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Heart Institute (heart + institute)
Selected AbstractsThe Effect of Administering Erythropoiesis-Stimulating Proteins in Patients With Chronic Heart Failure: Results From a Retrospective StudyCONGESTIVE HEART FAILURE, Issue 6 2006Reynolds M. Delgado MD Anemia is prevalent in patients with chronic heart failure and is associated with worse symptoms and poor prognosis. The authors reviewed the charts of all patients (N=467) treated at Texas Heart Institute from January 2000 to October 2003, during which time a clinical protocol offered treatment with erythropoiesis-stimulating proteins. Post-treatment, the authors observed a significant increase in mean ± SD hemoglobin, from 9.9±1.1 g/dL to 11.7±1.5 g/dL (P<.0001), improvement of renal function (a decrease in mean levels of creatinine and blood urea nitrogen), and fewer hospital admissions (1.0±1.4 vs 1.8±1.6; P=.0003) without an increase in adverse clinical events, compared with pretreatment and compared with an untreated control group. These results suggest a potential benefit of anemia treatment with recombinant erythropoiesis-stimulating proteins in patients with chronic heart failure. [source] The praxis of clinical knowledge: Learning to care for paediatric patients with a congenital heart anomalyINTERNATIONAL JOURNAL OF NURSING PRACTICE, Issue 3 2007Suzi Robertson-Malt RN PhD BN(Hons) In Saudi Arabia, the major tertiary care unit for the treatment of cardiovascular disease is the King Faisal Heart Institute (KFHI). Its state of the art technology and patient profile facilitates nurses to become highly knowledgeable in the diversity of treatment modalities and nursing care of a range of paediatric pathology. Like many global nursing organizations, the KFHI is experiencing nursing shortages and nurses coming to work in this highly specialized area are lacking some of the basic understanding and skills development necessary to work efficiently and effectively in the area. This paper describes the work of the cardiovascular education team in developing a praxis-based curriculum that equips nurses to not only function at a high level in the cardiovascular area but also facilitate success in their future careers when they leave Saudi Arabia. [source] Surrogate endpoints and emerging surrogate endpoints for risk reduction of cardiovascular diseaseNUTRITION REVIEWS, Issue 2 2008Crystal M Rasnake This article reviews surrogate endpoints and emerging biomarkers that were discussed at the annual "Cardiovascular Biomarkers and Surrogate Endpoints" symposium cosponsored by the US Food and Drug Administration (FDA) and the Montreal Heart Institute. The FDA's Center for Food Safety and Applied Nutrition (CFSAN) uses surrogate endpoints in its scientific review of a substance/disease relationship for a health claim. CFSAN currently recognizes three validated surrogate endpoints: blood pressure, blood total cholesterol, and blood low-density lipoprotein (LDL) concentration in its review of a health claim for cardiovascular disease (CVD). Numerous potential surrogate endpoints of CVD are being evaluated as the pathophysiology of heart disease is becoming better understood. However, these emerging biomarkers need to be validated as surrogate endpoints before they are used by CFSAN in the evaluation of a CVD health claim. [source] Laser Lead Extraction: Predictors of Success and ComplicationsPACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 2 2007JEAN-FRANÇOIS ROUX M.D. Background: Paralleling the rise in pacemaker and defibrillator implantations, lead extraction procedures are increasingly required. Concerns regarding failure and complications remain. Methods and Results: A total of 200 lead extraction procudures were performed at the Montreal Heart Institute between September 2000 and August 2005. In 23 patients, all leads were removed by traction with a locking stylet. A total of 270 leads were extracted using a laser sheath system (Spectranectics, Colorado Springs, CO, USA) in 177 procedures involving 175 patients (74% male), age 62±16 years. Procedural indications were: infection 88 (50%), dysfunction 54 (30%), upgrade 21 (12%), and other 14 (8%). Overall, 241 leads (89%) were successfully extracted, 7 (3%) were partially extracted (,4 cm retained), and 22 (8%) were non-extractable. In multivariate analyses, predictors of failed extraction were longer time from implant (OR 1.16 per year, P=0.0001) and history of hypertension (OR 5.2, P=0.0023). Acute complications occurred in 14 of 177 procedures (7.9%): 8 (4.5%) minor and 6 (3.4%) major, with one death. In multivariate analyses, the only predictor of acute complications was laser lead extraction from both right and left sides during the same procedure (OR 9.4, P = 0.0119). In addition, 3 of 10 patients with failed or partially extracted infected systems eventually required open chest explantation because of endocarditis. Conclusion: Most leads not amenable to manual traction may be successfully extracted by a percutaneous laser sheath system. While most complications are minor, major complications including death may occur. Older