bluuebunny/crossref_metadata_2025_split huggingface dataset:
A new concept in the sewing rings for mechanical heart valves
Authors: Kurian Mathew V , Umasankar Payanam R , Sabareeswaran Arumugam , Shenoy Sachin J , Subban Vijayakumar , Joseph Mathew K 
Published: May 2013

Background: valve-associated complications challenge the quality of life and longevity after heart valve replacement. Inappropriate healing may be a contributing factor. Objective: to evaluate a new design mechanical heart valve in an animal model. Methods and results: the new valve was fabricated by substituting the sewing ring with an inbuilt suture ridge and an overlying fabric flap. It improved the effective orifice area. Animal experiments were performed on pigs to compare this valve with standard valve models. The animals were kept on dual antiplatelet drugs. Six of the 8 test animals survived the observation period of 140 days compared to 2 of the 6 controls. Among the test valves, one had thrombosis and 3 had significant tissue hyperplasia, whereas 5 control valves had thrombosis associated with significant tissue hyperplasia. Three test valves had paravalvular defects compared to none in the control group. Histology showed good tissue incorporation of the fabric flap of the test valves, whereas the control valves had tissue infiltration limited to the peripheral fabric layer of the sewing ring. Conclusion: the new valve has improved effective orifice area, and the animal study showed better survival, good healing, and a lower incidence of thrombosis and tissue hyperplasia.
Aortic valve replacement with biological substitutes in children
Authors: Talwar Sachin , Malankar Dhananjay , Garg Sanket , Choudhary Shiv Kumar , Saxena Anita , Velayoudham Devagourou , Kumar Arkalgud Sampath 
Published: May 2013

Background: this study was performed to assess the results of aortic valve replacement in children with biological substitutes including homografts, pulmonary autografts (Ross procedure), and aortic valve reconstruction with autologous pericardium (Duran technique). Methods: between March 1992 and July 2009, 73 children with aortic valve disease (mean age, 11.8 ± 2.7 years) underwent aortic valve replacement with biological substitutes including homografts, pulmonary autografts, and aortic valve reconstruction with autologous pericardium. Associated procedures were mitral valve repair in 32 and subaortic membrane resection in 3. Results: early mortality was 1.4% (1 patient). Median follow-up was 94 months. Sixty (83.3%) survivors had insignificant aortic regurgitation. Reoperation was required in 7 (9.6%) patients: for autograft dysfunction alone in 2, autograft failure and failed mitral valve repair in 2, autograft dysfunction with severe pulmonary homograft regurgitation in 1, severe homograft aortic valve regurgitation in 1, and right ventricular outflow tract obstruction in 1. There were 4 (5.4%) late deaths. Actuarial reoperation-free, event-free, and aortic valve dysfunction-free survival were 92.5% ± 4%, 93.4% ± 3.3 %, 94% ± 2.9%, 86.2% ± 4.3%, respectively, at 94 months. Conclusions: aortic valve replacement with biological substitutes is associated with acceptable hemodynamics and midterm results.
Sonoclot analysis in children with congenital heart disease
Authors: Chaudhary Vishal , Chauhan Sandeep , Choudhury Minati , Kiran Usha , Talwar Sachin , Kapoor Poonam M 
Published: May 2013

Background: This study aimed to compare preoperative baseline Sonoclot variables between acyanotic and cyanotic congenital heart disease patients. Methods: 100 patients aged from infancy to 9-years were studied. Fifty patients each from the cyanotic and acyanotic groups were studied for sonoclot parameters preoperatively. After inhalational anesthetic induction, blood was collected from the arterial line and analyzed in a Sonoclot analyzer to measure Sonoclot activated coagulation time, clot rate, and platelet function. Results: Sonoclot activated coagulation time was normal in both groups, but lower in the cyanotic group (127.95 ± 51.4 s) than the acyanotic group (147.85 ± 45.48 s; p = 0.54). Both groups had abnormal clot rates and platelet function. The clot rate was significantly lower in the cyanotic group (19.31 ± 10.68 Uċmin−1) than acyanotic group (24.88 ± 9.23 Uċmin−1; p = 0.009). Platelet function was deranged in 31% of patients (cyanotic, 59%; acyanotic, 8%; p < 0.001). Platelet function was the most severely affected baseline parameter. Conclusions: Pediatric acyanotic and cyanotic congenital heart disease patients have deranged coagulation parameters as assessed by the Sonoclot analyzer. The abnormality is more marked in cyanotic patients. Platelet function is the most severely affected parameter. These baseline parameters in conjunction with post-bypass parameters for an individual patient will help in the formulation of specific blood component transfusion guidelines.
Remote ischemic preconditioning in percutaneous coronary revascularization: a double-blind randomized controlled clinical trial
Authors: Ghaemian Ali , Nouraei S Mahmoud , Abdollahian Fatemeh , Naghshvar Farshad , Giussani Dino A , Nouraei SA Reza 
Published: May 2013

Objective: To assess the impact of pre-procedural remote ischemic preconditioning on the incidence of myocardial complications following percutaneous coronary intervention. Background: Ischemic preconditioning of a remote vascular territory improves the subsequent ischemic tolerance of distant organs. Method: The Myocardial Event Reduction with Ischemic Preconditioning Therapy (MERIT) trial recruited 80 consecutive patients undergoing elective angioplasty with drug-eluting stents to receive two 5-min lower limb tourniquet occlusions or an un-inflated tourniquet (controls) 1 h before the procedure. The primary outcome was troponin T level at 24 h. Secondary outcomes were intra-procedural chest pain and ST-segment deviation. Results: 6 patients in the control group and 2 in the ischemic preconditioning group had pre-procedural raised troponin T ( p = 0.23). This increased to 16 (40%) in the control group and 5 (12.5%) in the study group at 24 h ( p = 0.01). Fewer patients in the study group experienced intra-procedural chest pain (1 vs. 7, p = 0.056). Mean ST-segment deviation time was 13 ± 35 s in the study group and 58 ± 118 s in the control group ( p = 0.02). At a mean follow-up of 11 months, the major adverse cardiac event rate did not differ significantly between the groups. Conclusion: These data suggest that ischemic preconditioning reduces the absolute risk of post-procedure cardiomyocyte necrosis by 27.5%, and reduces intra-procedural chest pain and ST-segment deviation in patients undergoing percutaneous coronary interventions. We suggest its routine use in percutaneous coronary intervention, although the long-term prognostic impact in this patient group warrants further investigation.
Radiopaque foreign body inhalations
Authors: Sersar Sameh Ibrahim 
Published: May 2013

Background: The most frequent cause of accidental household death in children under 6 years of age is inhalation of a foreign body. Delayed management is blamed for death. The absence of a recognizable penetration syndrome complicates and delays not only the diagnosis but also the treatment of foreign body inhalation. Objective: This report aimed to highlight the problem of radiopaque foreign body inhalation and analyze part of our experience in the treatment of such cases. Methods: A multicenter experience in the management of radiopaque inhaled foreign bodies in 3 centers in Egypt and Saudi Arabia was reviewed retrospectively, including old and new techniques to remove the foreign body. The study included data from 136 cases. Results: The majority of patients were female (91.17%). The mean age was 12 years. More than one-third of the inhaled foreign bodies were found on the left side. A positive history of chocking was reported in more than 95%. Almost 87% presented in the first 24 h after inhalation. Conclusion: Early rigid bronchoscopic extraction of inhaled radiopaque foreign bodies can be achieved with acceptable results. Video-assisted bronchoscopic removal of an inhaled foreign body may be safer.
Detection of ALK fusion in lung cancer using fluorescence in situ hybridization
Authors: Kobayashi Masashi , Sonobe Makoto , Takahashi Tsuyoshi , Yoshizawa Akihiko , Kikuchi Ryutaro , Date Hiroshi 
Published: May 2013

Objective: To develop an easy-to-use technique for EML4-ALK detection and establish the effective selection of candidates for screening. Background: We previously reported clinicopathological findings of patients with lung cancer harboring the EML4-ALK fusion gene. Anaplastic lymphoma kinase inhibitors have therapeutic effects in lung cancer patients with EML4-ALK, accounting for merely 1%–5% of lung cancers. Methods: We investigated EML4-ALK in tumors from 581 patients. EML4-ALK was detected by a reverse transcription polymerase-chain reaction and by the newly established criteria and algorithm using a fluorescence in situ hybridization method. To establish an algorithm to restrict candidates chosen for ALK fusion gene detection, clinicopathological findings as well as EGFR, ERBB2, and KRAS mutations were analyzed. Results: 8 (1.3%) tumors had EML4-ALK, EGFR, KRAS, and ERBB2 mutations, which were mutually exclusive and were detected in 191 (32.8%), 56 (9.6%), and 11 (1.8%) tumors, respectively. We screened 581 patients with tumors and another 27 who were nonsmokers or mild smokers (<20 packs per year) lacking EGFR, KRAS, and ERBB2 mutations and who had adenocarcinomas exhibiting an acinar component with moderate or poor differentiation. Of the 27 patients, 8 (29.6%) had EML4-ALK. Conclusions: We propose criteria for selecting candidates for efficient detection of the fusion gene.
Local administration of tranexamic acid in off-pump coronary artery bypass
Authors: Aoki Masakazu , Okawa Yasuhide , Goto Yoshihiro , Ogawa Shinji , Baba Hiroshi 
Published: May 2013

Purpose: We administered tranexamic acid locally to patients undergoing off-pump coronary artery bypass, to investigate the hemostatic effects and safety. Patients and methods: The subjects were 100 consecutive patients who underwent off-pump coronary artery bypass between July 2009 and January 2011. We assigned 50 patients in the early phase, in which tranexamic acid was not employed, to group N, and 50 in the late phase, in which tranexamic acid was employed, to group T. In group T, 10 mL of a solution containing 1 g of tranexamic acid in was sprayed into the pericardial cavity and mediastinum before the sternum was closed. We compared the volume of postoperative blood loss, blood transfusion volume, and complications between the 2 groups. Results: The volume of blood loss in 24 h after intensive care unit admission was 492 mL in group N and 303 mL in group T ( p < 0.0001); the decrease in blood loss in the group receiving tranexamic acid was approximately 40%. There was no significant difference in the blood transfusion volumes. There were no side effects of tranexamic acid. Conclusion: In patients undergoing off-pump coronary artery bypass, local administration of tranexamic acid may decrease the volume of postoperative blood loss. The local administration method is simple, inexpensive, and safe.
Oxidative stress and liver monooxygenase function after heart valve surgery
Authors: Nepomniashchikh Valery A , Lomivorotov Vladimir V , Deryagin Michael N , Lomivorotov Vladimir N , Kniazkova Lyubov G , Fominskiy Evgeniy V , Novikov Maxim A 
Published: May 2013

Background and objectives: this prospective study was carried out to evaluate oxidative stress and liver monooxygenase function after cardiac surgery in patients with acquired valvular heart disease. Methods: 97 patients were studied. Oxidative stress was quantified with malondialdehyde, coupled trienes, hepatocuprein, and catalase activity. Liver monooxygenase function was evaluated with antipyrine pharmacokinetics. For statistical analyses, the Dunnett test and Pearson’s correlation coefficient were used. Results: on the 1st–2nd postoperative days, high lipid peroxidation activation (malondialdehyde: 9.6 ± 2.7 vs. 6.9 ± 2.0 nmol·mL−1, p < 0.05) and a significant decrease in liver monooxygenase function (antipyrine clearance: 18.3 ± 11.1 vs. 39.0 ± 18.9 mL·kg−1·h−1, p < 0.05) were revealed. On the 3rd–4th and 11th–12th postoperative days, the intensity of oxidative stress decreased and monooxygenase function returned to baseline (antipyrine clearance: 45.6 ± 17.9 vs. 39.0 ± 18.9 mL·kg−1·h−1). The analysis showed a negative relationship between oxidative stress and liver monooxygenase function. Conclusion: patients undergoing surgery for acquired valvular heart disease have considerable oxidative stress and a decrease in liver monooxygenase function on the 1st–2nd postoperative days. Activation of lipid peroxidation is one of the main reasons for suppression of microsomal monooxygenases activity. A slowdown of liver microsomal oxidation might change the pharmacokinetic response of patients under drug therapy.
Arch replacement using antegrade selective cerebral perfusion for shaggy aorta
Authors: Takagi Yasushi , Ando Motomi , Akita Kiyotoshi , Ishida Michiko , Kaneko Kan , Sato Masato 
Published: May 2013

Background: Embolic stroke during arch replacement is a serious concern in patients with shaggy aorta. Objective: To evaluate shaggy aorta in patients who received total aortic arch replacement with antegrade selective cerebral perfusion utilizing axillary perfusion. Method: Between January 2005 and December 2010, 63 patients underwent preoperative contrast-enhanced computed tomography scanning of the aorta to evaluate atheromatous plaque. We analyzed operative data to investigate which factors were associated with outcomes and survival. Results: Shaggy aorta was found in 34 (54%) patients. There were 3 (5%) cases in the ascending aorta, 26 (41%) in the aortic arch, and 19 (30%) in the descending aorta. Operative mortality occurred in 1 (2%) patient. Although stroke occurred in 2 (3%) shaggy aorta patients, shaggy aorta was not associated with an increased likelihood of stroke ( p = 0.4951). Survival was significantly lower in patients with shaggy descending aorta ( p = 0.0411) and in patients >75-years old ( p = 0.0200); these traits were identified as independent risk factors for late death ( p = 0.0368 and p = 0.0100, respectively). Conclusion: We concluded that our perfusion technique protects patients with shaggy aorta against embolism, and that the survival is lower in patients with shaggy descending aorta.
Central vein stenosis in an Asian hemodialysis population
Authors: Thwaites Stephen E , Robless Peter A 
Published: May 2013

Objective and background: Central vein stenosis occurs commonly after instrumentation of the major thoracic veins. We aimed to investigate factors that contributed to this condition in an Asian hemodialysis population, and the results of intervention. Patients and methods: Hemodialysis patients diagnosed with central vein stenosis between January 2003 and December 2008, were identified from the records of the National University Hospital, Singapore. Eligible controls had a minimum of 2 years of hemodialysis via an arteriovenous fistula and/or central venous catheter, without clinical or radiological evidence of central vein stenosis. Results: Central vein stenosis was diagnosed in 108 patients. The most common presenting features were arm swelling (32%) and failed hemodialysis catheter insertion (28%). The median frequency of permanent hemodialysis catheter insertion in those who subsequently developed venous stenosis (1.44 per patient per year) was 4 times that of controls (0.36 per patient per year; p < 0.001). Ischemic heart disease ( p = 0.03) and in certain patients, arteriovenous fistula surgery were associated with the development of central vein stenosis; whereas line sepsis, diabetes, and hypertension were not. Central vein angioplasty was attempted in 53 patients; the primary patency was 52% at 1 year. Conclusion: Central vein stenosis is associated with a higher frequency of hemodialysis catheter insertion and access surgery. Efforts to decrease permanent hemodialysis catheter use should reduce the incidence of central vein stenosis.
Anatomical characteristics of the thoracic aortic arch in an Asian population
Authors: Chiu Peixuan , Lee Heow Pueh , Venkatesh Sudhakar K , Ho Pei 
Published: May 2013

Background: Endovascular repair of the aortic arch is often unsatisfactory due to poor stent-vessel conformity and inadequate landing zones. Objective: To study the anatomical characteristics of the aortic arch and provide basic information for the development of arch-specific endovascular devices. Materials and methods: Three-dimensional models were reconstructed in Mimics (image segmentation software) from computed tomography aortograms of 120 elderly Asian patients, by manual segmentation. The centerline of each Three-dimensional aortic model was calculated using a repulsive force field method. Measurements of the aorta and supra-aortic branches were analyzed using Patran (finite-element software). A three-dimensional statistical aortic arch model was built using principal component analysis. Results: The mean diameters of the ascending and descending aorta, and the origins of the innominate, left common carotid, and left subclavian artery were 39.4 ± 6.7, 34.5 ± 7.9, 18.0 ± 3.8, 12.6 ± 2.7, and 14.1 ± 2.5 mm, respectively. The length of the ascending aorta, innominate to left common carotid artery, and left common carotid to left subclavian artery were 62.6 ± 11.4, 12.0 ± 5.6, and 18.7 ± 5.6 mm along the centerline. The mean angle of curvature was 103.8 ± 25 degrees. Principal component analysis of the three-dimensional centerlines derived 3 main modes of variation, which account for 61% of the overall shape range. Conclusion: Aortic arch anatomical information from an elderly Asian population can be useful for the development of future endovascular devices.
Pericardial fluid and serum biomarkers equally predict ventricular dysfunction
Authors: Amjad Sofia , Sami Shahid A , Basir Muhammad Nageeb , Hameed Kamran , Fujita Masatoshi , Ahmad Hakeemuddin Razi 
Published: May 2013

