Surgical management of life threatening events caused by intermittent aortic insufficiency in a native valve: case report

We describe a case of a patient admitted with apparent life threatening events characterized by hypotension and bradycardia. The patient was ultimately found to have intermittent severe aortic insufficiency. Upon surgical exploration, abnormalities were discovered in the aortic valve, which had a small left coronary cusp with absence of the nodulus of Arantius. Following surgical repair of the valve, aimed at preventing the small cusp from becoming stuck in the open position, the patient has remained episode free for over one year

Numerical comparison of the closing dynamics of a new trileaflet and a bileaflet mechanical aortic heart valve

[[abstract]]The closing velocity of the leaflets of mechanical heart valves is excessively rapid and can cause the cavitation phenomenon. Cavitation bubbles collapse and produce high pressure which then damages red blood cells and platelets. The closure mechanism of the trileaflet valve uses the vortices in the aortic sinus to help close the leaflets, which differs from that of the monoleaflet or bileaflet mechanical heart valves which mainly depends on the reverse flow. We used the commercial software program Fluent to run numerical simulations of the St. Jude Medical bileaflet valve and a new trileaflet mechanical heart valve. The results of these numerical simulations were validated with flow field experiments. The closing velocity of the trileaflet valve was clearly slower than that of the St. Jude Medical bileaflet valve, which would effectively reduce the occurrence of cavitation. The findings of this study are expected to advance the development of the trileaflet valve.[[incitationindex]]SCI[[booktype]]電子版[[booktype]]紙

Quantitative optical determination of the viability of platelet concentrates.

An optical method to assess platelet viability in platelet transfusion concentrates has been developed which is based on the observation that healthy, discoid platelets transmit more light in shear flow than aged, spherical cells. Using a specially designed glass channel, the rise in transmission of light through platelet samples with agitation is referenced against a measurement of transmission without flow. Referencing the measurements may minimize the effects of red blood cell contamination, as well as other variations among platelet packs such as plasma characteristics and plastic container variability. At an optimal frequency of agitation, the ratio of the transmission of light with agitation to that of the sample at rest is found to correlate highly with the concentration of discoid platelets, r = 0.92 to 0.95 (P less than 0.001), for light sources including a HeNe laser and two LEDs. Using this index, the discoid platelet counts of twelve platelet packs are estimated and compared with manual counts. The mean difference between the two methods was 0.009 x 10(9) discoid platelets ml-1 with a standard deviation of 0.11 x 10(9) cells ml-1. We conclude that the method may be applied to the development of a non-invasive device to monitor the concentration of viable, discoid platelets in storage