leads are at higher risk for failed extraction. Endocarditis may ensue if infected leads are incompletely removed. [source] Heart Transplantation at the Ottawa Heart Institute: Comparison with Canadian and International ResultsARTIFICIAL ORGANS, Issue 2 2004Ross A. Davies Abstract:, Heart transplantation has been carried out in 340 patients in Ottawa, including seventy-one who required mechanical circulatory support as a bridge to transplant. Survival in Ottawa was compared with other Canadian centers based on data from the Canadian Organ Replacement Register up to the year 2000 and with the International Society of Heart and Lung Transplantation (ISHLT) registry 2001. For survival analysis, the number of adult patients at risk at year 0 was 303 (87 transplanted from 1985 to 1990, 105 from 1990 to 1994, and 111 from 1995 to 2000). The Statistical Analysis System (SAS) life test procedure was used. Survival was not adjusted for comorbidities or heart failure class. For the year of transplant 1985,1989, one-, five-, and ten-year patient survival in Ottawa was 83%, 70%, and 60%, respectively, compared to 82%, 71%, and 54%, respectively, for Canada (Wilcoxon test, P = 0.71), and compared to one- and five-year survival for ISHLT from 1980 to 1987 at 76% and 60%, respectively. For 1990,1994, one-, five-, and ten-year patient survival in Ottawa was 88%, 81%, and 74%, respectively, compared to 80%, 71%, and 61%, respectively, for Canada (P = 0.05), and compared to one- and five-year survival for ISHLT from 1998 to 1992 at 80% and 68%, respectively. For 1995,2000, one- and five-year patient survival in Ottawa was 90% and 82%, respectively, compared to 85% and 76%, respectively, for Canada (P = 0.09), and compared to one- and five-year survival for ISHLT from 1993 to 1996 at 82% and 68%, respectively. Survival after heart transplantation in Ottawa compares ,favorably ,with ,Canadian ,and ,international data. [source] Mechanical Behavior and Stability of the Internal Membrane of the InCor Ventricular Assist DeviceARTIFICIAL ORGANS, Issue 11 2001Pedro Baroni Da Costa Teixeira Abstract: This paper describes and analyzes the mechanical behavior of the internal membrane of the InCor VAD (Heart Institute [InCor], University of São Paulo, Brazil), applying the knowledge and tools of structural engineering analysis. This membrane plays an important role in the operation of the ventricular assist device (VAD) because it separates the blood chamber from the pneumatic one, transmitting the pneumatic load to the blood, thus making the desired blood flow possible. The loading repeats itself every time the VAD beats. Therefore the performance, reliability, and durability of the membrane are critical for the performance of the VAD. The mathematical model is based on the large deflection theory of thin shells and on the finite element method. The snap-through instability phenomenon, which is responsible for transmission of the pneumatic load to the blood, was observed in the membrane both when modeled mathematically and experimentally. Principal stresses and strain distributions were obtained with this model at certain load levels along the pre- and postbuckling paths. [source] Medical management of significant coronary angiographic stenoses: Outcome of 60 patients observed for 433 patient yearsCLINICAL CARDIOLOGY, Issue 8 2000Charles L. Baird Jr. M.D. Abstract Background: Percutaneous transluminal coronary angioplasty (PTCA) has become routine in the management of patients with stable angina pectoris and significant coronary stenoses, while medical management of such patients has declined. Hypothesis: The purpose of the present study was to evaluate the outcome of 60 patients at the Virginia Heart Institute with stable angina pectoris, observed between 1976 and 1997, who had documented evidence of severe angiographic disease but were elected to be monitored and managed in an outpatient pharmacologic rehabilitation program. Methods: Sixty patients with significant stenoses by coronary angiography (21 with single-vessel, 26 with double-vessel, and 13 with triple-vessel) without impaired ventricular function, exercise-induced ischemia or hypotension, limited exercise performance, malignant arrhythmias, or drug intolerance were enrolled in a program of pharmacologic rehabilitation and observed for an average of 7.2 years. Results: Among the 60 patients, there were 6 deaths at a mean interval of 8.3 years. Two deaths were in patients ineligible for revascularization. Another patient who died had refused revascularization after new-onset left ventricular dysfunction, and another died intraoperatively during abdominal aortic aneurysm repair. Two patients died while exercising. Thirteen patients underwent follow-up catheterization for worsening angina; 11 of 13 showed progression, predominantly from new lesions. Four of 11 were referred for revascularization; 7 of 11 continued medical treatment; 49 patients were stable on medical therapy throughout the period of observation. Conclusion: Medical management of selected patients with significant coronary stenoses is safe and effective. [source] | ||||||||||