Cardiogenic shock associated with loco-regional anesthesia rescued with left ventricular assist device implantation

A healthy 53 year old man developed profound cardiogenic shock following instillation of bupivacaine-lidocaine-epinephrine solution as a locoregional anesthetic for elective outpatient shoulder surgery. Intubation, resuscitation, and transfer to the nearby hospital were done: echocardiography showed profound biventricular dysfunction; cardiac catheterization showed normal coronary arteries. Despite placement of an intra-aortic balloon pump and intravenous vasoactive drugs, the patient remained in shock. Stabilization was achieved with emergent institution of cardiopulmonary bypass and placement of a temporary left ventricular assist device (LVAD). Twenty-four hours later, cardiac function normalized and the LVAD was removed. The patient was discharged five days later and remained with normal heart function in three-year follow-up

Left ventricular assist device implantation in high risk destination therapy patients: an alternative surgical approach

Left Ventricular Assist Device (LVAD) for Destination Therapy (DT) is an established therapy for end stage heart failure patients who are not transplant candidates. Many DT patients requiring LVADs have had prior open heart surgery, the majority of whom had prior sternotomy. In addition, DT patients tend to be older and more likely to have more significant co-morbidities than their Bridge-To-Transplant (BTT) counterparts. As such, placement of an implantable LVAD in DT patients can be technically hazardous and potentially prone to more perioperative complications. The purpose of this report is to describe an alternative implantation approach for the implantation of the Heartmate II™ LVAD in high risk DT patients

Hybrid ventricular assist device: Heartmate XVE LVAD and Abiomed AB5000 RVAD.

The need for a right ventricular assist device following an implantable left ventricular assist device creates a complex situation for the surgeon, nursing staff, and the patient. The purpose of this report is to describe the rationale, technical, and perioperative issues of a hybrid ventricular assist device consisting of a Heartmate XVE (Thoratec, Inc., Pleasonton, CA) left ventricular assist device and Abiomed AB5000 right ventricular assist device (Abiomed, Inc., Danvers, MA)

Where Brain, Body and World Collide

The production cross section of electrons from semileptonic decays of beauty hadrons was measured at mid-rapidity (|y| < 0.8) in the transverse momentum range 1 < pt < 8 Gev/c with the ALICE experiment at the CERN LHC in pp collisions at a center of mass energy sqrt{s} = 7 TeV using an integrated luminosity of 2.2 nb^{-1}. Electrons from beauty hadron decays were selected based on the displacement of the decay vertex from the collision vertex. A perturbative QCD calculation agrees with the measurement within uncertainties. The data were extrapolated to the full phase space to determine the total cross section for the production of beauty quark-antiquark pairs

Centrality, rapidity and transverse momentum dependence of J/ψJ/\psi suppression in Pb-Pb collisions at sNN\sqrt{s_{\rm NN}}=2.76 TeV

