Sample records for aortic balloon pump

  1. Transfemoral transcatheter aortic valve implantation in a patient with a severe aortic stenosis and cardiogenic shock requiring intra-aortic balloon pump support. (United States)

    Chodór, Piotr; Wilczek, Krzysztof; Przybylski, Roman; Świątkowski, Andrzej; Głowacki, Jan; Kalarus, Zbigniew; Zembala, Marian


    The following paper presents a patient with severe aortic stenosis and severely reduced left ventricular ejection fraction with intra-aortic balloon pump counterpulsation support, who underwent transfemoral aortic valve implantation of a CoreValve prosthesis.

  2. Transfemoral transcatheter aortic valve implantation in a patient with a severe aortic stenosis and cardiogenic shock requiring intra-aortic balloon pump support


    Chodór, Piotr; Wilczek, Krzysztof; Przybylski, Roman; Świątkowski, Andrzej; Głowacki, Jan; Kalarus, Zbigniew; Zembala, Marian


    The following paper presents a patient with severe aortic stenosis and severely reduced left ventricular ejection fraction with intra-aortic balloon pump counterpulsation support, who underwent transfemoral aortic valve implantation of a CoreValve prosthesis.

  3. Loss of Guide Wire: A Rare Complication of Intra-Aortic Balloon Pump Insertion

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    Manouchehr Hekmat


    Full Text Available At the final stages of a coronary artery bypass graft operation on a 64-year-old man, an experienced physician attempted to insert an intra-aortic balloon pump into the femoral artery via the Seldinger technique. However, while the balloon pump was being passed over the guide wire, the latter was completely lost.The guide wire should be held at the tip at all times to prevent passage into the vessel. Strict adherence to this rule will prevent guide-wire loss, which is, albeit rare and completely avoidable, a potentially life-threatening complication of central vein or artery catheterization, with reported fatality rates of up to 20% when the whole wire is lost. The literature contains several reports on guide-wire loss during central venous, arterial, and hemodialysis catheterization, but we report for the first time the loss of a guide wire as a rare complication of intra-aortic balloon pump insertion.

  4. Effect of intra-aortic balloon pump on coronary blood flow during different balloon cycles support: A computer study. (United States)

    Aye, Thin Pa Pa; Htet, Zwe Lin; Singhavilai, Thamvarit; Naiyanetr, Phornphop


    Intra-aortic balloon pump (IABP) has been used in clinical treatment as a mechanical circulatory support device for patients with heart failure. A computer model is used to study the effect on coronary blood flow (CBF) with different balloon cycles under both normal and pathological conditions. The model of cardiovascular and IABP is developed by using MATLAB SIMULINK. The effect on coronary blood flow has been studied under both normal and pathological conditions using different balloon cycles (balloon off; 1:4; 1:2; 1:1). A pathological heart is implemented by reducing the left ventricular contractility. The result of this study shows that the rate of balloon cycles is related to the level of coronary blood flow.

  5. Undiagnosed aortic dissection in patient with intra-aortic balloon pump (United States)

    Raut, Monish S.; Maheshwari, Arun; Sharma, Manish


    60 years old lady presented with chest pain and was admitted in local hospital. Electrocardiogram was suggestive of anterior myocardial ischemia. Patient underwent coronary angiography which revealed severe triple vessles coronary artery disease. As patient was hemodynamically unstable and in cardiogenic shock, intraaortic balloon pump was inserted .IABP augmented diastolic blood pressure was less than unassisted systolic blood pressure despite setting maximum augmentation on IABP machine. PMID:27397468

  6. Undiagnosed aortic dissection in patient with intra-aortic balloon pump

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    Monish S Raut


    Full Text Available 60 years old lady presented with chest pain and was admitted in local hospital. Electrocardiogram was suggestive of anterior myocardial ischemia. Patient underwent coronary angiography which revealed severe triple vessles coronary artery disease. As patient was hemodynamically unstable and in cardiogenic shock, intraaortic balloon pump was inserted .IABP augmented diastolic blood pressure was less than unassisted systolic blood pressure despite setting maximum augmentation on IABP machine.

