The synergy between percutaneous coronary intervention with TAXUS and cardiac surgery study: A surgical perspective

he SYNTAX (The Synergy between percutaneous coronary intervention with TAXUS and cardiac surgery) study is an important study to indicate the best treatment option for patients who have three vessel coronary artery disease and/or left main stem coronary disease (LMD). CABG (coronary artery bypass grafting) is still the preferred therapy for these patient groups with proven low mortality and excellent long term survival rates. PCI-DES (percutaneous coronary intervention with drug eluting stents) is a relative non-invasive procedure with comparable short and medium term survival, but with a much higher repeat revascularisation rate.The SYNTAX Study enrolled 1800 patients in a randomised arm and 1275 in a registry arm. A SYNTAX Score was developed to assess the lesion morphology. At 12 months follow-up in the randomised group there was an increased death rate (4.3% vs 3.5%), myocardial infarction rate (4.8% vs 3.2%) and repeat revascularisation rate (13.7% vs 5.9%) in the PCI-TAXUS (percutaneous coronary intervention with TAXUS stent) group compared to the CABG group. This trend continues up to 24 months with increased death rate (6.2% vs 4.9%), myocardial infarction rate (5.9% vs 3.3%), repeat procedure rate (17.4% vs 8.6%) and MACCE rate (23.4% vs 16.3%) in the PCI group compared to the CABG group.The aim of the SYNTAX Study was to prove non-inferiority of PCI (percutaneous coronary intervention) compared to CABG in these patient populations. Non-inferiority of PCITAXUS compared to CABG in this study population could not be shown at 12 or 24 months. The cerebrovascular event rate was higher in the CABG group in both study arms (2.2% vs 0.6%) in the first year, but a nearly similar CVA rate during the next 12 months. The study will terminate in 2011 and will give much-needed information regarding the optimal treatment option in patients with three vessel disease and/or left main disease

A new window of opportunity for TAVI

This short report features the role of multi detector computer tomography (MDCT) in imaging the ascending aorta to assess the feasibility of a transaortic access route for transcatheter placement of an Edwards SAPIEN XTTM aortic valve

Determination of ADSL capacity in a generic exchange environment

Please read the abstract in the front matter this documentDissertation (M Eng (Electronic Engineering))--University of Pretoria, 2006.Electrical, Electronic and Computer Engineeringunrestricte

The bryofloristic elements of Southern Africa

A TWINSPAN classification divides the moss flora of southern Africa (South Africa, Namibia, Botswana, Swaziland, and Lesotho) into two main bryofloristic elements: (1) the Xerophytic (south-western) element mainly distributed in the winter rainfall and semi-arid to arid, temperate areas of southern Africa, and (2) the Mesophytic (subtropical) element distributed in more stable, subtropical habitats of the northern, eastern and southern parts of southern Africa. The Xerophytic element is dominated by acrocarpous mosses, including the ephemerals, while the Mesophytic element contains most of the pleurocarpous mosses. The main Xerophytic element is subdivided into the Eastern Highlands and Cape Elements while the Mesophytic element consists of the Afromontane Grassland and Afromontane Forest Elements. The Afromontane Forest Element is the largest bryofloristic element and contains the most southern African moss endemics. The four bryofloristic elements are subdivided into eight subelements: the Eastern Highlands Element into the Mont Aux Sources and Widespread Subelements, the Cape Element into the West Coast and Boland Subelements, the Afromontane Grassland Element into the Disjunct Cape Peninsula and Drakensberg Subelements, and the Afromontane Forest Element into the Widespread Afromontane and Tropical Afromontane Subelements. Many of the bryofloristic elements and distribution centres correspond with phytogeographical elements and centres described for the seed plants of southern Africa. The Afromontane area in the south-western Cape is identified as a bryogeographical hotspot

First experience with the Edwards SAPIEN transcatheter aortic valve implantation (TAVI). Data from the Western Cape, South Africa

