4 research outputs found
Efficacy and safety of percutaneous mitral balloon valvotomy in patients with mitral stenosis: A systematic review and meta-analysis
Aims: Percutaneous mitral balloon valvotomy PMBV is an acceptable alternative to Mitral valve surgery
for patients with mitral stenosis. The purpose of this study was to explore the immediate results of PMBV
with respect to echocardiographic changes, outcomes, and complications, using a meta-analysis
approach.
Methods: MEDLINE, and EMBASE databases were searched (01/2012 to 10/2018) for original research
articles regarding the efficacy and safety of PMBV. Two reviewers independently screened references
for inclusion and abstracted data including article details and echocardiographic parameters before
and 24–72 h after PMBV, follow-up duration, and acute complications. Disagreements were resolved
by third adjudicator. Quality of all included studies was evaluated using the Newcastle-Ottawa Scale NOS.
Results: 44/990 references met the inclusion criteria representing 6537 patients. Our findings suggest
that PMBV leads to a significant increase in MVA (MD = 0.81 cm2; 0.76–0.87, p < 0.00001), LVEDP
(MD = 1.89 mmHg; 0.52–3.26, p = 0.007), LVEDV EDV (MD = 5.81 ml; 2.65–8.97, p = 0.0003) and decrease
in MPG (MD = 7.96 mmHg; 8.73 to 7.20, p < 0.00001), LAP (MD = 10.09 mmHg; 11.06 to 9.12,
p < 0.00001), and SPAP (MD = 15.55 mmHg; 17.92 to 13.18, p < 0.00001). On short term basis, the
pooled overall incidence estimates of repeat PMBV, mitral valve surgery, post-PMBV severe MR, and post-
PMBV stroke, and systemic thromboembolism were 0.5%, 2%, 1.4%, 0.4%, and 0.7% respectively. On long
term basis, the pooled overall incidence estimates of repeat PMBV, mitral valve surgery, post-PMBV severe
MR, and post-PMBV stroke, systemic thromboembolism were 5%, 11.5%, 5.5%, 2.7%, and 1.7% respectively
Conclusion: PMBV represents a successful approach for patients with mitral stenosis as evidenced by
improvement in echocardiographic parameters and low rate of complications.The authors received no financial support for the research,
authorship and publication of this article
Stem Cell-Related Studies and Stem Cell-Based Therapies in Liver Diseases
Owing to the increasing worldwide burden of liver diseases, the crucial need for safe and effective interventions for treating end-stage liver failure has been a very productive line of inquiry in the discipline of hepatology for many years. Liver transplantation is recognized as the most effective treatment for end-stage liver disease; however, the shortage of donor organs, high medical costs, and lifelong use of immunosuppressive agents represent major drawbacks and demand exploration for alternative treatments. Stem cell-based therapies have been widely studied in the field of liver diseases and are considered to be among the most promising therapies. Herein, we review recent advances in the application of stem cell-related therapies in liver disease with the aim of providing readers with relevant knowledge in this field and inspiration to spur further inquiry
Preclinical Experience of the Mayo Spheroid Reservoir Bioartificial Liver (SRBAL) in Management of Acute Liver Failure
The Spheroid Reservoir Bioartificial Liver (SRBAL) is an innovative treatment option for acute liver failure (ALF). This extracorporeal support device, which provides detoxification and other liver functions using high-density culture of porcine hepatocyte spheroids, has been reported in three randomized large animal studies. A meta-analysis of these three preclinical studies was performed to establish efficacy of SRBAL treatment in terms of survival benefit and neuroprotective effect. The studies included two hepatotoxic drug models of ALF (D-galactosamine, α-amanitin/lipopolysaccharide) or a liver resection model (85% hepatectomy) in pigs or monkeys. The SRBAL treatment was started in three different settings starting at 12 h, 24 h or 48 h after induction of ALF; comparisons were made with two similar control groups in each model. SRBAL therapy was associated with significant survival and neuroprotective benefits in all three animal models of ALF. The benefits of therapy were dose dependent with the most effective configuration of SRBAL being continuous treatment of 24 h duration and dose of 200 g of porcine hepatic spheroids. Future clinical testing of SRBAL in patients with ALF appears warranted