  7. The management of impending myocardial infarction using coronary artery by-pass grafting and an intra-aortic balloon pump. (United States)

    Harris, P L; Woollard, K; Bartoli, A; Makey, A R


    Of 33 patients with impending myocardial infarction 25 were treated using a combination of coronary artery by-pass grafting and intra-aortic balloon pumping. Eight patients were treated with coronary artery by-pass grafting alone. Twenty-two of the 25 patients who were treated with the combined technique made a full recovery. Three patients sustained definite myocardial infarctions and one of these died. Five of the 8 patients treated by grafting alone suffered infarction and of these 3 died. The value of intra-aortic balloon pumping in combination with coronary artery by-pass grafting in the management of impending myocardial infarction is discussed.

  8. The Effects of Intra-Aortic Balloon Pump Support on Macrocirculation and Tissue Microcirculation in Patients with Cardiogenic Shock

    NARCIS (Netherlands)

    C.A. den Uil; W.K. Lagrand; M. van der Ent; L.S.D. Jewbali; J.J. Brugts; P.E. Spronk; M.L. Simoons


    Objectives: It was the aim of this study to evaluate the effects of intra-aortic balloon pump (IABP) counterpulsation on sublingual microcirculation as a model for tissue perfusion. Methods: In 13 patients with cardiogenic shock treated with IABP, the IABP assist ratio was reduced from 1: 1 to 1: 8

  9. Usefulness of Intra-Aortic Balloon Pump Counterpulsation in Patients With Cardiogenic Shock from Acute Myocardial Infarction

    NARCIS (Netherlands)

    J.M. Cheng; S.D.A. Valk; C.A. den Uil; M. van der Ent; W.K. Lagrand; M. van der Sande; R.T. van Domburg; M.L. Simoons


    Although intra-aortic balloon pump (IABP) counterpulsation is increasingly being used for the treatment of patients with cardiogenic shock from acute myocardial infarction, data on the long-term outcomes are lacking. The aim of the present study was to evaluate the 30-day and long-term mortality and

  10. Femorofemoral grafts for lower limb ischemia caused by intra-aortic balloon pump. (United States)

    Friedell, M L; Alpert, J; Parsonnet, V; Brief, D K; Brener, B J; Goldenkranz, R J; Nozick, J


    From January 1975 to December 1985, 1454 patients had an intra-aortic balloon inserted for cardiac assistance. Eighty balloon-dependent patients had severe limb ischemia and required a femorofemoral graft (FFG) (5% of the total group of patients). Twenty-nine of the 80 patients with grafts (or 36%) left the hospital and 28 were followed up for an average of 40 months to determine late complications associated with the crossover grafts. All grafts remained patent. The 28 patients were classified into five groups according to the degree and type of lower limb ischemia. Group I consisted of 13 asymptomatic patients (46%); group II had four (14%) patients with mild claudication caused by preexisting peripheral arteriosclerosis; group III comprised four patients (14%) without preexisting disease but claudication subsequent to the FFG; group IV had five patients with irreversible ischemic sequelae before grafting ending in amputation, foot drop, or persistent paresthesia; and group V consisted of two patients with graft infection (7%). The perioperative mortality rate of the balloon-dependent patients with an FFG (64%) reflects the gravity of the cardiac condition. Placement of an FFG to relieve limb ischemia in these patients is followed by few immediate or late complications in the survivors and any persistent limb changes were related to the prolonged ischemia present before revascularization. Our data suggest that in balloon-dependent patients with limb-threatening ischemia, aggressive use of the FFG is limb-saving, durable, and allows continuation of balloon support.

