Left-Sided Reoperations After Arterial Switch Operation: A European Multicenter Study.

BACKGROUND We sought to report the frequency, types, and outcomes of left-sided reoperations (LSRs) after an arterial switch operation (ASO) for patients with D-transposition of the great arteries (D-TGA) and double-outlet right ventricle (DORV) TGA-type. METHODS Seventeen centers belonging to the European Congenital Heart Surgeons Association (ECHSA) contributed to data collection. We included 111 patients who underwent LSRs after 7,951 ASOs (1.4%) between January 1975 and December 2010. Original diagnoses included D-TGA (n = 99) and DORV TGA-type (n = 12). Main indications for LSR were neoaortic valve insufficiency (n = 52 [47%]) and coronary artery problems (CAPs) (n = 21 [19%]). RESULTS Median age at reoperation was 8.2 years (interquartile range [IQR], 2.9-14 years). Seven patients died early after LSRs (6.3%); 4 patients with D-TGA (5.9%) and 3 patients with DORV TGA-type (25%) (p = 0.02). Median age at last follow-up was 16.1 years (IQR, 9.9-21.8 years). Seventeen patients (16%) required another reoperation, which was more frequent in patients with DORV- TGA type (4 of 9 [45%]) than in patients with D-TGA (13 of 95 [14%]). Late death occurred in 4 patients (4 of 104 [3.8%]). The majority of survivors were asymptomatic at last clinical examination (84 of 100 [84%]). CONCLUSIONS Reoperations for residual LSRs are infrequent but may become necessary late after an ASO, predominantly for neoaortic valve insufficiency and CAPs. Risk at reoperation is not negligible, and DORV TGA-type anatomy, as well as procedures on the coronary arteries, were significantly associated with a higher morbidity and a lower overall survival. Recurrent reoperations after LSRs may be required

Reversing Inoperability in Eisenmenger Syndrome: The "Drug-and-Banding" Approach

Eisenmenger syndrome (ES) has been considered a cause of inoperability in patients with congenital heart disease (CHD). Even if long-standing vasodilators are efficient to reduce pulmonary vascular resistance (PVR), the best approach to grant stable repair of these patients is still unknown. We describe the case of a 28-year-old man with a diagnosis of untreated large ventricular septal defect and established ES. After few years of vasodilator therapy, the patient underwent pulmonary banding with significant reduction of his PVR. His CHD was then repaired, with clinical and functional improvement at 2-year follow-up

Efficienza inibitrice di basi di schiff come inibitori di corrosione del bronzo

International audienceAs part of an M-ERA.NET project called B-IMPACT some polidentate Schiff bases were synthesized and tested as corrosion inhibitors of bronze. The tests consisted of exposures of bronze specimens to a concentrated artificial acid rain solution, containing or not containing the studied substances added under saturation conditions (< 10(3) M). Their inhibiting effect was evaluated during 20 day immersions by means of non-destructive electrochemical tests (Electrochemical Impedance Spectroscopy) and by finally recording the polarization curves. Observations by a scanning electron microscope coupled with Energy Dispersive X-ray Spectroscopy allowed comparing the morphology of corrosion attack in the absence and presence of inhibitors. The best inhibiting properties were achieved in the presence of 2-(salicylideneimino)thiophenol (SITP). The addition of phosphate ions to SITP induced the formation of a surface film particularly resistant against localized corrosion phenomena. Raman and XPS spectroscopy were applied in order to investigate the inhibition mechanism of sire without and with the presence of phosphate ions.Nell’ambito di un progetto M-ErA.NET denominato B-IMPACT, sono state sintetizzate alcune basi di schiff polidentate che sono state usate come inibitori della corrosione del bronzo. Le prove consistevano in esposizioni ad una soluzione di pioggia acida artificiale con-centrata, in cui le sostanze erano presenti in concentrazioni di saturazione (< 10-3 M). Il loro effetto inibitore è stato valutato durante 20 giorni di immersione tramite prove elettrochimiche non distruttive (spettroscopia di Impedenza Elettrochimica) e attraverso la regi-strazione di curve di polarizzazione. Osservazioni al microscopio elettronico a scansione accoppiato ad una microsonda a dispersione di energia hanno permesso di confrontare la morfologia dell’attacco corrosivo in assenza e in presenza di inibitori. Le migliori proprietà inibitrici sono state rilevate in presenza di 2-salicilideneimmino tiofenolo (sITP). L’aggiunta di ioni fosfato al sITP induce la formazione di film superficiali particolarmente resistenti nei confronti di fenomeni di corrosione localizzata. sono inoltre state applicate la spettro-scopia raman ed XPs per meglio investigare il meccanismo di inibizione del sITP, sia in assenza che in presenza di ioni fosfato

Evaluation of 2-(salicylideneimino) thiophenol and other Schiff bases as bronze corrosion inhibitors by electrochemical techniques and surface analysis