Background: Transcatheter aortic valve implantation (TAVI) is an exciting new technology that was launched in South Africa in October 2009 for the treatment of aortic stenosis in patients at high risk for conventional surgery. We report our initial experience with TAVI in the Western Cape, South Africa. Methods: 70 patients with severe symptomatic aortic stenosis underwent TAVI with the Edwards SAPIEN device (26 via transapical approach and 44 via transfemoral) at Panorama and Vergelegen Mediclinic hospitals in the Western Cape. All implants were performed by a team consisting of 2 cardiothoracic anaesthesiologists, 2 cardiothoracicsurgeons, 2 cardiologists and an echo expert. Results: Patients were at high risk with a mean age of 80 years and a mean logistic EuroSCORE of 26. The acute procedural success rate was 97% with two acute deaths. At 30 days, there were a total of 5 deaths. Major vascular complications were seen in 6 cases (9%). Only one stroke was seen during the follow-up period. Conclusions: With a multidisciplinary team approach and careful patient selection, TAVI can be performed by a high volume centre in South Africa with results comparable to international published outcomes

First case of trans apical implantation of an aortic valve in a patient with dextrocardia

We describe the clinical presentation and implantation procedure of the first transcatheter aortic valve implantation described in a patient with dextrocardia

Design of a Gigabit DSL modem using super orthogonal complete complementary codes

This paper describes the preliminary design and simulation towards a gigabit digital subscriber line modem that provides multi-user interference-free communication in a far-end crosstalk dominated environment by incorporating super orthogonal complete complementary spreading into the existing xDSL modem architecture. This is in contrast to existing vectoring and dynamic spectral management techniques that use joint processing and pre-processing of each user's signal to mitigate far-end crosstalk. A novel code allocation algorithm is introduced to provide all users with equal data rate ratios, even with bad line profiles and high-required data rates. Preliminary simulation results show that 1 Gbps aggregate throughput can be obtained for the system over a single pair of 0.5 mm copper wire over a distance from 180 to 150 m, depending on whether ADSL2+ or VDSL2 Profile 30a service bands are avoided, if present.The National Research Foundation of South Africa (Grant reference TP1207183332), Telkom and Bytes Universal Systems.http://onlinelibrary.wiley.com/journal/10.1002/(ISSN)2161-39152017-11-30Electrical, Electronic and Computer Engineerin

Transcatheter aortic valve in mitral annular calcifi cation (TAV-in-MAC) : a new treatment option for mitral valve replacement in patients with severe annular calcification

CITATION: Weich, H., et al. 2019. Transcatheter aortic valve in mitral annular calcifi cation (TAV-in-MAC) : a new treatment option for mitral valve replacement in patients with severe annular calcification. SA Heart, 16(2):136-139, doi:10.24170/16-1-3643.The original publication is available at http://www.journals.ac.za/index.php/SAHJENGLISH ABSTRACT: Severe mitral annular calcification is not an uncommon occurrence in the elderly and up to now, this has often precluded surgical replacement of the mitral valve. Initial attempts at percutaneous placement of transcatheter aortic valves in the calcified mitral annulus, has not been very successful due to obstruction of the left ventricular outflow tract. We describe a surgical approach where the anterior mitral valve leaflet was resected and a balloon expandable transcatheter aortic valve then deployed within the calcified annulus. The benefits of this technique over a fully percutaneous approach is discussed.https://www.journals.ac.za/index.php/SAHJ/article/view/3643Publisher's versio

Space-time precoded CDMA-OFDMA employing super-orthogonal complete complementary codes

This paper addresses and illustrates, both analytically as well as by means of simulation, the equivalence of a cyclically rotated complete complementary coded (CRCCC) code division multiple access orthogonal frequency division multiplexed (CDMA-OFDM) BPSK/QPSK system and a narrowband uncoded BPSK/QPSK reference system. The equivalence can be attributed to the MUI-free characteristic performance of CRCCCs. It is demonstrated that when employed in a multiple-input multiple-output (MIMO) antenna configuration along with orthogonal space-time block codes (OSTBCs), the maximum theoretical diversity order of NTxNRx is achieved. Most significantly, simulations show that CDMA-OFDM using CRCCCs is capable of rendering additional multipath diversity gain at no additional processing cost. This signifies improved performance when compared with conventional ST-OFDM systems.This work is based on the research supported in part by the National Research Foundation of South Africa (Grant reference TP1207183332) and our industry partners Telkom and Bytes Universal Systems.http://www.saiee.org.za/DirectoryDisplay/DirectoryCMSPages.aspx?name=Publications#id=1588&dirname=ARJ&dirid=337am2016Electrical, Electronic and Computer Engineerin