  11. The need for intra aortic balloon pump support following open heart surgery: risk analysis and outcome.

    LENUS (Irish Health Repository)

    Parissis, Haralabos


    BACKGROUND: The early and intermediate outcome of patients requiring intraaortic balloon pump (IABP) was studied in a cohort of 2697 adult cardiac surgical patients. METHODS: 136 patients requiring IABP (5.04%) support analysed over a 4 year period. Prospective data collection, obtained. RESULTS: The overall operative mortality was 35.3%. The "operation specific" mortality was higher on the Valve population.The mortality (%) as per time of balloon insertion was: Preoperative 18.2, Intraoperative 33.3, postoperative 58.3 (p < 0.05).The incremental risk factors for death were: Female gender (Odds Ratio (OR) = 3.87 with Confidence Intervals (CI) = 1.3-11.6), Smoking (OR = 4.88, CI = 1.23- 19.37), Preoperative Creatinine>120 (OR = 3.3, CI = 1.14-9.7), Cross Clamp time>80 min (OR = 4.16, CI = 1.73-9.98) and IABP insertion postoperatively (OR = 19.19, CI = 3.16-116.47).The incremental risk factors for the development of complications were: Poor EF (OR = 3.16, CI = 0.87-11.52), Euroscore >7 (OR = 2.99, CI = 1.14-7.88), history of PVD (OR = 4.99, CI = 1.32-18.86).The 5 years survival was 79.2% for the CABG population and 71.5% for the valve group. (Hazard ratio = 1.78, CI = 0.92-3.46). CONCLUSIONS: IABP represents a safe option of supporting the failing heart. The need for IABP especially in a high risk Valve population is associated with early unfavourable outcome, however the positive mid term results further justify its use.

  12. Beneficial triple-site cardiac resynchronization in a patient supported with an intra-aortic balloon pump for end-stage heart failure


    Ciszewski, Jan; Maciąg, Aleksander; Gepner, Katarzyna; Smolis-Bąk, Edyta; Sterliński, Maciej


    The authors present the case of a 62-year-old male patient with an implantable cardioverter-defibrillator and end-stage heart failure supported with an intra-aortic balloon pump. Implantation of a triple-site cardiac resynchronization system and complex heart failure treatment brought a significant improvement, return to home activity and 17-month survival. The patient died due to heart failure aggravation. Within this time he was rehospitalized and successfully treated twice for an electrica...

  13. Transaortic Intra-Aortic Balloon Pump Catheter Insertion through a Separate Saphenous Vein Graft in Patients with Severe Aortoiliac Disease

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    Faruk Toktas


    Full Text Available Background. Intra-aortic balloon pump (IABP is the most widely used mechanical assist device for hemodynamic support in high risk patients undergoing cardiac surgery. The aim of our study was to confirm whether transaortic route is a suitable alternative to allow IABP insertion in patients with severe aortoiliac diseases. Methods. This study included 7 consecutive patients undergoing coronary artery bypass grafting for severe coronary artery disease associated with severe aortoiliac disease. These patients could not be weaned from cardiopulmonary bypass and required the IABP support, which were placed through the ascending aorta. IABP catheter was inserted indirectly through a separate saphenous vein graft anastomosed to the ascending aorta by an end-to-side manner under a partial occluding clamp and advanced to the desired position in the descending thoracic aorta and exteriorly brought into the subcutaneous tissues in the jugulum. Results. The procedure was successfully performed in all the patients. The mean duration of IABP support was 54.0±13.4 hours. There were no in-hospital mortality and complications related to transaortic route. IABP removal did not require repeat sternotomy. At postoperative 6th month, multislice CT examination showed thrombotic occlusion at the remnant of the saphenous vein graft. Conclusions. This technique is a simple, reliable, and reproducible option in patients with severe aortoiliac disease in whom retrograde femoral route is not possible.

