59 research outputs found

    ΠžΡ€Π³Π°Π½ΠΈΠ·Π°Ρ†ΠΈΡ Ρ€Π°Π±ΠΎΡ‚ ΠΏΠΎ Π»ΠΎΠΊΠ°Π»ΠΈΠ·Π°Ρ†ΠΈΠΈ ΠΈ Π»ΠΈΠΊΠ²ΠΈΠ΄Π°Ρ†ΠΈΠΈ Π°Π²Π°Ρ€ΠΈΠΉΠ½ΠΎΠ³ΠΎ Ρ€Π°Π·Π»ΠΈΠ²Π° Π½Π΅Ρ„Ρ‚ΠΈ ΠΈ Π½Π΅Ρ„Ρ‚Π΅ΠΏΡ€ΠΎΠ΄ΡƒΠΊΡ‚ΠΎΠ² Π½Π° Π²ΠΎΠ΄Π½ΠΎΠΉ повСрхности

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    ΠžΠ±ΡŠΠ΅ΠΊΡ‚ΠΎΠΌ исслСдования ΡΠ²Π»ΡΡŽΡ‚ΡΡ ΠΌΠ΅Ρ‚ΠΎΠ΄Ρ‹ Π»ΠΎΠΊΠ°Π»ΠΈΠ·Π°Ρ†ΠΈΠΈ ΠΈ Π»ΠΈΠΊΠ²ΠΈΠ΄Π°Ρ†ΠΈΠΈ Ρ€Π°Π·Π»ΠΈΠ²ΠΎΠ² Π½Π΅Ρ„Ρ‚ΠΈ Π½Π° Π²ΠΎΠ΄Π½ΠΎΠΉ повСрхности. ЦСль Ρ€Π°Π±ΠΎΡ‚Ρ‹ – провСсти Π°Π½Π°Π»ΠΈΠ· ΡΡƒΡ‰Π΅ΡΡ‚Π²ΡƒΡŽΡ‰ΠΈΡ… ΠΌΠ΅Ρ‚ΠΎΠ΄ΠΎΠ² ΠΈ тактичСских мСроприятий ΠΏΠΎ Π»ΠΎΠΊΠ°Π»ΠΈΠ·Π°Ρ†ΠΈΠΈ ΠΈ Π»ΠΈΠΊΠ²ΠΈΠ΄Π°Ρ†ΠΈΠΈ Ρ€Π°Π·Π»ΠΈΠ²ΠΎΠ² Π½Π΅Ρ„Ρ‚ΠΈ Π½Π° Π²ΠΎΠ΄Π½ΠΎΠΉ повСрхности. Π’ процСссС исслСдования проводился Π°Π½Π°Π»ΠΈΠ· ΠΈΠΌΠ΅ΡŽΡ‰ΠΈΡ…ΡΡ Π΄Π°Π½Π½Ρ‹Ρ…, Π½Π° основС ΠΊΠΎΡ‚ΠΎΡ€Ρ‹Ρ… Π±Ρ‹Π»ΠΈ Π²Ρ‹Π΄Π΅Π»Π΅Π½ΠΈΠ΅ Π½Π°ΠΈΠ±ΠΎΠ»Π΅Π΅ эффСктивныС ΠΌΠ΅Ρ‚ΠΎΠ΄Ρ‹ Π»ΠΎΠΊΠ°Π»ΠΈΠ·Π°Ρ†ΠΈΠΈ ΠΈ Π»ΠΈΠΊΠ²ΠΈΠ΄Π°Ρ†ΠΈΠΈ Ρ€Π°Π·Π»ΠΈΠ²ΠΎΠ² Π½Π΅Ρ„Ρ‚ΠΈ Π½Π° Π²ΠΎΠ΄Π½ΠΎΠΉ повСрхности. ΠŸΡ€ΠΎΠ²Π΅Π΄Π΅Π½ расчСт объСма Π²Ρ‹Ρ‚Π΅ΠΊΡˆΠ΅ΠΉ Π½Π΅Ρ„Ρ‚ΠΈ ΠΈ количСства сорбСнта, Ρ‚Ρ€Π΅Π±ΡƒΠ΅ΠΌΠΎΠ³ΠΎ для Π»ΠΈΠΊΠ²ΠΈΠ΄Π°Ρ†ΠΈΠΈ Ρ€Π°Π·Π»ΠΈΠ²Π°. Π’ Ρ€Π΅Π·ΡƒΠ»ΡŒΡ‚Π°Ρ‚Π΅ исслСдования Π±Ρ‹Π»ΠΎ выявлСно, Ρ‡Ρ‚ΠΎ Π½Π°ΠΈΠ±ΠΎΠ»Π΅Π΅ эффСктивным способом Π»ΠΎΠΊΠ°Π»ΠΈΠ·Π°Ρ†ΠΈΠΈ Ρ€Π°Π·Π»ΠΈΠ²ΠΎΠ² Π½Π° Π²ΠΎΠ΄Π½ΠΎΠΉ повСрхности ΡΠ²Π»ΡΡŽΡ‚ΡΡ Π±ΠΎΠ½Ρ‹ с Ρ€Π°Π·Π»ΠΈΡ‡Π½Ρ‹ΠΌΠΈ ΠΌΠ΅Ρ…Π°Π½ΠΈΠ·ΠΌΠ°ΠΌΠΈ ΠΈΡ… установки, Π° Π½Π°ΠΈΠ±ΠΎΠ»Π΅Π΅ эффСктивными ΠΌΠ΅Ρ‚ΠΎΠ΄Π°ΠΌΠΈ Π»ΠΈΠΊΠ²ΠΈΠ΄Π°Ρ†ΠΈΠΈ – использованиС скиммСров ΠΈ сорбСнтов.