Background: serum level of amino-terminal pro-B-type natriuretic peptide, a cardiac hormone produced by the heart, is elevated in patients with left ventricular dysfunction. The purpose of this study was to compare the abilities of serum and pericardial fluid levels of amino-terminal pro-B-type natriuretic peptide to detect the left ventricular systolic dysfunction determined by echocardiography. Methods: 50 patients undergoing coronary artery bypass grafting were included in this study. Left ventricular systolic function was assessed using echocardiography before coronary artery bypass grafting. The samples of serum and pericardial fluid were collected during surgery, and amino-terminal pro-B-type natriuretic peptide levels were assessed by an electrochemiluminescence immunoassay. The log value of amino-terminal pro-B-type natriuretic peptide concentrations was calculated. Results: the pericardial fluid levels of log amino-terminal pro-B-type natriuretic peptide were significantly elevated compared to the serum levels in patients with impaired left ventricular systolic function. Both serum and pericardial fluid levels of log amino-terminal pro-B-type natriuretic peptide correlated significantly with left ventricular ejection fraction and end-diastolic and end-systolic volume indices. Furthermore, a paired comparison of receiver operating characteristic curves showed a similar performance of amino-terminal pro-B-type natriuretic peptide levels both in serum and pericardial fluid to discriminate left ventricular systolic dysfunction. Conclusion: serum amino-terminal pro-B-type natriuretic peptide levels have comparable diagnostic value for left ventricular systolic dysfunction with its pericardial fluid levels in patients undergoing CABG.
Surgical outcome of congenital heart disease in Down’s syndrome
Authors: Lal Praveen S , Chavan Bhushan , Devendran Vimala Rani , Varghese Roy , Murmu Uday Charan , Kumar Raghavannair Suresh 
Published: May 2013

Background and objective: only a few studies have compared surgical outcomes in children with and without Down’s syndrome. The purpose of this study was to investigate the surgical outcome in children with Down’s syndrome and congenital heart disease and to compare it with that in age- and sex-matched non-Down controls. Patients and methods: the charts of 32 consecutive Down’s syndrome patients who underwent surgery for congenital heart disease in a single center from January 2006 to May 2010, were compared with the data of 32 age- and sex-matched non-Down controls, focusing on comparative echocardiographic details, surgical outcome, and intensive care unit data. The data were compared using the 2-group t test. The children were followed up for a median period of 48 months. Results: the most common cardiac lesion in the study group was ventricular septal defect (41%) followed by atrioventricular septal defect (28%). Ventilation and intensive care unit stay were significantly longer in Down’s syndrome children, with a trend towards more respiratory complications. At a median follow-up of 48 months, there were no cardiac events or mortality in the study group. Simple lesions were more common than atrioventricular septal defect in Down’s syndrome. Conclusion: children with Down’s syndrome can be operated on with negligible mortality and good functional outcome, but with a higher surgical morbidity.
Effect of landiolol hydrochloride after off-pump coronary artery bypass
Authors: Maisawa Kazuma , Yamazaki Kenji , Ishitoya Hiroshi , Shimamura Yoshiei 
Published: May 2013

Objectives: many studies have shown that oral beta blockers reduce the incidence of atrial fibrillation after coronary artery bypass. The goal of this study was to determine whether landiolol, an intravenous beta blocker, reduces the incidence of atrial fibrillation after off-pump coronary artery bypass. Methods: 39 consecutive patients were given landiolol after coronary artery bypass, and 20 who were not given landiolol served as a control group. Landiolol was intravenously administered at 1 µgċkg−1ċmin−1 in the intensive care unit. Results: the mean dose of landiolol was 2.3 ± 1.2 1 µgċkg−1ċmin−1. The incidence of atrial fibrillation during intensive care unit stay was significantly lower in the landiolol group compared to the control group: 2.6% (1/39) vs. 20% (4/20). Heart rate after landiolol administration was significantly lower than that before administration, whereas landiolol had no effect on blood pressure. C-reactive protein and creatine kinase levels 7 days after surgery were significantly lower in the landiolol group. Conclusion: continuous administration of landiolol at a low dose after off-pump coronary artery bypass reduced the incidence of atrial fibrillation.