  14. Role of Intra-Aortic Balloon Pump and Extracorporeal Membrane Oxygenation in Early Graft Failure After Cardiac Transplantation. (United States)

    Loforte, Antonio; Murana, Giacomo; Cefarelli, Mariano; Jafrancesco, Giuliano; Sabatino, Mario; Martin Suarez, Sofia; Pilato, Emanuele; Pacini, Davide; Grigioni, Francesco; Bartolomeo, Roberto Di; Marinelli, Giuseppe


    Early graft failure (EGF) is a major risk factor for death after heart transplantation (Htx). We investigated the predictive risk factors for moderate-to-severe EGF requiring an intra-aortic balloon pump (IABP) or extracorporeal membrane oxygenation (ECMO) circulatory support as treatment after Htx. Between January 2000 and December 2014, 412 consecutive adult patients underwent isolated Htx at our institution. Moderate and severe EGF were defined as the need for IABP and ECMO support, respectively, within 24 h after Htx. All available recipient and donor variables were analyzed to assess the risk of EGF occurrence. Overall, moderate-to-severe EGF occurred in 46 (11.1%) patients. Twenty-nine (63.04%) patients required peripheral or central ECMO support in the treatment of severe EGF and 17 (36.9%) patients required IABP support for the treatment of moderate EGF. The predictive risk factors for moderate-to-severe EGF in recipients, as assessed by logistic regression analysis, were a preoperative transpulmonary gradient > 12 mm Hg (odds ratio [OR] 5.2; P = 0.023), a preoperative inotropic score > 10 (OR 8.5; P = 0.0001), and preoperative ECMO support (OR 4.2; P = 0.012). For donors, the predictive risk factor was a donor score ≥ 17 (OR 8.3; P = 0.006). The absence of EGF was correlated with improved long-term survival: 94% at 1 year and 81% at 5 years without EGF versus 76% and 36% at 1 year (P ECMO support, respectively. In-hospital weaned and survived patients after IABP or ECMO treatment for moderate-to-severe EGF had a similar 5-year conditional survival rate as transplant patients who had not suffered EGF: 88% without EGF versus 84% with EGF treated with mechanical circulatory support devices (P = 0.08). The occurrence of EGF is a multifactorial deleterious event that depends on donor and recipient profiles. IABP and ECMO support are reliable treatment strategies, depending on the grade of EGF. Furthermore, surviving patients

  15. Intra-aortic balloon pump use does not affect the renal function in patients undergoing off pump coronary artery bypass surgery

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    Muniraju Geetha


    Full Text Available Renal dysfunction is known to occur during cardiac surgery. A few factors such as perioperative hypotension, use of potential nephrotoxic therapeutic agents, radio opaque contrast media in the recent past, intra-aortic balloon pump (IABP and cardiopulmonary bypass have been blamed as the contributing factors to the causation of postoperative renal dysfunction in cardiac surgical patients. At times, in patients with renal failure and low cardiac output status, one may face the dilemma if the use of IABP is safe. We undertook this prospective observational study to determine the degree of possible renal injury when IABP is used by measuring serial values of serum creatinine and Cystatin C. Elective patients scheduled for off-pump coronary artery bypass surgery requiring preoperative use of IABP were included in this study. Cystatin C and serum creatinine levels were checked at fixed intervals after institution of IABP. Twenty-two patients were eligible for enrolment to the study. There was no significant change in the values of serum creatinine; from the basal value of 1.10 ± 0.233 to 0.98 ± 0.363 mg /dL (P value >0.05. Cystatin C levels significantly decreased from the basal level of 0.98 ± 0.29 to 0.89 ± 0.23 (P value <0.05. Contrary to the belief, Cystatin C, the early indicator of renal dysfunction decreases suggesting absence of renal injury after the use of IABP. Absence of elevation of cystatin C levels in our study suggests the lack of potential of the IABP to cause renal dysfunction in patients who received elective IABP therapy preoperatively.

  16. A systematic review and meta-analysis of intra-aortic balloon pump therapy in ST-elevation myocardial infarction: should we change the guidelines?

