- Efficacy and safety of a novel catheter for transradial cerebral angiography. [Journal Article]
- AVAnn Vasc Surg 2019 Jun 11
- CONCLUSIONS: This novel catheter improved the success rate of selective left vertebral artery catheterization, and allowed for simplification of the relevant surgical steps. The controllability of this novel catheter was satisfactory, and its associated surgical risk was found to be low.
- Computational fluid dynamics simulations as a complementary study for transcatheter endovascular stent implantation for re-coarctation of the aorta associated with minimal pressure drop: an aneurysmal ductal ampulla with aortic isthmus narrowing. [Journal Article]
- CYCardiol Young 2019 Jun 14; :1-9
- CONCLUSIONS: We used computational fluid dynamics to study re-coarctation involving an aneurysmal ductal ampulla and aortic isthmus narrowing. Despite minimal pressure drop, computational fluid dynamics identified flow patterns that would place the patient at risk for: thromboembolic events, rupture of the ampulla, and impaired descending aortic wall integrity. Thus, catheter-directed stenting was undertaken and proved successful. Computational fluid dynamics yielded important information, not only about the case presented, but about the complementary role it can serve in the management of patients with complex aortic arch obstruction.
- Living the heart in three dimensions: applications of 3D printing in CHD. [Journal Article]
- CYCardiol Young 2019 Jun 14; :1-11
- Advances in biomedical engineering have led to three-dimensional (3D)-printed models being used for a broad range of different applications. Teaching medical personnel, communicating with patients an…
Advances in biomedical engineering have led to three-dimensional (3D)-printed models being used for a broad range of different applications. Teaching medical personnel, communicating with patients and relatives, planning complex heart surgery, or designing new techniques for repair of CHD via cardiac catheterisation are now options available using patient-specific 3D-printed models. The management of CHD can be challenging owing to the wide spectrum of morphological conditions and the differences between patients. Direct visualisation and manipulation of the patients' individual anatomy has opened new horizons in personalised treatment, providing the possibility of performing the whole procedure in vitro beforehand, thus anticipating complications and possible outcomes. In this review, we discuss the workflow to implement 3D printing in clinical practice, the imaging modalities used for anatomical segmentation, the applications of this emerging technique in patients with structural heart disease, and its limitations and future directions.
- Unanticipated admissions to paediatric cardiac critical care after cardiac catheterisations. [Journal Article]
- CYCardiol Young 2019 Jun 14; :1-10
- CONCLUSIONS: Admission to CCCU following cardiac catheterisation was uncommon and tended to occur in younger children undergoing interventional procedures. Outcomes did not differ between patients experiencing planned and unplanned CCCU admission. Ongoing development of risk stratification tools may help to decrease unplanned CCCU admissions. Further studies are needed to determine whether unplanned admission following paediatric cardiac catheterisation should be utilised as a quality indicator.
- [Endoscopic management of anterior urethral strictures by use of direct visual internal urethrotomy with mitomycin C and clean intermittent catheterization]. [Journal Article]
- UUrologe A 2019 Jun 13
- StatPearls: Intra-Aortic Balloon Pump (IABP) [BOOK]
- BOOKStatPearls Publishing: Treasure Island (FL)
- Patients with the clinical and biochemical signs and symptoms of hypoperfusion secondary to cardiac failure or cardiac arrest carry high short-term mortality. Various mechanical circulatory devic…
Patients with the clinical and biochemical signs and symptoms of hypoperfusion secondary to cardiac failure or cardiac arrest carry high short-term mortality. Various mechanical circulatory devices have been developed to mitigate the adverse outcomes of cardiogenic shock until treating the underlying cause. To date, four types of mechanical circulatory support devices exist that includes Intra-aortic balloon pump (IABP), non-IABP ventricular circulatory assist devices, extracorporeal membrane oxygenation devices, and non-percutaneous ventricular assist devices. Intra-aortic balloon pump is the simplest, cost-effective, easy to implant and explant in the coronary catheterization laboratory by an interventional cardiologist and can effectively be managed in an intensive care unit by an intensivist. Although IABP has a modest hemodynamic beneficial effect as compared with novel, advanced mechanical circulatory support devices, it has a better safety profile, relative simplicity to use, and the beneficial cardiovascular physiological impact. These features make IABP a frequently used circulatory support device in patients requiring hemodynamic support either in cardiogenic shock or at risk of hemodynamic decompensation during a high-risk coronary intervention. However, currently available evidence related to the use of IABP is in constant flux. Therefore, it is important to review the safety and efficacy of IABP in various clinical conditions and appraise the health care providers of current evidence base literature related to IABP. In this article, we have reviewed the physiological and hemodynamic effects of IABP on the cardiovascular system as well as the safety and efficacy of its use in various cardiovascular clinical conditions.