International audiencen this research, different Schiff bases were synthesized and tested as bronze corrosion inhibitors in concentrated synthetic acid rain at pH 3.3. Some of them showed good inhibiting effects, as detected by EIS and polarization curve recording. The most efficient inhibitor (2-(salicylideneimino) thiophenol, SITP) was also tested with ad-dition of sodium dihydrogen phosphate (P). P improved the surface film resistance against breakdown phe-nomena. XPS and SEM investigations showed that SITP and SITP + P significantly hinder decuprification. Moreover, SITP forms a protective layer on bronze, composed of both Cu(I)-SITP complexes and adsorbed in-hibitor molecules. Cu(II) phosphates were also detected with P addition

Efficienza inibitrice di basi di schiff come inibitori di corrosione del bronzo

International audienceAs part of an M-ERA.NET project called B-IMPACT some polidentate Schiff bases were synthesized and tested as corrosion inhibitors of bronze. The tests consisted of exposures of bronze specimens to a concentrated artificial acid rain solution, containing or not containing the studied substances added under saturation conditions (< 10(3) M). Their inhibiting effect was evaluated during 20 day immersions by means of non-destructive electrochemical tests (Electrochemical Impedance Spectroscopy) and by finally recording the polarization curves. Observations by a scanning electron microscope coupled with Energy Dispersive X-ray Spectroscopy allowed comparing the morphology of corrosion attack in the absence and presence of inhibitors. The best inhibiting properties were achieved in the presence of 2-(salicylideneimino)thiophenol (SITP). The addition of phosphate ions to SITP induced the formation of a surface film particularly resistant against localized corrosion phenomena. Raman and XPS spectroscopy were applied in order to investigate the inhibition mechanism of sire without and with the presence of phosphate ions.Nell’ambito di un progetto M-ErA.NET denominato B-IMPACT, sono state sintetizzate alcune basi di schiff polidentate che sono state usate come inibitori della corrosione del bronzo. Le prove consistevano in esposizioni ad una soluzione di pioggia acida artificiale con-centrata, in cui le sostanze erano presenti in concentrazioni di saturazione (< 10-3 M). Il loro effetto inibitore è stato valutato durante 20 giorni di immersione tramite prove elettrochimiche non distruttive (spettroscopia di Impedenza Elettrochimica) e attraverso la regi-strazione di curve di polarizzazione. Osservazioni al microscopio elettronico a scansione accoppiato ad una microsonda a dispersione di energia hanno permesso di confrontare la morfologia dell’attacco corrosivo in assenza e in presenza di inibitori. Le migliori proprietà inibitrici sono state rilevate in presenza di 2-salicilideneimmino tiofenolo (sITP). L’aggiunta di ioni fosfato al sITP induce la formazione di film superficiali particolarmente resistenti nei confronti di fenomeni di corrosione localizzata. sono inoltre state applicate la spettro-scopia raman ed XPs per meglio investigare il meccanismo di inibizione del sITP, sia in assenza che in presenza di ioni fosfato

Inhibiting effects of some Schiff bases on the corrosion of bronze exposed to artificial acidic rain

Conservation of artistic heritage is of great importance for the future of the historical and cultural identity of a society. Both ancient and modern bronze artworks are an important part of this cultural heritage and the production of effective and environmentally satisfactory protective treatments is a central and still unresolved issue. The M-ERA.NET project named B-IMPACT (Bronze-IMproved non-hazardous PAtina CoaTings) operates in this context and aims at developing innovative, eco-friendly and non-hazardous protective coatings for bronze surfaces exposed to the outdoor environment. This research has the objective to identify new effective bronze corrosion inhibitors for the future entrapment in surface coatings so giving a contribution to the development of alternative efficient surface treatments. A number of organic compounds proved to be good corrosion inhibitors for copper [1-5], but mainly azoles, such as triazoles [6-8], tetrazoles [6,9], imidazoles [10] and thiadiazoles [6,9,11], were tested for bronze protection. Mostly benzotriazole (BTA) and triazole derivatives were used and applied in the conservation field [6,8], although there are toxicity and perhaps human carcinogenicity concerns due to their handling and leaching in the environment [12,13]. Some Schiff bases derivatives are claimed to be efficient [1,3,14,15] and environment friendly [1] inhibitors of copper corrosion in acid and neutral chloride solution. For these reasons, some specifically synthesized Schiff bases were tested by electrochemical methods, as BTA alternative inhibitors of bronze corrosion, during exposures to concentrated acidic rain. The inhibition mechanism of the most efficient substance was also studied by surface analyses methods (Scanning Electron Microscope (SEM) observations, Raman and X-Ray Photoelectron Spectroscopy (XPS)

Surgery for Adult Patients with Congenital Heart Disease: Results from the European Database

Adults with congenital heart disease (ACHD) represent a growing population. To evaluate frequency, type and outcomes of cardiac surgery in ACHD, we gathered data from the European Congenital Heart Surgeons Association Database of 20,602 adult patients ( 6518 years) with a diagnosis of congenital heart disease who underwent cardiac surgery, between January 1997 and December 2017. We demonstrated that overall surgical workload (as absolute frequencies of surgical procedures per year) for this specific subset of patients increased steadily during the study period. The most common procedural groups included septal defects repair (n = 5740, 28%), right-heart lesions repair (n = 5542, 27%) and left-heart lesions repair (n = 4566, 22%); almost one-third of the procedures were re-operations (n = 5509, 27%). When considering the year-by-year relative frequencies of the main procedural groups, we observed a variation of the surgical scenario during the last two decades, characterized by a significant increase over time for right and left-heart lesions repair (p < 0.0001, both); while a significant decrease was seen for septal defects repair (p < 0.0001) and transplant (p = 0.03). Overall hospital mortality was 3% (n = 622/20,602 patients) and was stable over time. An inverse relationship between mortality and the number of patients operated in each center (p < 0.0001) was observed

Late management of the aortic root after repair of tetralogy of Fallot: A European multicentre study

OBJECTIVES: We sought to determine the indications, type, and outcomes of reoperations on the aortic root after repair of tetralogy of Fallot (TOF). METHODS: Eleven centers belonging to the European Congenital Heart Surgeons Association contributed to the data collection process. We included 36 patients who underwent surgical procedures on the aortic root, including surgery on the aortic valve and ascending aorta, between January 1975 and December 2017. Original diagnoses included TOF-pulmonary stenosis (n = 18) and TOF-pulmonary atresia (n = 18). The main indications for reoperation were aortic insufficiency (n = 19, 53%), aortic insufficiency and dilatation of the ascending aorta (n = 10, 28%), aortic root dilatation (n = 4, 11%), and ascending aorta dilatation (n = 3, 8%). RESULTS: The median age at reoperation was 30.4 years (interquartile range 20.3-45.3 years), and mechanical aortic valve replacement was the most common procedure performed. Five patients died early after reoperation (14%), and larger ascending aorta diameters were associated with early mortality (P = .04). The median age at the last follow-up was 41.4 years (interquartile range 24.5-51.6 years). Late death occurred in five patients (5/31, 16%). Most survivors (15/26, 58%) were asymptomatic at the last clinical examination (New York Heart Association, NYHA class I). The remaining patients were NYHA class II (n = 7) and III (n = 3). The most common symptoms were fatigue (n = 5), dyspnea (n = 4), and exercise intolerance (n = 3). CONCLUSIONS: Reoperations on the aortic root are infrequent but may become necessary late after TOF repair. The main indications for reoperation are aortic insufficiency, either isolated or associated with a dilatation of the ascending aorta. The surgical risk at reoperation was high and the presence of ascending aorta dilation is related to higher mortality.status: publishe

Late management of the aortic root after repair of tetralogy of Fallot: A European multicentre study.

OBJECTIVES: We sought to determine the indications, type, and outcomes of reoperations on the aortic root after repair of tetralogy of Fallot (TOF). METHODS: Eleven centers belonging to the European Congenital Heart Surgeons Association contributed to the data collection process. We included 36 patients who underwent surgical procedures on the aortic root, including surgery on the aortic valve and ascending aorta, between January 1975 and December 2017. Original diagnoses included TOF-pulmonary stenosis (n = 18) and TOF-pulmonary atresia (n = 18). The main indications for reoperation were aortic insufficiency (n = 19, 53%), aortic insufficiency and dilatation of the ascending aorta (n = 10, 28%), aortic root dilatation (n = 4, 11%), and ascending aorta dilatation (n = 3, 8%). RESULTS: The median age at reoperation was 30.4 years (interquartile range 20.3-45.3 years), and mechanical aortic valve replacement was the most common procedure performed. Five patients died early after reoperation (14%), and larger ascending aorta diameters were associated with early mortality (P = .04). The median age at the last follow-up was 41.4 years (interquartile range 24.5-51.6 years). Late death occurred in five patients (5/31, 16%). Most survivors (15/26, 58%) were asymptomatic at the last clinical examination (New York Heart Association, NYHA class I). The remaining patients were NYHA class II (n = 7) and III (n = 3). The most common symptoms were fatigue (n = 5), dyspnea (n = 4), and exercise intolerance (n = 3). CONCLUSIONS: Reoperations on the aortic root are infrequent but may become necessary late after TOF repair. The main indications for reoperation are aortic insufficiency, either isolated or associated with a dilatation of the ascending aorta. The surgical risk at reoperation was high and the presence of ascending aorta dilation is related to higher mortality

Left-Sided Reoperations After Arterial Switch Operation: A European Multicenter Study

We sought to report the frequency, types, and outcomes of left-sided reoperations (LSRs) after an arterial switch operation (ASO) for patients with D-transposition of the great arteries (D-TGA) and double-outlet right ventricle (DORV) TGA-type