    NARCIS (Netherlands)

    K.D. Sjauw; A.E. Engström; M.M. Vis; R.J. van der Schaaf; J.,Jr Baan; K.T. Koch; R.J. de Winter; J.J. Piek; J.G.P. Tijssen; J.P.S. Henriques


    Aims Intra-aortic balloon counterpulsation (IABP) in ST-segment elevation myocardial infarction (STEMI) with cardiogenic shock is strongly recommended (class IB) in the current guidelines. We performed meta-analyses to evaluate the evidence for IABP in STEMI with and without cardiogenic shock. Metho

  17. Temporal Trends of In-Hospital Mortality in Patients Treated with Intra-Aortic Balloon Pumping: A Nationwide Population Study in Taiwan, 1998-2008.

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    Chung-Han Ho

    Full Text Available Intra-aortic balloon pumping (IABP is widely used for hemodynamic support in critical patients with cardiogenic shock (CS. We examined whether the in-hospital mortality of patients in Taiwan treated with IABP has recently declined. We used Taiwan's National Health Insurance Research Database to retrospectively review the in-hospital all-cause mortality of 9952 (7146 men [71.8%] 18-year-old and older patients treated with IABP between 1998 and 2008. The mortality rate was 13.84% (n = 1377. The urbanization levels of the hospitals, and the number of days in the intensive care unit, of hospitalization, and of IABP treatment, and prior percutaneous coronary intervention (PCI were associated with mortality. Seven thousand six hundred thirty-five patients (76.72% underwent coronary artery bypass grafting (CABG surgery, and 576 (5.79% underwent high-risk PCI with IABP treatment. The number of patients treated with IABP significantly increased during this decade (ptrend < 0.0001, the in-hospital all-cause mortality for patients treated with IABP significantly decreased (ptrend = 0.0243, but the in-hospital all-cause mortality of patients who underwent CABG and PCI plus IABP did not decrease. In conclusion, the in-hospital mortality rate of IABP treatment decreased annually in Taiwan during the study period. However, high-risk patients who underwent coronary revascularization with IABP had a higher and unstable in-hospital mortality rate.

  18. Inflation and deflation timing of the AutoCAT 2 WAVE intra-aortic balloon pump using the autoPilot mode in a clinical setting. (United States)

    Bakker, E W M; Visser, K; van der Wal, A; Kuiper, M A; Koopmans, M; Breedveld, R


    The primary goal of this observational clinical study was to register the occurrence of incorrect inflation and deflation timing of an intra-aortic balloon pump in autoPilot mode. The secondary goal was to identify possible causes of incorrect timing. During IABP assistance of 60 patients, every four hours a strip was printed with the IABP frequency set to 1:2. Strips were examined for timing discrepancies beyond 40 ms from the dicrotic notch (inflation) and the end of the diastolic phase (deflation). In this way, 320 printed strips were examined. A total of 52 strips (16%) showed incorrect timing. On 24 of these strips, the incorrect timing was called incidental, as it showed on only one or a few beats. The other 28 cases of erroneous timing were called consistent, as more than 50% of the beats on the strip showed incorrect timing. We observed arrhythmia in 69% of all cases of incorrect timing. When timing was correct, arrhythmia was found on 13 (5%) of 268 strips. A poor quality electrocardiograph (ECG) signal showed on 37% of all strips with incorrect timing and 11% of all strips with proper timing. We conclude that inflation and deflation timing of the IABP is not always correct when using the autoPilot mode. The quality of the ECG input signal and the occurrence of arrhythmia appear to be related to erroneous timing. Switching from autoPilot mode to operator mode may not always prevent incorrect timing.

