A proposed search for a fourth neutrino with a PBq antineutrino source

Several observed anomalies in neutrino oscillation data can be explained by a hypothetical fourth neutrino separated from the three standard neutrinos by a squared mass difference of a few eV^2. We show that this hypothesis can be tested with a PBq (ten kilocurie scale) 144Ce or 106Ru antineutrino beta-source deployed at the center of a large low background liquid scintillator detector. In particular, the compact size of such a source could yield an energy-dependent oscillating pattern in event spatial distribution that would unabiguously determine neutrino mass differences and mixing angles.Comment: 4 pages ; 1 table ; 4 figures - Add energy spectrum shape only analysis + referee comments/suggestion

171 Definitive pacemaker requirement after percutaneous Edwards Sapien aortic valve implantation: a rare complication

In 2009, more than 6000 patients have been treated with percutaneous aortic valve implantation using one of the two commercialized models of bioprothesis. The occurrence of complete atrioventricular block (AV-Block) requiring a pacemaker was described after implantation, particularly with the Corevalve (up to 25%).Purpose of the StudyTo evaluate the occurrence of conduction abnormalities and requirements for permanent pacing after Edwards Sapien aortic valve implantation.MethodsWe analyzed the standard 12-lead electrocardiograms (ECGs) of 55 consecutive Pts in whom an Edwards Sapien aortic valve was successfully implanted between June 2006 and December 2008 using either trans-femoral or trans-apical approach. We examined the ECGs before treatment, at day 1, and at one-month and analyzed the presence of a second or third-degree AV-block.ResultsMean age was 82 +/- 8.4 years and 46% were female. Logistic Euroscore was 27.8 + 14.9%. We noted a slight increase in HR at day-1 (78.8 + 16 vs 74.9 + 13 b / min, p=0.005) with decrease in QT interval (395±47.7 vs 416.8±40.2 ms, p=0.02). These values returned to baseline values at 1 month. There was no change in PR interval (198.8±42.4 vs 199.7±45.7 ms at day 1, p=0.98 and 199.3±39.8 ms at day 30, p=0.56) and QRS duration (113.3±26.2 vs 116.8±28 ms at day 1, p=0.14 and 113.2±25.4 ms at day 30, p=0.63) neither in the occurrence of hemiblocks. A new left bundle branch developed in 5 Pts (9%) at day one but was not present anymore at day-30. A permanent pacemaker was implanted in 2 cases (4.1%) for 3-degree AV-block: at day 3 one for persistent AV-Block developed immediately after aortic valve predilatation and at day 10 in the second case due to the delayed occurrence of 3-degree AV-Block.ConclusionsIn our experience, conductive disorders and the requirement of a definitive pacemaker after implantation of an Edwards-Sapien bioprothesis are unfrequent (4.1%)

Multicenter Evaluation of Edwards SAPIEN Positioning During Transcatheter Aortic Valve Implantation With Correlates for Device Movement During Final Deployment

ObjectivesThis study sought to evaluate the exact location of Edwards SAPIEN (Edwards Lifesciences, Irvine, California) devices in different stages of implantation and to quantify possible operator-independent device movement during final deployment.BackgroundAccurate device positioning during transcatheter aortic valve implantation is crucial in order to achieve optimal results.MethodsThis multicenter study consisted of 68 procedures with reliable pacemaker capture. Device positions were assessed using fluoroscopic images and the C-THV system (Paieon Medical, Rosh Ha'Ayin, Israel).ResultsThe location after implantation was significantly higher than in the final stage of rapid pacing: 16.7 ± 16.3% of device height below the plane of the lower sinus border versus 32.6 ± 13.8%, p < 0.0001. Operator-independent device-center upper movement during final deployment was 2 ± 1.43 mm, range: −1.3 to 4.6 mm. Device movement was asymmetrical, occurring more in the lower part of the device than in its upper part (3.2 ± 1.4 mm vs. 0.75 ± 1.5 mm, p < 0.001), resulting in device shortening. Multivariate analysis revealed that moderate and severe aortic valve calcification had 49% higher upward movement than mild calcification (p = 0.03), and aortic sinus volume was negatively correlated with movement size (r = −0.35, p = 0.005). This movement was independent of device version (SAPIEN vs. SAPIEN XT), procedural access (transfemoral vs. transapical), and interventricular septum width.ConclusionsThe final Edwards SAPIEN position is mostly aortic in relation to the lower sinus border. There is an operator-independent upward movement of the device center during the final stage of implantation. Anticipated upward movement of the device should influence its positioning before final deployment

Transcatheter valve implantation for patients with aortic stenosis: a position statement from the European Association of Cardio-Thoracic Surgery (EACTS) and the European Society of Cardiology (ESC), in collaboration with the European Association of Percutaneous Cardiovascular Interventions (EAPCI)

Aims: To critically review the available transcatheter aortic valve implantation techniques and their results, as well as propose recommendations for their use and development. Methods and results: A committee of experts including European Association of Cardio-Thoracic Surgery and European Society of Cardiology representatives met to reach a consensus based on the analysis of the available data obtained with transcatheter aortic valve implantation and their own experience. The evidence suggests that this technique is feasible and provides haemodynamic and clinical improvement for up to 2 years in patients with severe symptomatic aortic stenosis at high risk or with contraindications for surgery. Questions remain mainly concerning safety and long-term durability, which have to be assessed. Surgeons and cardiologists working as a team should select candidates, perform the procedure, and assess the results. Today, the use of this technique should be restricted to high-risk patients or those with contraindications for surgery. However, this may be extended to lower risk patients if the initial promise holds to be true after careful evaluation. Conclusion: Transcatheter aortic valve implantation is a promising technique, which may offer an alternative to conventional surgery for high-risk patients with aortic stenosis. Today, careful evaluation is needed to avoid the risk of uncontrolled diffusio

Analyse du ventricule droit en mode doppler tissulaire myocardique (application à l'étude des cardiomyopathies non obstructives)

L'analyse de la fonction régionale du ventricule droit en mode Doppler tissulaire myocardique, est simple, fiable, et rapide. Notre étude montre chez le sujet sain le caractère indépendant par rapport à l'âge des vélocités systoliques de la paroi libre du ventricule droit, mais retrouve une diminution des vélocités proto-diastoliques chez les sujets âgés de plus de 60 ans traduisant une altération de la relaxation ventriculaire droite liée à l'âge. L' étude de la déformation régionale au niveau de la paroi libre du ventricule droit retrouve un pic de déformation systolique homogène, sans lien avec l'âge. Chez les patients atteints de cardiomyopathie dilatée, on retrouve en mode Doppler tissulaire myocardiyue une diminution des vélocités pariétales limitée à la portion basale de la paroi latérale du ventricule droit, traduisant une diminution de la contractilité et de relaxation ventriculaire droite. L'analyse de la déformation montre un pic de déformation systolique diminué de façon homogène et diffuse chez ces patients, et un délai de couplage électro mécanique augmenté, qui pourraient constituer des facteurs pronostiques intéressants chez les patients atteints de cardiomyopathie dilatée. Le Doppler tissulaire myocardique associé à l'analyse de la déformation régionale du ventricule droit constitue un outil très intéressant, ouvrant un vaste champ d'applications cliniques dans l'ensemble de la pathologie du ventricule droit.ROUEN-BU Médecine-Pharmacie (765402102) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF