22 research outputs found
Role of Echocardiography in Percutaneous Mitral Valve Interventions
Intraprocedural imaging continues to evolve in parallel with advances in percutaneous mitral valve interventions. This didactic review uses several illustrations and rich intraprocedural videos to further describe and demonstrate the role of the most up-to-date echocardiographic and advanced imaging technologies in the patient selection and intraprocedural guidance of percutaneous mitral valve interventions. We will focus on 3 interventions: 1) percutaneous balloon mitral valvuloplasty for mitral stenosis; 2) transcatheter edge-to-edge repair of mitral valve regurgitation; and 3) transcatheter closure of periprosthetic mitral regurgitation. In addition, we discuss potential pitfalls of 3-dimensional transesophageal echocardiography and show examples of this technique
SCUAD and chronic rhinosinusitis. Reinforcing hypothesis driven research in difficult cases
Background: Our objective is to present recent research findings on
recalcitrant chronic rhinosinusitis (CRS) in relation to “Severe
Chronic Upper Airway Disease” (SCUAD).
Methodology: Literature review using Medline and Embase databases
(search ternns’chronic rhinosinusitis”,”chronic sinusitis”or
“Severe Chronic Upper Airway Disease”) limited to articles published
in the English language.
Results: Complex pathophysiological mechanisms characterize various
forms of chronic rhinitis and rhinosinusitis (CRS), where inflammation
persists in spite of adequate medical treatment. In these cases, a
multifactorial etiology often underlies the development of sino-nasal
inflammation. The interaction between chronic upper and lower airway
inflammation via neurogenic and systemic pathways may complicate the
therapy of these patients, and lead to insufficient symptom control.
Conclusion: The recently introduced definition of”Severe Chronic
Upper Airway Disease” (SCUAD) increases awareness of those patients
with persistent inflammation and symptoms despite guideline-driven
pharmacologic treatment. The concept of SCUAD may prove helpful in
directing research towards clarifying the definition, diagnosis and
pathophysiology of rhinitis and rhinosinusitis, their limits and
overlap. In this review, a hypothesis on SCUAD immunopathology is also
presented
Recommended from our members
Clinical consensus statement: appropriate use of computed tomography for paranasal sinus disease.
ObjectiveTo develop a consensus statement on the appropriate use of computed tomography (CT) for paranasal sinus disease.Subjects and methodsA modified Delphi method was used to refine expert opinion and reach consensus by the panel.ResultsAfter 3 full Delphi rounds, 33 items reached consensus and 16 statements were dropped because of not reaching consensus or redundancy. The statements that reached consensus were grouped into 4 categories: pediatric sinusitis, medical management, surgical planning, and complication of sinusitis or sinonasal tumor. The panel unanimously agreed with 13 of the 33 statements. In addition, at least 75% of the panel strongly agreed with 14 of 33 statements across all of the categories.ConclusionsFor children, careful consideration should be taken when performing CT imaging but is needed in the setting of treatment failures and complications, either of the pathological process itself or as a result of iatrogenic (surgical) complications. For adults, imaging is necessary in surgical planning, for treatment of medical and surgical complications, and in all aspects of the complete management of patients with sinonasal and skull base pathology