  19. Influence of preoperative coronary collateral circulation on in-hospital mortality in patients undergoing coronary artery bypass graft surgery with intra-aortic balloon pump support

    Institute of Scientific and Technical Information of China (English)

    Hasan Gungor; Cemil Zencir; Abraham Samuel Babu; Cagdas Akgullu; Ufuk Eryilmaz; Ali Zorlu; Mithat Selvi


    Background Outcomes in patients requiring coronary artery bypass graft (CABG) surgery have been improved with devices such as the intra-aortic balloon pump (IABP).Good coronary collateral circulation (CCC) has been shown to reduce mortality in patients with coronary artery disease (CAD).We aimed to investigate whether poor preoperative CCC grade is a predictor of in-hospital mortality in CABG surgery requiring IABP support.Methods Fifty-five consecutive patients who were undergoing isolated first time on-pump CABG surgery with IABP support were enrolled into this study and CCC of those patients was evaluated.Results Twenty-seven patients had poor CCC and 28 patients had good CCC.In-hospital mortality rate in poor CCC group was significantly higher than good CCC group (14 (50%) vs.4 (13%),P=0.013).Preoperative hemoglobin level (OR:0.752; 95% CI,0.571-0.991,P=0.043),chronic obstructive pulmonary disease (OR:6.731; 95% CI,1.159-39.085,P=0.034) and poor CCC grade (OR:5.750; 95% CI,1.575-20.986,P=0.008) were associated with post-CABG in-hospital mortality.Poor CCC grade (OR:4.853; 95% CI,1.124-20.952,P=0.034) and preoperative hemoglobin level (OR:0.624; 95% CI,0.476-0.954,P=0.026) were independent predictors of in-hospital mortality after CABG.Conclusion Preoperative poor CCC and hemoglobin are predictors of in-hospital mortality after CABG with IABP support.

  20. Clinical therapeutic efficacy of intra-aortic balloon pump as an adjuvant treatment after percutaneous coronary intervention in patients with coronary heart disease associated with chronic kidney disease

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    Zi-lan JING


    Full Text Available Objective To explore the clinical efficacy of intra-aortic balloon pump (IABP as an auxiliary treatment of percutaneous coronary intervention (PCI in patients with coronary heart disease (CHD associated with chronic kidney disease. Methods One hundred and twenty CHD patients with concomitant chronic kidney disease and receiving PCI in our hospital from Jan. 2000 to Jul. 2014, and 123 simple CHD patients without renal dysfunction, who had undergone PCI with concomitant IABP for the cardiac pump failure, cardiogenic shock, acute left heart failure, unstable angina pectoris (UP which was not allayed by medical treatment, or acute myocardial infarction (AMI, were selected for observation of preoperative condition, in-hospital mortality and prognosis of patients in two groups. Results There was no statistically significant difference in general clinical data including gender, age, and concomitant hypertension and diabetes, and preoperative blood lipid, AST, D-dimer, APTT, and international normalized ratio (INR showed also no statistically significant difference before surgery between two groups of patients (P>0.05. The difference in proportion of AMI, the left main trunk and (or three-branches involvement was of no statistical significance (P>0.05, but there was significant difference in the incidence of previous myocardial infarction, TnT, CK-MB, Cr, BUN, stent number, IABP application time (P0.05 between the two groups. Logistic regression analysis revealed that diabetes and the number of stents were independent risk factors for in-hospital and long-term mortalities. Conclusions By means of the effective cardiac assistance of IABP, CHD patients with renal insufficiency have the same short and long term clinical prognosis as simple CHD patients without renal dysfunction who has undergone PCI. Diabetes and the number of stents are independent risk factors for in-hospital and 1-year mortality. DOI: 10.11855/j.issn.0577-7402.2015.04.03

  1. Efficacy of Intra-aortic Balloon Pump before versus after Primary Percutaneous Coronary Intervention in Patients with Cardiogenic Shock from ST-elevation Myocardial Infarction

    Institute of Scientific and Technical Information of China (English)

