Continuous or interrupted pledgeted suture technique in stented bioprosthetic aortic valve replacement:a comparison of in-hospital outcomes

Background: There is ambiguity in the literature regarding the continuous suture technique (CST) for aortic valve replacement (AVR). At our center, there has been a gradual shift towards CST over the interrupted pledgeted technique (IPT). This study aims at comparing outcomes for both techniques. Methods: We performed a retrospective analysis of a single-center study of patients undergoing AVR between January 2011 and July 2020. Patients were divided into two groups: Continuous suture technique and interrupted pledget-reinforced sutures. The pre-operative and In-hospital clinical characteristics and echocardiographic hemodynamics (i.e. transvalvular gradients and paravalvular leakage) were compared between CST and IPT. Results: We compared 791 patients with CST to 568 patients with IPT (median age: 73 and 74 years, respectively, p = 0.02). In CST there were 35% concomitant procedure vs. 31% in IPT (p = 0.16). Early mortality was 3.2% in CST versus 4.8% in IPT (p = 0.15), and a second cross-clamp due to a paravalvular-leak in 0.5% vs. 1.2%, respectively (p = 0.22). The CST was not associated with new-onset conduction-blocks mandating pacemaker implants(OR 1.07, 95% CI 0.54–2.14; P = 0.85). The postoperative gradients on echocardiography were lower in CST compared to IPT, especially in smaller annuli (peak gradients: 15.7mmHg vs. 20.5mmHg, in valve size &lt; 23 mm, p &lt; 0.001). Conclusions: The continuous suture technique was associated with lower postoperative gradients and shorter cross-clamp time compared to interrupted pledgeted technique. Differences in paravalvular leaks were non-significant, although slightly less in the continuous suture technique. There were no further differences in valve-related complications. Hence, continues suture technique is safe, with better hemodynamics compared to the interrupted pledgeted technique. This may be of clinical importance, especially in smaller size annular size.</p

Continuous or interrupted pledgeted suture technique in stented bioprosthetic aortic valve replacement:a comparison of in-hospital outcomes

Background: There is ambiguity in the literature regarding the continuous suture technique (CST) for aortic valve replacement (AVR). At our center, there has been a gradual shift towards CST over the interrupted pledgeted technique (IPT). This study aims at comparing outcomes for both techniques. Methods: We performed a retrospective analysis of a single-center study of patients undergoing AVR between January 2011 and July 2020. Patients were divided into two groups: Continuous suture technique and interrupted pledget-reinforced sutures. The pre-operative and In-hospital clinical characteristics and echocardiographic hemodynamics (i.e. transvalvular gradients and paravalvular leakage) were compared between CST and IPT. Results: We compared 791 patients with CST to 568 patients with IPT (median age: 73 and 74 years, respectively, p = 0.02). In CST there were 35% concomitant procedure vs. 31% in IPT (p = 0.16). Early mortality was 3.2% in CST versus 4.8% in IPT (p = 0.15), and a second cross-clamp due to a paravalvular-leak in 0.5% vs. 1.2%, respectively (p = 0.22). The CST was not associated with new-onset conduction-blocks mandating pacemaker implants(OR 1.07, 95% CI 0.54–2.14; P = 0.85). The postoperative gradients on echocardiography were lower in CST compared to IPT, especially in smaller annuli (peak gradients: 15.7mmHg vs. 20.5mmHg, in valve size &lt; 23 mm, p &lt; 0.001). Conclusions: The continuous suture technique was associated with lower postoperative gradients and shorter cross-clamp time compared to interrupted pledgeted technique. Differences in paravalvular leaks were non-significant, although slightly less in the continuous suture technique. There were no further differences in valve-related complications. Hence, continues suture technique is safe, with better hemodynamics compared to the interrupted pledgeted technique. This may be of clinical importance, especially in smaller size annular size.</p

Etude de la fatigue thermomécanique des composants de puissance de type triac soumis à des cycles actifs de température