ΠžΠ±ΡŠΠ΅ΠΊΡ‚ΠΎΠΌ исслСдования ΡΠ²Π»ΡΡŽΡ‚ΡΡ ΠΌΠ΅Ρ‚ΠΎΠ΄Ρ‹ Π»ΠΎΠΊΠ°Π»ΠΈΠ·Π°Ρ†ΠΈΠΈ ΠΈ Π»ΠΈΠΊΠ²ΠΈΠ΄Π°Ρ†ΠΈΠΈ Ρ€Π°Π·Π»ΠΈΠ²ΠΎΠ² Π½Π΅Ρ„Ρ‚ΠΈ Π½Π° Π²ΠΎΠ΄Π½ΠΎΠΉ повСрхности. ЦСль Ρ€Π°Π±ΠΎΡ‚Ρ‹ – провСсти Π°Π½Π°Π»ΠΈΠ· ΡΡƒΡ‰Π΅ΡΡ‚Π²ΡƒΡŽΡ‰ΠΈΡ… ΠΌΠ΅Ρ‚ΠΎΠ΄ΠΎΠ² ΠΈ тактичСских мСроприятий ΠΏΠΎ Π»ΠΎΠΊΠ°Π»ΠΈΠ·Π°Ρ†ΠΈΠΈ ΠΈ Π»ΠΈΠΊΠ²ΠΈΠ΄Π°Ρ†ΠΈΠΈ Ρ€Π°Π·Π»ΠΈΠ²ΠΎΠ² Π½Π΅Ρ„Ρ‚ΠΈ Π½Π° Π²ΠΎΠ΄Π½ΠΎΠΉ повСрхности. Π’ процСссС исслСдования проводился Π°Π½Π°Π»ΠΈΠ· ΠΈΠΌΠ΅ΡŽΡ‰ΠΈΡ…ΡΡ Π΄Π°Π½Π½Ρ‹Ρ…, Π½Π° основС ΠΊΠΎΡ‚ΠΎΡ€Ρ‹Ρ… Π±Ρ‹Π»ΠΈ Π²Ρ‹Π΄Π΅Π»Π΅Π½ΠΈΠ΅ Π½Π°ΠΈΠ±ΠΎΠ»Π΅Π΅ эффСктивныС ΠΌΠ΅Ρ‚ΠΎΠ΄Ρ‹ Π»ΠΎΠΊΠ°Π»ΠΈΠ·Π°Ρ†ΠΈΠΈ ΠΈ Π»ΠΈΠΊΠ²ΠΈΠ΄Π°Ρ†ΠΈΠΈ Ρ€Π°Π·Π»ΠΈΠ²ΠΎΠ² Π½Π΅Ρ„Ρ‚ΠΈ Π½Π° Π²ΠΎΠ΄Π½ΠΎΠΉ повСрхности. ΠŸΡ€ΠΎΠ²Π΅Π΄Π΅Π½ расчСт объСма Π²Ρ‹Ρ‚Π΅ΠΊΡˆΠ΅ΠΉ Π½Π΅Ρ„Ρ‚ΠΈ ΠΈ количСства сорбСнта, Ρ‚Ρ€Π΅Π±ΡƒΠ΅ΠΌΠΎΠ³ΠΎ для Π»ΠΈΠΊΠ²ΠΈΠ΄Π°Ρ†ΠΈΠΈ Ρ€Π°Π·Π»ΠΈΠ²Π°. Π’ Ρ€Π΅Π·ΡƒΠ»ΡŒΡ‚Π°Ρ‚Π΅ исслСдования Π±Ρ‹Π»ΠΎ выявлСно, Ρ‡Ρ‚ΠΎ Π½Π°ΠΈΠ±ΠΎΠ»Π΅Π΅ эффСктивным способом Π»ΠΎΠΊΠ°Π»ΠΈΠ·Π°Ρ†ΠΈΠΈ Ρ€Π°Π·Π»ΠΈΠ²ΠΎΠ² Π½Π° Π²ΠΎΠ΄Π½ΠΎΠΉ повСрхности ΡΠ²Π»ΡΡŽΡ‚ΡΡ Π±ΠΎΠ½Ρ‹ с Ρ€Π°Π·Π»ΠΈΡ‡Π½Ρ‹ΠΌΠΈ ΠΌΠ΅Ρ…Π°Π½ΠΈΠ·ΠΌΠ°ΠΌΠΈ ΠΈΡ… установки, Π° Π½Π°ΠΈΠ±ΠΎΠ»Π΅Π΅ эффСктивными ΠΌΠ΅Ρ‚ΠΎΠ΄Π°ΠΌΠΈ Π»ΠΈΠΊΠ²ΠΈΠ΄Π°Ρ†ΠΈΠΈ – использованиС скиммСров ΠΈ сорбСнтов

