Myocardial revascularization using on-pump beating heart among patients with left ventricular dysfunction

Abstract Objectives On-pump beating heart technique for myocardial revascularization has been used successfully among both low and high risk patients. Its application among low ejection fraction patients is limited. The aim of our study is to evaluate this technique among patients with low ejection fraction and to compare results with off-pump bypass technique. Methods This retrospective study includes 137 patients with ejection fraction below 0.35 who underwent isolated coronary artery bypass surgery. 39 patients underwent myocardial revascularization using on-pump beating heart (ONCAB/BH), while 98 patients had off-pump beating heart (OPCAB). Different preoperative, operative and postoperative variables were evaluated among both groups. Results Patients profiles and risk factors were similar among both groups, except for the number of patients undergoing redo CABG which was significantly higher among ONCAB/BH (13% vs 3%; p = 0.025). Ejection fraction (EF) varied from 10-34%. The mean EF for patients who underwent ONCAB/BH was 28 ± 6 in comparison to 26 ± 5 for OPCAB patients (P = 0.093). Predicted risk for surgery according to EuroSCORE was similar among both groups (P = 0.443). The number of grafts performed per patient was significantly more among patients who underwent ONCAB/BH (2.2 ± 0.7 Vs 1.7 ± 0.7; P = 0.002). Completeness of revascularization was significantly greater in the ONCAB/BH patients (72% Vs 46%, P = 0.015). The incidence of hospital mortality and combined major morbidity was more among ONCAB/BH in comparison to OPCAB, but the difference was not significant. However, the incidence of blood loss, ventricular arrythmias, inotropic support, ICU, hospital stay and blood transfusion were significantly greater among patients who underwent ONCAB/BH. Conclusions On-pump beating heart technique can be used in myocardial revascularization among patients with left ventricular dysfunction. The technique was found to be associated with better myocardial revascularization when compared with OPCAB technique. However, the incidence of morbidity and mortality was more than OPCAB.</p

The effect of latitude on the performance of different solar trackers in Europe and Africa

In this paper, the effect of latitude on the performance of different solar trackers is examined. The hourly solar radiation data of different locations around Europe and Africa measured on a horizontal surface is collected and utilized. Widely validated Perez anisotropic model is used to predict the diffuse component of the solar radiation on an inclined surface. Different solar trackers namely, Full/dual-axis, East-West (EW), North-South (NS), Inclined East-West (IEW), and Vertical-axis (V) trackers are considered in calculating the available solar potential of the locations. The performance of the solar trackers in terms of the energy gain is ranked according to the area location latitudes. The results show that the tracking performance is highly dependent on the locations, thus changes with the latitude. The percentage variation among the implemented one-axis tracking options relative to dual-axis trackers ranges from 0.42% to 23.4%. Overall, the increase in the energy gain of dual-axis trackers compared to the optimal fixed panel for the locations varies from 17.72% to 31.23%, thus emphasizes the importance of solar trackers. Finally, the study is expected to aid designers in the selection and installation of appropriate solar trackers in the regions