Minimal access median sternotomy for aortic valve replacement in elderly patients

BACKGROUND: We report our clinical experience with a approach for aortic valve replacement (AVR) via minimal access skin incision and complete median sternotomy. This approach was used in patients with higher age and multiple co-morbidities, facilitating an easy access with short bypass and cross clamp times. It was especially performed in patients asking for an excellent cosmetic result, who did not qualifying for minimally-invasive AVR via partial upper sternotomy. METHODS: AVR via minimal-access median sternotomy, was performed in 58 patients between 01/2009 and 11/2011. Intra- and postoperative data including cross clamp time, cardiopulmonary bypass time, mortality, stroke, pacemaker implantation, re-operation for bleeding, ventilation time, ICU and hospital stay, wound infection, sternal dehiscence or fracture and 30 day mortality were collected. RESULTS: Mean patients age was 76.1 +/−9.4 years, 72% were female. Minimal-access AVR could be performed with a mean length of midline skin incision of 7.8 cm. Aortic cross-clamping time was 54.6 +/−6.3 min, cardiopulmonary bypass time 71.2+/−11.3 min and time of surgery 154.1 +/−26.8 min. Re-operation for bleeding had to be performed in 1 case (1.7%). There were no strokes or pacemaker implantations needed. Mean ventilation time was 4.5 h, ICU stay was 2 days and mean length of hospital stay was 6 days. 6 months follow up showed mortality of 0% and no sternal dehiscence or wound infection was observed. CONCLUSION: Minimal-access AVR via complete median sternotomy can be performed safely,in this elderly patient cohort without adding additional operative risk compared to conventional AVR. By avoidiance of large skin incisions this approach combines excellent cosmetic results with fast surgery time and excellent postoperative recovery

Comparison between FLC and PID Controller for 5DOF robot arm

Controlling robot manipulator is essential problem to guarantee the robot execute the desired task with minimum error. This paper presents a fuzzy logic controller (FLC) for manipulating 5DOF robot arm based on independent joint control method. The proposed controller design aims to overcome the drawbacks of classical PID controller. The simulation is done using Matlab/ SIMULINK by comparing the performance of the two controllers for Lynx6 robot arm in terms of time response. Based on the simulation results, the FLC provides good results than PID controller

Letters

www.elsevier.com/locate/aml Abstract-Motivated essentially by their possible need in a fairly large number of physical and chemical contexts, Mavromatis and Alsssar [l] derived several associated Laguerre integral results by eliminating au unnecessary constraint used in an earlier paper on the subject by Mavromatis [2]. The main object of the present sequel to these recent works is to investigate and apply much more general families of integral formulas, involving products of two or more Laguerre polynomials, which have been considered in the mathematical literature rather extensively. @ 2003 Elsevier Ltd. All rights reserved. Keywords-Laguerre polynomials, Orthogonality property, Generalized hypergeometric function