Long-term cerebral thromboembolic complications of transapical endocardial resynchronization therapy

Purpose: Cardiac resynchronization therapy (CRT) is an established therapeutic option in selected heart failure patients (pts). However, the transvenous left ventricular (LV) lead implantation remains ineffectual in a considerable number of pts. Transapical LV (TALV) lead implantation is an alternative minimally invasive, surgical, endocardial implantation technique. The aim of the present prospective study is to determine the long-term outcome, including the cerebral thromboembolic complications, of pts

Bilateral Remote Ischemic Conditioning in Children:a two-center, double-blind, randomized controlled trial in young children undergoing cardiac surgery

Objective: The study objective was to determine whether adequately delivered bilateral remote ischemic preconditioning is cardioprotective in young children undergoing surgery for 2 common congenital heart defects with or without cyanosis.Methods: We performed a prospective, double-blind, randomized controlled trial at 2 centers in the United Kingdom. Children aged 3 to 36 months undergoing tetralogy of Fallot repair or ventricular septal defect closure were randomized 1:1 to receive bilateral preconditioning or sham intervention. Participants were followed up until hospital discharge or 30 days. The primary outcome was area under the curve for high-sensitivity troponin-T in the first 24 hours after surgery, analyzed by intention-to-treat. Right atrial biopsies were obtained in selected participants.Results: Between October 2016 and December 2020, 120 eligible children were randomized to receive bilateral preconditioning (n = 60) or sham intervention (n = 60). The primary outcome, area under the curve for high-sensitivity troponin-T, was higher in the preconditioning group (mean: 70.0 ± 50.9 μg/L/h, n = 56) than in controls (mean: 55.6 ± 30.1 μg/L/h, n = 58) (mean difference, 13.2 μg/L/h; 95% CI, 0.5-25.8; P = .04). Subgroup analyses did not show a differential treatment effect by oxygen saturations (pinteraction = .25), but there was evidence of a differential effect by underlying defect (pinteraction = .04). Secondary outcomes and myocardial metabolism, quantified in atrial biopsies, were not different between randomized groups.Conclusions: Bilateral remote ischemic preconditioning does not attenuate myocardial injury in children undergoing surgical repair for congenital heart defects, and there was evidence of potential harm in unstented tetralogy of Fallot. The routine use of remote ischemic preconditioning cannot be recommended for myocardial protection during pediatric cardiac surgery

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FREIE BEARBEITUNGEN 15 Neue Ausgabe sämtlicher Werke (-) Freie Bearbeitungen 15 (2,15.2003) ( - ) Einband ( - ) Gesamttitelseite (II) Titelseite (III) Inhalt - Index (V) Zur Ausgabe / General Preface (VII) Vorwort / Preface (XI) Abkürzungen - Abbreviations (XXI) Abbildungen / Faksimiles: Liebesszene und Fortunas Kugel (XXII) Abbildung / Faksimile: O! Wenn es doch immer so bliebe! (XXIV) Abbildung / Faksimile: Marche hongroise d'après Schubert (XXV) Abbildung / Faksimile: Tarentelle de César Cui (XXVI) Freie Bearbeitungen XV / Free Arrangements XV (1) Polonaise aus Tschaikowskis Oper "Jewgeny Onegin" (3) Prélude à la Polka d'Alexandre Porfiryevitch Borodine (15) 2da Mazurka per pianoforte di Pier Adolfo Tirindelli variata da F. Liszt (16) Liebesszene und Fortunas Kugel aus dem Oratorium "Die sieben Todsünden" von Aldabert von Goldschmidt (23) O! Wenn es doch immer so bliebe! Lied von Anton Rubinstein Op. 34 No. 9 (37) Der Asra - Lied von Anton Rubinstein Op. 32 No. 6 (47) Provenzalisches Minnelied - Chanson provençale | von - de Robert Schumann (51) Drei Lieder zu Julius Wolffs Epos "Tannhäuser" komponiert von Otto Lessmann - Tre canti... (56) 1. Der Lenz ist gekommen (56) 2. Trinklied (62) 3. Du schaust mich an (66) Réminiscences de Boccanegra de Verdi (69) Feierlicher Marsch zum heiligen Gral - Marche solennelle vers le saint Gral - Marcia solenne al san Gral (81) Marche hongroise d'après Franz Schubert (88) Valse de concert d'après la "Suite en forme de valse" de Jean de Végh de Vereb - Konzertwalzer nach der "Walzer Suite" (99) "Ha Прощание" - Abschied - Russisches Volkslied (114) Tarentelle de César Cui (116) Critical Notes (134) Werbung ( -

Energy Policies in the European Union

textabstractBackground: Coronary sinus lead placement for transvenous left ventricular (LV) pacing in cardiac resynchronization therapy (CRT) has a significant failure rate at implant and a considerable dislocation rate during follow-up. For these patients epicardial pacing lead implantation is the most frequently used alternative. Recent data support endocardial lead implantation through the atrial septum and the mitral valve, because this method provides further hemodynamic advantages. On the other hand transseptal CRT carries a significant risk for device related infective endocarditis of the mitral valve. The aim of this prospective, nonrandomized study was to demonstrate the feasibility of a fundamentally new approach for endocardial LV lead implantation. Methods: We performed 12 transapical LV lead implantations in 10 end-sta

Alternative Techniques for Left Ventricular Pacing in Cardiac Resynchronization Therapy

Cardiac resynchronization therapy (CRT) is an important treatment modality for a well-defined subgroup of heart failure patients. Coronary sinus (CS) lead placement is the first-line clinical approach but the insertion is unsuccessful in about 5-10% of the patients. In recent years, the number of CRT recipients and the considerable need for left ventricular (LV) lead revisions increased enormously. Numerous techniques and technologies have been specifically developed to provide alternatives for the CS LV pacing. Currently, the surgical access is most frequently used as a second choice by either minithoracotomy or especially the video-assisted thoracoscopy. The transseptal or transapical endocardial LV lead implantations are being developed but there are no longer follow-up data in larger patient cohorts. These new techniques should be reserved for patients failing conventional or surgical CRT implants. In the future, randomized studies are needed to asses the potential benefits of some alternative LV pacing techniques and other new technologies for LV lead placement are expected