    Asymptomatic papillary fibroelastoma of the Aortic valve in a young woman - a case report

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    Echocardiography represents an invaluable diagnostic tool for the detection of intracardiac masses while simultaneously provides information about their size, location, mobility and attachment site as well as the presence and extent of any consequent hemodynamic derangement

    Feasibility and safety of continuous retrograde administration of Del Nido cardioplegia: a case series.

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    Background Del Nido (DN) cardioplegia, a calcium-free, hyperkalemic solution containing lidocaine and magnesium has been developed to help reduce intracellular calcium influx and the resulting myocyte damage in the immediate postischemic period following cardiac arrest. DN cardioplegia has been used for pediatric cardiac surgery but its use in complex reoperative surgery has not been studied. We specifically report the outcomes of patients undergoing reoperative cardiac surgery after previous coronary artery bypass grafting with a patent internal mammary artery (IMA). Methods Patients undergoing reoperative cardiac surgery with prior coronary bypass grafting surgery were studied between 2010 and 2013. Fourteen patients were identified who required continued retrograde cardioplegia administration. In all cases, an initial antegrade dose was given, followed by continuous retrograde administration. Demographics, co-morbidities, intra-operative variables including cardioplegia volumes, post-operative complications, and patient outcomes were collected. Results The mean age of all patients was 73.3+/βˆ’6.7 years, and 93 % were male. Aortic cross clamp time and cardiopulmonary bypass times were 81+/βˆ’35 and 151+/βˆ’79 mins, respectively. Antegrade, retrograde and total cardioplegia doses were 1101+/βˆ’398, 3096+/βˆ’3185 and 4367+/βˆ’3751 ml, respectively. An average of 0.93+/βˆ’0.92 inotropes and 1.50+/βˆ’0.76 pressors were used on ICU admission after surgery. ICU and total hospital lengths of stay were 5.5+/βˆ’7.4 and 9.6+/βˆ’8.0 days, respectively. Complications occurred in two patients (14 %) (pneumonia and prolonged mechanical ventilation) and new arrhythmias occurred in five patients (36 %) (four new-onset atrial fibrillation and one pulseless electrical activity requiring 2 min of chest compression). No perioperative myocardial infarctions were noted based on electrocardiograms and cardiac serum markers. Postoperatively, left ventricular function was preserved in all patients whereas two patients (14 %) had mild decrease in right ventricular function as assessed by echocardiography. No mortality was observed. Conclusion Del Nido cardioplegia solution provides acceptable myocardial protection for cardiac surgery that requires continuous retrograde cardioplegia administration. DN cardioplegia’s administration in a continuous retrograde fashion with a patent IMA is believed to provide adequate myocardial protection while avoiding injuring the IMA through dissection and clamping