- A Prospective Study of the Urinary and Gastrointestinal Microbiome in Prepubertal Males. [Journal Article]
- UUrology 2019 Jun 10
- CONCLUSIONS: This study provides one of the first characterizations of the urinary microbiome in prepubertal males. Defining the baseline healthy microbiome in children may lay the foundation for understanding the long-term impact of factors such as antibiotic use in the development of a healthy microbiome as well as the development of future urological and gastrointestinal diseases.
- Stiff left atrial syndrome after low-dose radiotherapy for right breast cancer: The need for invasive hemodynamics at exercise. [Case Reports]
- CCCatheter Cardiovasc Interv 2019 Jun 13
- Stiff left atrial (LA) syndrome is a distinct phenotype of heart failure with preserved ejection fraction, characterized by predominant high LA pressure. We describe the case of a middle-aged woman w…
Stiff left atrial (LA) syndrome is a distinct phenotype of heart failure with preserved ejection fraction, characterized by predominant high LA pressure. We describe the case of a middle-aged woman who developed exertional breathlessness during low-dose radiotherapy for right breast cancer and who was eventually found to be affected by stiff LA syndrome. Invasive hemodynamics allowed the recognition of pathognomonic tall V waves in the wedge position during exercise, in spite of inconclusive noninvasive investigations.
- An unusual arteriovenous malformation involving the cervical vessels treated with endovascular repair. [Case Reports]
- JVJ Vasc Surg Cases Innov Tech 2019; 5(2):136-138
- We present an unusual and complex arteriovenous malformation involving the vertebral artery, subclavian artery, and internal jugular vein in a 31-year-old man with no history of trauma or catheteriza…
We present an unusual and complex arteriovenous malformation involving the vertebral artery, subclavian artery, and internal jugular vein in a 31-year-old man with no history of trauma or catheterization. The repair was done using endovascular techniques to minimize complications from nerve or vascular injury. The massively dilated jugular vein has remained diminished in size and the patient has remained asymptomatic at 8 months. We discuss the occurrence of this rare malformation as well as treatment options along with their risks and benefits.
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- Reverse Ramp Testing in Left Ventricular Assist Device Support and Myocardial Recovery. [Journal Article]
- AJASAIO J 2019 Jun 06
- Mechanical unloading with left ventricular assist device (LVAD) support can lead to clinically meaningful reversal of stress-related compensatory mechanisms. However, true assessment of left ventricu…
Mechanical unloading with left ventricular assist device (LVAD) support can lead to clinically meaningful reversal of stress-related compensatory mechanisms. However, true assessment of left ventricular ejection fraction (LVEF) is not possible, whereas the left ventricle is unloaded by LVAD therapy making identification of patients with myocardial recovery even more challenging. We introduce our new protocol, the "reverse ramp test" for HeartWare HVAD, HeartMate II, and HeartMate 3. The reverse ramp is transthoracic echo (TTE) and right heart catheterization (RHC)-based protocol with LVAD turn down steps to minimal support allowing for a more accurate assessment of myocardial function.