The inclusive J/$\psi$ nuclear modification factor ($R_{AA}$) in Pb-Pb collisions at $\sqrt{s_{NN}}$=2.76TeV has been measured by ALICE as a function of centrality in the $e^+e^-$ decay channel at mid-rapidity |y| < 0.8 and as a function of centrality, transverse momentum and rapidity in the $\mu^+\mu^-$ decay channel at forward-rapidity 2.5 < y < 4.The J/$\psi$ yields measured in Pb-Pb are suppressed compared to those in pp collisions scaled by the number of binary collisions.The $R_{AA}$ integrated over a centrality range corresponding to 90% of the inelastic Pb-Pb cross section is 0.72 +- 0.06 (stat.) +- 0.10 (syst.) at mid-rapidity and 0.57 +- 0.01 (stat.) +- 0.09 (syst.) at forward-rapidity. At low transverse momentum, significantly larger values of $R_{AA}$ are measured at forward-rapidity compared to measurements at lower energy.These features suggest that a contribution to the J/$\psi$ yield originates from charm quarks (re)combination in the deconfined partonic medium.The inclusive J/ψ nuclear modification factor ( RAA ) in Pb–Pb collisions at sNN=2.76 TeV has been measured by ALICE as a function of centrality in the e+e− decay channel at mid-rapidity ( |y|<0.8 ) and as a function of centrality, transverse momentum and rapidity in the μ+μ− decay channel at forward-rapidity ( 2.5<y<4 ). The J/ψ yields measured in Pb–Pb are suppressed compared to those in pp collisions scaled by the number of binary collisions. The RAA integrated over a centrality range corresponding to 90% of the inelastic Pb–Pb cross section is 0.72±0.06(stat.)±0.10(syst.) at mid-rapidity and 0.58±0.01(stat.)±0.09(syst.) at forward-rapidity. At low transverse momentum, significantly larger values of RAA are measured at forward-rapidity compared to measurements at lower energy. These features suggest that a contribution to the J/ψ yield originates from charm quark (re)combination in the deconfined partonic medium.The inclusive $J/\psi$ nuclear modification factor $R_{\rm AA}$ in Pb-Pb collisions at $\sqrt{s_{\rm NN}}$=2.76 TeV has been measured by ALICE as a function of centrality in the e$^+$e$^-$ decay channel at mid-rapidity $|y|<0.8$ and as a function of centrality, transverse momentum and rapidity in the $\mu^{+}\mu^{-}$ decay channel at forward-rapidity $2.5<y<4$.The $J/\psi$ yields measured in Pb-Pb are suppressed compared to those in pp collisions scaled by the number of binary collisions. The $R_{\rm AA}$ integrated over a centrality range corresponding to 90% of the inelastic Pb-Pb cross section is $0.72\pm0.06$ (stat.) $\pm0.10$ (syst.) at mid-rapidity and $0.57 \pm 0.01$ (stat.) $\pm0.09$ (syst.) at forward-rapidity. At low transverse momentum, significantly larger values of $R_{\rm AA}$ are measured at forward-rapidity compared to measurements at lower energy. These features suggest that a contribution to the $J/\psi$ yield originates from charm quarks (re)combination in the deconfined partonic medium

Two- and three-pion quantum statistics correlations in Pb-Pb collisions at sNN=\sqrt{{s}_{NN}} = 2.76 TeV at the CERN Large Hadron Collider

Correlations induced by quantum statistics are sensitive to the spatio-temporal extent as well as dynamics of particle emitting sources in heavy-ion collisions. In addition, such correlations can be used to search for the presence of a coherent component of pion production. Two and three-pion correlations of same and mixed-charge are measured at low relative momentum to estimate the coherent fraction of charged pions in Pb-Pb collisions at $\sqrt{s_{NN}}$= 2.76 TeV at the LHC with ALICE. The genuine three-pion quantum statistics correlation is found to be suppressed relative to the two-pion correlation based on the assumption of fully chaotic pion emission.The suppression is observed to decrease with triplet momentum. The observed suppression at low triplet momentum may correspond to a coherent fraction in charged pion emission of 22% +- 12%.Correlations induced by quantum statistics are sensitive to the spatio-temporal extent as well as dynamics of particle emitting sources in heavy-ion collisions. In addition, such correlations can be used to search for the presence of a coherent component of pion production. Two and three-pion correlations of same and mixed-charge are measured at low relative momentum to estimate the coherent fraction of charged pions in Pb-Pb collisions at $\sqrt{s_{\rm NN}}=2.76$ TeV at the LHC with ALICE. The genuine three-pion quantum statistics correlation is found to be suppressed relative to the two-pion correlation based on the assumption of fully chaotic pion emission. The suppression is observed to decrease with triplet momentum. The observed suppression at low triplet momentum may correspond to a coherent fraction in charged pion emission of 23% $\pm$ 8%.Correlations induced by quantum statistics are sensitive to the spatiotemporal extent as well as dynamics of particle-emitting sources in heavy-ion collisions. In addition, such correlations can be used to search for the presence of a coherent component of pion production. Two- and three-pion correlations of same and mixed charge are measured at low relative momentum to estimate the coherent fraction of charged pions in Pb-Pb collisions at sNN=2.76 TeV at the CERN Large Hadron Collider with ALICE. The genuine three-pion quantum statistics correlation is found to be suppressed relative to the two-pion correlation based on the assumption of fully chaotic pion emission. The suppression is observed to decrease with triplet momentum. The observed suppression at low triplet momentum may correspond to a coherent fraction in charged-pion emission of 23%±8%.</p