Novel full-flow valves, impact on early mitral post-replacement period: a non-randomised controlled cohort trial

Background. Among cardiovascular diseases, valve pathology of various aetiology comprises a primary factor of chronic heart failure. Mitral valve diseases afflict over half of all patients with acquired heart defects. Today’s long-term outcomes of mitral valve replacement are not quite satisfactory, which urges the invention of novel vales. Such a modern artificial valve is the nationally developed bivalve full-flow MedInzh-ST prothesis.Objectives. Assessment of advantages of the novel MedInzh-ST full-flow mechanical valve vs. MedInzh-2 model in analyses of short-term postoperative outcomes.Methods. Over a five-year period, 116 patients underwent indicated mitral replacement with MedInzh valves. The full-flow MedInzh-ST was implanted in 55 patients, and MedInzh-2 — in 61. All patients had transthoracic echocardiography for structural and functional heart and implant control prior to surgery and discharge from hospital. Clinical and echocardiographic analyses were performed in the early postoperative period.Results. The choice of valve model had no effect on the rates of postoperative complications and hospital mortality. All lethal cases were not associated with the valve malfunction. All patients with predominant mitral stenosis revealed the reliably lower peak and mean transmitral pressure gradient and pulmonary artery systolic pressure, irrespective of the valve model. The novel full-flow valve implantation significantly more often associated with a reduced right ventricle size. All patients with predominant insufficiency were observed to reduce mitral regurgitation and the left ventricular size upon defect correction. Patients with full-flow protheses significantly more often had a reduced end-systolic dimension.Conclusion. The MedInzh-ST full-flow mechanical valve satisfies the modern requirements for efficacy and safety. Mitral stenosis correction with full-flow valves is shown to exert a greater effect on reverse right ventricular remodelling compared to the classical model

Left ventricular diastolic dysfunction and transmitral blood flow parameters in patients after COVID-19

Background. People who previously had COVID-19 infection have an increased risk of developing cardiovascular diseases. Left ventricular diastolic dysfunction is an early marker of the development of cardiac pathology. Its early detection is important for the adequate therapy order and dynamic monitoring of patients. In this regard, it seems relevant to study the effect of a recent COVID-19 infection on the left ventricular diastolic function and transmitral blood flow parameters in apparently healthy individuals without clinical and instrumental signs of cardiovascular pathology. The aim of the study. To assess the changes in the diastolic and systolic function of  the left ventricle, its anatomical parameters and transmitral blood flow parameters in two groups of  apparently healthy individuals: those who had and those who had not COVID-19 infection. Materials and methods. Transthoracic echocardiography was performed according to the standard technique and its results were analyzed in 66 examined patients who were recognized as apparently healthy according to the results of  regular comprehensive clinical and instrumental studies. The first group included 30 individuals who underwent an echocardiographic study before or during the COVID-19 pandemic, but did not have a coronavirus infection; the second group consisted of 36 people who recovered from COVID-19. The indicators of the presence of left ventricular diastolic dysfunction and the transmitral blood flow parameters were assessed. The study was approved at a meeting of the Medical Ethics Committee under the Ministry of Health of the Republic of Karelia and of Petrozavodsk State University (Minutes No. 47 of 01.11.2023). Results. The frequency of the left ventricular diastolic dysfunction did not differ in  the  first and second groups of patients. Statistically significant differences were recorded in the average flow deceleration time for both early and late filling of the left ventricle in people who had and did not have COVID-19 infection. A change in the phase structure of the transmitral blood flow may be an early manifestation of intracardiac hemodynamic disorders in people who have recovered from COVID-19

Detailed α-decay study of 180Tl

International audienceA detailed $\alpha$-decay spectroscopy study of $^{180}\mathrm{Tl}$ has been performed at ISOLDE (CERN). $Z$-selective ionization by the Resonance Ionization Laser Ion Source (RILIS) coupled to mass separation provided a high-purity beam of $^{180}\mathrm{Tl}$. Fine-structure $\alpha$ decays to excited levels in the daughter $^{176}\mathrm{Au}$ were identified and an $\alpha$-decay scheme of $^{180}\mathrm{Tl}$ was constructed based on an analysis of $\alpha$-$\gamma$ and $\alpha$-$\gamma$-$\gamma$ coincidences. Multipolarities of several $\gamma$-ray transitions deexciting levels in $^{176}\mathrm{Au}$ were determined. Based on the analysis of reduced $\alpha$-decay widths, it was found that all $\alpha$ decays are hindered, which signifies a change of configuration between the parent and all daughter states

