TMVR after TA-TAVR: a re-redo surgery—case report

IntroductionTranscatheter mitral valve replacement (TMVR) is a valuable treatment option in patients with severe mitral regurgitation. Prior transapical transcatheter aortic valve replacement (TA-TAVR) may complicate the procedure and is therefore considered a relative contraindication. In this case report, the authors describe the successful TMVR as a tertiary cardiac surgery and transapical redo procedure.Case SummaryAn 83-year-old male patient, suffering from dyspnoea and angina, was diagnosed with severe mitral valve regurgitation (MR). He had already undergone cardiac surgery in the form of coronary artery bypass grafting at the age of 64 and TA-TAVR at 79 years. After a failed attempt at mitral valve transcatheter edge-to-edge repair, he opted for TMVR. Pre-TMVR computed tomography simulation was used to analyse possible interactions between the prostheses and to predict the neo-left ventricular outflow tract (neo-LVOT). The operation was carried out without complications. There was no bleeding and the LV function remained unchanged. On MRI, the valves were perfectly aligned without any signs of paravalvular leakage or LVOT obstruction. The patient was discharged seven days postoperatively. At the one-year follow up, there was no need for rehospitalisation and the patient had clinically improved (from NYHA IV to II). Echocardiography demonstrated a mean transvalvular gradient of under 5 mmHg and no residual MR.ConclusionA redo transapical access for TMVR as a tertiary cardiac operation can be easily performed. Pre-operative CT suggested good alignment of the aortic and mitral valved stent which was confirmed postoperatively

Kaleidoscope - construction of objectivity

The MA thesis "Kaleidoscope - construction of objectivity" tries to find objective elements in a primary source and to transport it in a objective way. The thesis is about two layer of information of those sources. I divide them into the mask and the substance. The mask is the information which is obvious, on top of everything: The written content of a letter, the happening which is captured in a photograph. The Substance is the information of the material. It is the information of the ink and the paper the letter was written with and the material which captured the image. It is about the chemical components, its natural changing. It all gets influenced by the human who collects, stores, archives it and the one who uses it as a source for a thesis. Is any objectivity possible? As a example the thesis focuses on a heritage of the photographer of West-Berlin times 60s - 80s. It tries to deconstruct the heritage´s elements and rearrange them in a installation. It is an subjective art work out of objective and subjective elements of someone else´s art work

Etude structurale et dynamique de l'organisation des caseines dans la fabrication du fromage fondu

CNRS T Bordereau / INIST-CNRS - Institut de l'Information Scientifique et TechniqueSIGLEFRFranc

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Processing and segmentation of 3D images

The article summarises the technological developments of the recent years in the area of Processing and segmentation of 3D Images. It reviews the established method in the areas of Pre-processing, Segmentation, Classification, Edge Detection, 3D Boundary Tracking, Geodesic Active Contours, Extraction of Tubular Objects, Atlas Registration and Interactive Segmentation

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