Studying the effects of elongational properties on atomization of weakly viscoelastic solutions using Rayleigh Ohnesorge Jetting Extensional Rheometry (ROJER)

The extensional rheological properties of dilute polymer solutions play a dominant role in many commercial processes such as air-assisted atomization. This is a high deformation rate process important in application of diverse materials such as paints, fertilizer sprays and delivery of airborne drugs. Dilute polymeric solutions which have identical values of high shear-rate viscosity (HSV) often exhibit different values of Sauter Mean Diameter (SMD) in their spray size distributions as a result of differing extensional rheological properties. We explore the atomization of a series of model Poly(ethylene oxide) (PEO) solutions dissolved in water/glycerol mixtures. Each solution is sprayed with an air-assisted spray gun under similar conditions and imaged with a commercial spray measurement system. The values of HSV for PEO solutions are close to the solvent viscosity and matched to those of typical ink or paint samples. The surface tensions of the fluids are also tuned to be very similar, however both the SMD and the droplet size distribution change considerably. For the highest molecular weight PEO systems, interconnected beads-on-string structures are observed at different positions of the spray fan. Capillary Break-up Extensional Rheometry (CaBER) can be used to measure the extensional properties of the more viscous solutions, but the well-known limitations of this approach include inertially-induced asymmetries, gravitational sagging and the very short filament lifetimes of low viscosity samples all of which constrain the range of relaxation times that can be probed. Consequently we also explore the use of Rayleigh Ohnesorge Jet Elongational Rheometry (ROJER) to probe the extensional response of these viscoelastic solutions at realistic timescales and deformation rates. A cylindrical liquid jet is excited by a piezo-actuator at a known frequency as it exits a micromachined nozzle, and stroboscopic imaging provides high temporal and spatial resolution in the break-up process. Analyzing the evolution in the jet diameter before break-up enables meaningful measurement of relaxation times down to values as small as 60 μs, and these values can be directly correlated with the differences in the final spray size distributions and the mean diameters. We outline a simple model for the fluid dynamics of the thinning filaments close to breakup that accurately describes the variation of the average droplet diameter as a function of the elongational relaxation time measured for each fluid

Long-Term Outcomes After Atrial Switch Operation for Transposition of the Great Arteries

Background: For patients with d-loop transposition of the great arteries (d-TGA) with a systemic right ventricle after an atrial switch operation, there is a need to identify risks for end-stage heart failure outcomes. Objectives: The authors aimed to determine factors associated with survival in a large cohort of such individuals. Methods: This multicenter, retrospective cohort study included adults with d-TGA and prior atrial switch surgery seen at a congenital heart center. Clinical data from initial and most recent visits were obtained. The composite primary outcome was death, transplantation, or mechanical circulatory support (MCS). Results: From 1,168 patients (38% female, age at first visit 29 ± 7.2 years) during a median 9.2 years of follow-up, 91 (8.8% per 10 person-years) met the outcome (66 deaths, 19 transplantations, 6 MCS). Patients experiencing sudden/arrhythmic death were younger than those dying of other causes (32.6 ± 6.4 years vs 42.4 ± 6.8 years; P 120 ms, and severe right ventricle dysfunction based on echocardiography. Conclusions: For most adults with d-TGA after atrial switch, progress to end-stage heart failure or death is slow. A simplified prediction score for 5-year adverse outcome is derived to help identify those at greatest risk

Long-Term Outcomes After Atrial Switch Operation for Transposition of the Great Arteries

Background: For patients with d-loop transposition of the great arteries (d-TGA) with a systemic right ventricle after an atrial switch operation, there is a need to identify risks for end-stage heart failure outcomes. Objectives: The authors aimed to determine factors associated with survival in a large cohort of such individuals. Methods: This multicenter, retrospective cohort study included adults with d-TGA and prior atrial switch surgery seen at a congenital heart center. Clinical data from initial and most recent visits were obtained. The composite primary outcome was death, transplantation, or mechanical circulatory support (MCS). Results: From 1,168 patients (38% female, age at first visit 29 ± 7.2 years) during a median 9.2 years of follow-up, 91 (8.8% per 10 person-years) met the outcome (66 deaths, 19 transplantations, 6 MCS). Patients experiencing sudden/arrhythmic death were younger than those dying of other causes (32.6 ± 6.4 years vs 42.4 ± 6.8 years; P 120 ms, and severe right ventricle dysfunction based on echocardiography. Conclusions: For most adults with d-TGA after atrial switch, progress to end-stage heart failure or death is slow. A simplified prediction score for 5-year adverse outcome is derived to help identify those at greatest risk

Long-Term Outcomes After Atrial Switch Operation for Transposition of the Great Arteries.

BACKGROUND: For patients with d-loop transposition of the great arteries (d-TGA) with a systemic right ventricle after an atrial switch operation, there is a need to identify risks for end-stage heart failure outcomes. OBJECTIVES: The authors aimed to determine factors associated with survival in a large cohort of such individuals. METHODS: This multicenter, retrospective cohort study included adults with d-TGA and prior atrial switch surgery seen at a congenital heart center. Clinical data from initial and most recent visits were obtained. The composite primary outcome was death, transplantation, or mechanical circulatory support (MCS). RESULTS: From 1,168 patients (38% female, age at first visit 29 ± 7.2 years) during a median 9.2 years of follow-up, 91 (8.8% per 10 person-years) met the outcome (66 deaths, 19 transplantations, 6 MCS). Patients experiencing sudden/arrhythmic death were younger than those dying of other causes (32.6 ± 6.4 years vs 42.4 ± 6.8 years; P \u3c 0.001). There was a long duration between sentinel clinical events and end-stage heart failure. Age, atrial arrhythmia, pacemaker, biventricular enlargement, systolic dysfunction, and tricuspid regurgitation were all associated with the primary outcome. Independent 5-year predictors of primary outcome were prior ventricular arrhythmia, heart failure admission, complex anatomy, QRS duration \u3e120 ms, and severe right ventricle dysfunction based on echocardiography. CONCLUSIONS: For most adults with d-TGA after atrial switch, progress to end-stage heart failure or death is slow. A simplified prediction score for 5-year adverse outcome is derived to help identify those at greatest risk