Les travaux présentés dans ce mémoire portent sur l'évaluation de la fatigue thermomécaniqued'une nouvelle famille de TRIAC 16 A, 600 V (boîtier TO-220), qualifiée de hautetempérature , pour des applications industrielles, grand public et d'éclairage.Nous avons cherché à évaluer la durée de vie de ces TRIAC et à analyser et comprendre lesmécanismes de dégradation, lorsque ces derniers subissent des cycles actifs de température.En particulier, nous avons étudié expérimentalement l'influence des profils thermiques (tempsde montée, de palier et excursion de température) sur la durée de vie des TRIAC. Ce travail apermis de déterminer le principal facteur d'accélération des défaillances des composants.Nous avons alors proposé un modèle de prédiction de la durée de vie des TRIAC qui s'appuiesur la corrélation entre les résultats des tests expérimentaux avec ceux obtenus en simulation(ANSYS®).This work deals with the thermo-mechanical fatigue evaluation of a new 16 A, 600 V (TO-220package), high temperature TRiAC family, used for industrial, lighting, and home appliances.We evaluated the lifetime of these TRIAC and analyzed their failure mechanisms, when thedevices were subjected to power cycling.Particularly, we analyzed the impact of a power cycling profile (with various rise and dwelldurations or temperature swings) on TRIAC lifetime. This study allowed us to define the mainacceleration factor responsible of the TRIAC package aging.Thus, we proposed a lifetime prediction model for TRIAC subjected to power cycling bycorrelating the experimental results with those obtained in simulation (ANSYS®).TOURS-Bibl.électronique (372610011) / SudocSudocFranceF

Improved Learning Outcomes in Labview for Undergraduate Students with Lego Mindstorms NXT Kit

International audienceIn the literature, several educational programs for undergraduate students in control engineering are based on a project-based learning. This paper belongs to this trend to teach the graphical-based computer language LabVIEW for measurement, data acquisition and control. The aim is to improve the student skills in the use of this software by means of a suitable methodology based on team to team competition using Modeling & Simulation. It is included in a program for undergraduate student bringing them to obtain a professional degree at the Technological Institute of the University of Bordeaux. Three different educational sessions are compared where different methodologies of teaching LabVIEW and finite state machine have been proposed to improve the learning outcomes. After a discussion on a standard solution for the project, the assessment of created programs was analyzed to establish the learning experiences in term of LabVIEW user and developer

Analysis of Electrical stresses in AC Switches Used for Control of Small Power Motors Present in Household Appliances

This paper describes a study on electric and thermal stresses induced in bidirectional switches used for control of small power motors present in household appliances, in order to find out the possible weakness of the current solution generally made of a triac and to determine the requirements for new dedicated devices in the ASDTM technology. First, a behavioral analysis of these motors must be performed and the interactions between the switch and the load have to be well defined

A modular formalisation of finite group theory

Abstract. In this paper, we present a formalisation of elementary group theory done in Coq. This work is the first milestone of a long-term effort to formalise Feit-Thompson theorem. As our further developments will heavily rely on this initial base, we took special care to articulate it in the most compositional way.

Original repair after Ross failure: A case report of bicuspidized unicuspid autograft.

No abstract availabl

Lifetime Prediction Modeling of Non-Insulated TO-220AB Packages with Lead-Based Solder Joints during Power Cycling

International audienc

Le Centre d’accueil d’évaluation et d’orientation (CAdEO) : une porte d’entrée territoriale dans les soins en santé mentale

Un premier Centre d’accueil d’évaluation et d’orientation (CAdEO) a été créé à Lyon début juin 2020 dans le but de faciliter l’accès aux soins en santé mentale. Cette structure permet à toute personne qui la sollicite d’accéder à une consultation psychiatrique dans les quelques jours qui suivent. Elle ne met pas en œuvre de suivi, mais elle lui permet d’être rapidement dirigée vers la structure ou le professionnel, d’exercice public ou privé, qui pourra déployer la prise en charge dont elle a besoin. Pour argumenter ses avis, le CAdEO s’appuie sur une équipe multidisciplinaire, qui comprend des psychiatres, des psychologues et des infirmiers (dont un infirmier en pratique avancée). Son secrétariat est ouvert du lundi au vendredi. Le CAdEO, qui est implanté en centre-ville, travaille en partenariat étroit avec les médecins généralistes de son territoire de santé, ainsi qu’avec tous les dispositifs sanitaires, médico-sociaux et sociaux intervenant dans le domaine de la santé mentale. Parmi ses consultants, environ 4 personnes sur 5 sont orientées vers le libéral ou l’associatif. Une personne sur 5 est orientée vers les autres dispositifs du secteur de psychiatrie générale dont le CAdEO constitue en ce cas la porte d’entrée