    Lin Yuan; Shao-Ping Nie


    Background:Previous studies showed that patients with cardiogenic shock (CS) from ST-elevation acute myocardial infarction (STEMI) supported by intra-aortic balloon pump (IABP) before primary percutaneous coronary intervention (PCI) decreased the risk of in-hospital mortality than patients who received IABP after PCI.However,little evidence is available on the optimal order of IABP insertion and primary PCI.The aim of this study was to investigate the impact of the sequence of IABP support and PCI and its association with major adverse cardiac and cerebrovascular events (MACCEs).Methods:Data were obtained from 218 consecutive patients with CS due to STEMI in Beijing Anzhen Hospital between 2008 and 2014,who were treated with IABP and PCI.The patients were divided into two groups:Group A in whom IABP received before PCI (n =106)and Group B in whom IABP received after PCI (n =112).We evaluated the myocardial perfusion using myocardial blush grade and resolution of ST-segment elevation.The primary endpoint was 12-month risk of MACCE.Results:Most baseline characteristics were similar in patients between the two groups.However,patients received IABP before PCI were associated with a delay of door-to-balloon time (DBT) and higher troponin Ⅰ level (P < 0.05).However,myocardial perfusion was significantly improved in patients treated with IABP before PCI (P < 0.05).Overall,IABP support before PCI was not associated with significantly lower risk of MACCE (P > 0.05).In addition,risk of all-cause mortality,bleeding,and acute kidney injury (AKI)was similar between two groups (P > 0.05).Multivariate analysis showed that DBT (odds ratio [OR] 2.5,95% confidence interval [CI]1.1-4.8,P=0.04),IABP support after PCI (OR 5.7,95% CI 2.7-8.4,P=0.01),and AKI (OR 7.4,95% CI 4.9-10.8,P=0.01) were the independent predictors of mortality at 12-month follow-up.Conclusions:Early IABP insertion before primary PCI is associated with improved myocardial perfusion although DBT


    Institute of Scientific and Technical Information of China (English)

    陈在金; 阮淑妹; 董明


    [Objective] To evaluate the role of intra-aortic balloon pump (IABP) in the management of cardiogenic shock. [Methods] Intra-aortic balloon pump was used in the treatment of 13 patients with cardiogenic shock after cardiac operation. The operations included 9 cases of coronary artery bypass grafting, 2 cases of mitral valve replacement combined with coronary artery bypass grafting and 1 case of aortic valve replacement. [Results] 9 (69.2%) patients recovered after IABP, with the successful rate of 69.2%. [Conclusion] IABP is effective in the management of cardiogenic shock.%[目的]对应用主动脉内球囊反搏(IABP)治疗心脏术后心源性休克的疗效进行评估.[方法]对13例心脏手术后并发心源性休克及低心排血量综合征的患者,应用IABP治疗.其中,单纯冠状动脉搭桥术9例,二尖瓣替换加冠状动脉搭桥术2例,再次行主动脉瓣替换术1例,再次行二尖瓣替换加三尖瓣替换术1例.[结果]9例患者心功能得到明显改善,度过围术期,顺利脱离IABP,成功率为69.2% (9/13).[结论]IABP是心脏术后心源性体克的有效手段,能明显降低病死率.

  3. Aortic valvuloplasty of calcific aortic stenosis with monofoil and trefoil balloon catheters: practical considerations

    NARCIS (Netherlands)

    S. Plante (Sylvain); M.J.B.M. van den Brand (Marcel); L.C.P. van Veen; C. di Mario (Carlo); C.E. Essed; K.J. Beatt (Kevin); P.W.J.C. Serruys (Patrick)


    textabstractIn order to evaluate the relation between balloon design (monofoil, trefoil) and valvular configuration, experimental aortic valvuloplasty was performed in four post-mortem hearts with calcific aortic stenosis of various morphology. The degree of obstruction of the aortic orifice was ass

  4. 预防应用主动脉内球囊反搏在低射血分数患者非体外循环冠状动脉旁路移植术的临床研究%Prophylactic application of intra-aortic balloon pump for low ejection fraction patients before off-pump coronary artery bypass grafting

    Institute of Scientific and Technical Information of China (English)