    3D Real-Time Echocardiography Combined with Mini Pressure Wire Generate Reliable Pressure-Volume Loops in Small Hearts

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    BACKGROUND: Pressure-volume loops (PVL) provide vital information regarding ventricular performance and pathophysiology in cardiac disease. Unfortunately, acquisition of PVL by conductance technology is not feasible in neonates and small children due to the available human catheter size and resulting invasiveness. The aim of the study was to validate the accuracy of PVL in small hearts using volume data obtained by real-time three-dimensional echocardiography (3DE) and simultaneously acquired pressure data. METHODS: In 17 piglets (weight range: 3.6–8.0 kg) left ventricular PVL were generated by 3DE and simultaneous recordings of ventricular pressure using a mini pressure wire (PVL3D). PVL3D were compared to conductance catheter measurements (PVLCond) under various hemodynamic conditions (baseline, alpha-adrenergic stimulation with phenylephrine, beta-adrenoreceptor-blockage using esmolol). In order to validate the accuracy of 3D volumetric data, cardiac magnetic resonance imaging (CMR) was performed in another 8 piglets. RESULTS: Correlation between CMR- and 3DE-derived volumes was good (enddiastolic volume: mean bias -0.03ml Β±1.34ml). Computation of PVL3D in small hearts was feasible and comparable to results obtained by conductance technology. Bland-Altman analysis showed a low bias between PVL3D and PVLCond. Systolic and diastolic parameters were closely associated (Intraclass-Correlation Coefficient for: systolic myocardial elastance 0.95, arterial elastance 0.93, diastolic relaxation constant tau 0.90, indexed end-diastolic volume 0.98). Hemodynamic changes under different conditions were well detected by both methods (ICC 0.82 to 0.98). Inter- and intra-observer coefficients of variation were below 5% for all parameters. CONCLUSIONS: PVL3D generated from 3DE combined with mini pressure wire represent a novel, feasible and reliable method to assess different hemodynamic conditions of cardiac function in hearts comparable to neonate and infant size. This methodology may be integrated into clinical practice and cardiac catheterization programs and has the capability to contribute to clinical decision making even in small hearts

    Human Cardiac-Derived Adherent Proliferating Cells Reduce Murine Acute Coxsackievirus B3-Induced Myocarditis

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    BACKGROUND: Under conventional heart failure therapy, inflammatory cardiomyopathy typically has a progressive course, indicating a need for alternative therapeutic strategies to improve long-term outcomes. We recently isolated and identified novel cardiac-derived cells from human cardiac biopsies: cardiac-derived adherent proliferating cells (CAPs). They have similarities with mesenchymal stromal cells, which are known for their anti-apoptotic and immunomodulatory properties. We explored whether CAPs application could be a novel strategy to improve acute Coxsackievirus B3 (CVB3)-induced myocarditis. METHODOLOGY/PRINCIPAL FINDINGS: To evaluate the safety of our approach, we first analyzed the expression of the coxsackie- and adenovirus receptor (CAR) and the co-receptor CD55 on CAPs, which are both required for effective CVB3 infectivity. We could demonstrate that CAPs only minimally express both receptors, which translates to minimal CVB3 copy numbers, and without viral particle release after CVB3 infection. Co-culture of CAPs with CVB3-infected HL-1 cardiomyocytes resulted in a reduction of CVB3-induced HL-1 apoptosis and viral progeny release. In addition, CAPs reduced CD4 and CD8 T cell proliferation. All CAPs-mediated protective effects were nitric oxide- and interleukin-10-dependent and required interferon-Ξ³. In an acute murine model of CVB3-induced myocarditis, application of CAPs led to a decrease of cardiac apoptosis, cardiac CVB3 viral load and improved left ventricular contractility parameters. This was associated with a decline in cardiac mononuclear cell activity, an increase in T regulatory cells and T cell apoptosis, and an increase in left ventricular interleukin-10 and interferon-Ξ³ mRNA expression. CONCLUSIONS: We conclude that CAPs are a unique type of cardiac-derived cells and promising tools to improve acute CVB3-induced myocarditis
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