range, 1,72 months) underwent LVT. Later, 8 patients with median age of 9.25 months (range, 1.33,84 months) underwent ASO. Prior to ASO, left ventricle (LV) collapse resolved in all and left ventricle to systemic pressure (LV/SP) ratio was 0.81 (range, 0.76,0.95) in 4 patients. Two patients who had LVT for ,14 days required postoperative extracorporeal membrane oxygenation (ECMO) support due to LV dysfunction. Seven patients survived to discharge. In non-LVT group, 10 patients with median age of 2.5 months (range, 1,98 months) underwent ASO. Five patients had LV collapse, and median LV/SP ratio was 0.67 (range, 0.56,1.19) in 5 patients. Seven patients needed ECMO support. Seven patients survived to discharge. Conclusion., Late presenters with d-TGA/IVS, who have LV collapse on echocardiography and/or a LV/SP ratio <0.67 on cardiac catheterization, should be subjected to LVT preferably for duration of longer than 14 days in order to avoid potential ECMO use. [source] The "Button Inside" Technique for the Aortic Root Replacement: A Modified Button TechniqueJOURNAL OF CARDIAC SURGERY, Issue 4 2006Carlo Canosa M.D. Anastomosis of the coronary buttons is performed from the inside of the composite valve graft previously including the coronary buttons in the composite valve graft. Reduced tension is present between coronary arteries and the composite valve graft once the heart is beating and the systemic pressure is increasing. In this way coronary buttons are reinforced directly by the composite aortic wall graft prosthesis. The coronary ostia are perfused with lower tension at the site of the coronary anastomoses. No bleeding from the suture line of the coronary buttons occurs using this new surgical approach. [source] Rapid Ventricular Pacing for Catheter Interventions in Congenital Aortic Stenosis and Coarctation: Effectiveness, Safety, and Rate Titration for Optimal ResultsJOURNAL OF INTERVENTIONAL CARDIOLOGY, Issue 1 2010CHETAN MEHTA M.B.B.S. Introduction: Infants and children with congenital aortic stenosis and coarctation of the aorta can be treated by catheter intervention. There are several pharmacological and mechanical techniques described to overcome the balloon movement; none, however, have proved entirely satisfactory. An alternative method to achieve balloon stability is the use of rapid ventricular pacing. We describe our experience with titrating the pacing rate and the use of this technique. Methods: A retrospective review of database was performed, to identify patients who underwent transcatheter intervention with rapid ventricular pacing. Invasive systemic pressures were documented with a catheter in the aorta. Rapid ventricular pacing was initiated at the rate of 180 per minute and increased by increments of 20 per minute to a rate required to achieve a drop in systemic pressure by 50% and a drop in pulse pressure by 25%. The balloon was inflated only after the desired pacing rate was reached. Pacing was continued until the balloon was completely deflated. Results: Thirty patients were identified, 29 of whom had interventions with rapid ventricular pacing. Balloon valvuloplasty of aortic valve was performed on 25 patients while 4 patients had stenting for coarctation by this technique. The rate of ventricular pacing required ranged from 200 to 260 per minute with a median rate of 240. Balloon stability at the time of intervention was achieved in 27 patients. Conclusion: Rapid ventricular pacing is a safe and effective method to provide transient decrease in cardiac output at the time of transcatheter interventions to achieve balloon stability. (J Interven Cardiol 2010;23:7,13) [source] A rapid biodiversity assessment methodology tested on intertidal rocky shoresAQUATIC CONSERVATION: MARINE AND FRESHWATER ECOSYSTEMS, Issue 4 2010Timothy D. O'hara Abstract 1.Conservation managers require biodiversity assessment tools to estimate the impact of human activities on biodiversity and to prioritize resources for habitat protection or restoration. Large-scale programs have been developed for freshwater ecosystems which grade sites by comparing measured versus expected species richness. These models have been applied successfully to habitats that suffer from systemic pressures, such as poor water quality. However, pressures in other habitats, such as rocky intertidal shores, are known to induce more subtle changes in community composition. 2.This paper tests a biodiversity assessment methodology that uses the ANOSIM R statistic to quantify the biological dissimilarity between a site being assessed and a series of reference sites selected on the basis of their similar environmental profile. Sites with high R values for assemblage composition have an anomalous assemblage for their environmental profile and are potentially disturbed. 3.This methodology successfully identified moderate to heavily perturbed sites in a pilot study on 65 rocky intertidal sites in south-eastern Australia. In general, measures based on percentage cover (flora and sessile invertebrates) were more sensitive than abundance (fauna). Copyright © 2010 John Wiley & Sons, Ltd. [source] | ||||||||||