178Hg and asymmetric fission of neutron-deficient pre-actinides

International audienceFission at low excitation energy is an ideal playground to probe the impact of nuclear structure on nuclear dynamics. While the importance of structural effects in the nascent fragments is well established in the (trans-)actinide region, the observation of asymmetric fission in several neutron-deficient pre-actinides can be explained by various mechanisms. To deepen our insight into that puzzle, an innovative approach based on inverse kinematics and an enhanced version of the VAMOS++ heavy-ion spectrometer was implemented at the GANIL facility, Caen. Fission of Hg178 was induced by fusion of Xe124 and Fe54. The two fragments were detected in coincidence using VAMOS++ supplemented with a new SEcond Detection arm. For the first time in the pre-actinide region, access to the pre-neutron mass and total kinetic energy distributions, and the simultaneous isotopic identification of one the fission fragment, was achieved. The present work describes the experimental approach, and discusses the pre-neutron observables in the context of an extended asymmetric-fission island located southwest of Pb208. A comparison with different models is performed, demonstrating the importance of this new asymmetric-fission island for elaborating on driving effects in fission

Infectious endocarditis course after ascending aorta replacement with a valved conduit

Objective. To demonstrate the peculiarities of infectious endocarditis course in patients after ascending aorta replacement using a valved conduit based on the personal observations.Material and methods. Six cases of delayed infectious endocarditis after ascending aorta replacement using a valved conduit are presented.Results. The pathological process was represented by aortic root abscess, paraprosthetic phlegmon, fistula penetrated into the conduit wall and cardiac chambers. There was no vegetation on the prosthesis therefore the diagnosis was complicated. Period from fever onset to final diagnosis lasted from 1 week to 2.5 months. The first pathologic changes in all cases were detected using transesophageal echocardiography, but this method was not informative in the early stages of the disease.Conclusion. Infectious endocarditis in patients after ascending aorta replacement using a valved conduit has its own peculiarities. The most frequently, the process leads to the development of aortic root abscess. Diagnosis of infectious endocarditis in such cases is difficult. Infectious endocarditis should be suspected in patients - carriers of valved conduit with unexplained fever and treatment should be started in accordance with the diagnosis. In this case, structural changes visualization to confirm the disease is not necessary

Predicting coronary graft occlusion in males with type 2 diabetes: an annual prospective study

Aim. Identification of factors affecting coronary bypass graft patency in patients with type 2 diabetes (T2D) during one year after coronary bypass grafting.Materials and methods. Coronary artery bypass grafting for stable effort angina was ordered in 23 men with T2D. The patients had transthoracic echocardiogram before surgery. All patients were verified for lupus anticoagulant (LA) in blood on the 14th day after surgery. A year later, the patients underwent coronary shuntography to assess bypass patency.Results. LA was detected in 15 of 23 patients (65%). One year after surgery, occlusions of coronary shunts were revealed in 10 of 23 patients. In patients with coronary shunt occlusions, end-diastolic and end-systolic dimensions, end-diastolic and end-systolic volumes, end-systolic and end-diastolic indices (EDD, ESD, EDV, ESV, ESI, EDI, respectively), as well as the LA ratio significantly exceeded those in patients without occlusions (Mann—Whitney p values 0.004, 0.012, 0.012, 0.006, 0.006, 0.004, 0.017, respectively). A method is proposed for predicting coronary shunt occlusions based on assessment of end-diastolic volume of left ventricle and the LA ratio.Conclusion. Echocardiographic values for left ventricle (EDD, ESD, EDV, ESV, ESI, EDI) and the LA ratio are predictors of coronary graft occlusions in patients with type 2 diabetes

A CASE OF SUCCESSFUL SURGICAL TREATMENT OF ASCENDING AORTIC ANEURISM RUPTURE WITH CARDIAC TAMPONADE IN A PATIENT LIVING IN A REMOTE AREA

This is a description of a clinical case of a 30-year-old patient with rupture of ascending aorta aneurism due to vascular media degeneration. The rupture gap was associated with cardiac tamponade and shock. As the patient lived in an area remote from a cardiac surgery center, the situation was close to fatal. A team of doctors, which flew forth to the place of the patient’s residence, put a drainage into pericardial cavity which made transportation of the patient for surgery possible. Prostethic repair of ascending aorta with a valve-containing conduit was successful, but there were numerous complications during postoperative period. Longterm (1.5 year after) assessment of the patient showed good results

Dissecting aortic aneurysm in a young woman

We present a case of thoracic aortic dissection in a 33-year-old woman. The diagnosis was difficult, and the right diagnosis was made 4 months after the initial clinical manifestation. Aortic dissection was caused by necrosis of the media combined with longstanding arterial hypertension. Surgical intervention was performed timely and was effective

β-delayed fission and α decay of 178Tl

A detailed nuclear-decay spectroscopy study of the neutron-deficient isotope 178Tl has been performed using the highly selective Resonance Ionization Laser Ion Source and ISOLDE mass separator (CERN), which allowed a unique isobarically pure beam of 178Tl to be produced. The first identification of the β-delayed fission of this isotope was made and its probability PβDF(178Tl)=0.15(6)% was determined. An asymmetric fission fragment mass distribution of the daughter isotope 178Hg (populated by the β decay of 178Tl) was deduced based on the measured fission fragment energies. The fine-structure α-decay pattern of 178Tl allowed the low-energy states in the daughter nucleus 174Au to be studied