    屈云飞; 孙晓宁; 张红强; 赖登祥; 张俭荣; 周素明


    目的:分析预防应用主动脉内球囊反搏(intra-aortic balloon pump,IABP)对术前低射血分数(EF值0.05);住院期间病死率试验组明显低于对照组(P0.05)。结论:术前低EF值冠心病预防性应用IABP是安全有效的,能够改善心功能,减少术后心梗、低心排、肾功能不全等严重并发症的发生,从而降低围术期病死率,提高低术前EF值病人OPCAB的手术疗效。%Objective:To analyze clinical and prognosis effect of intra-aortic balloon pump (IABP) application for low ejection fraction (ejection fraction0.05). In-hospital mortality of the IABP group was significantly lower than that of the control group. hTe differences of survival rate were not statistically signiifcant for 1 and 5 years atfer surgery between two groups (P>0.05). Conclusion:Preoperative prophylactic IABP application can not only significantly ameliorate patient heart function and reduce perioperative morbidity and mortality, but also considerably reduce surgical risk and improve surgical effect of low ejection fraction patients undergoing OPCAB.

  5. 主动脉外气囊隔膜泵心脏辅助装置的动物实验%The cardiac assistant effect of extra-aortic balloon pump on animals

    Institute of Scientific and Technical Information of China (English)

    周楚芝; 姬尚义; 杨晓涵; 季军; 陈伟新; 王小雷; 张艳辉; 刘希伶; 冯东杰


    Objective The aim of this study was to determine the effect of a new method of cardiac assistant therapy with an extra-aortic balloon pump on the experimental dogs in which myocardial ischemia or infarction were induced, and to ob serve its effectiveness and feasibility. Methods Twelve animal models of myocardia 1 infarction were established with the method of left anterior descending coronary artery ligation. They were divided randomly into two groups, six in the experimental group and six in the untreated group. The end points observed were the differences between the two groups in the blood pressure, cardiac function, myocardial enzymes, infarction size and routine blood variables before procedure, 1,2, 3, 4, 5 and 6 hours after myocardial infarction. Results All six dogs in the experimental group were survived, with a mortality rate of 0.The number of death in the control group was three, with a mortality rate of 50%. Measurements such as mean blood pressure,cardiac output, cardiac index in the experimental group were better than those in the control group ( P < 0.05 ). Mean heart rate before myocardial infarction in the experimental group was 156 beats per minute, as compared with 148 beats per minute in the control group, and was 128 vs. 67 beats per minute respectively six hours after myocardial infarction. The cardiac output was 3.48 vs. 4.98 liters per minute before myocardial infarction and was 6.10 vs. 0.85 liters per minute six hours after myocardial infarction. The average pressure was 94 mm Hg vs. 99 mm Hg before myocardial infarction and was 70 mm Hg vs. 33 mm Hg six hours after myocardial infarction. Conclusion The extra-aortic balloon pump significantly improved the hemodynamic variables of the experimental animals after myocardial infarction and reduced mortality. Injury to the blood cells may be the potential disadvantage.%目的 探讨主动脉外气囊隔膜泵心脏辅助治疗对心肌梗死后犬的影响,观察主动脉外反向搏动辅

  6. The role of balloon aortic valvuloplasty in the era of transcatheter aortic valve implantation (United States)

    Wilczek, Krzysztof; Pres, Damian; Krajewski, Adam; Poloński, Lech; Zembala, Marian; Gąsior, Mariusz


    Balloon aortic valvuloplasty is recommended in patients not suitable for transcatheter aortic valve implantation/aortic valve replacement (TAVI/AVR) or when such interventions are temporarily contraindicated. The number of performed balloon aortic valvuloplasty (BAV) procedures has been increasing in recent years. Valvuloplasty enables the selection of individuals with severe left ventricular dysfunction or with symptoms of uncertain origin resulting from concomitant disorders (including chronic obstructive pulmonary disease [COPD]) who can benefit from destination therapy (AVR/TAVI). Thanks to improved equipment, the number of adverse effects is now lower than it was in the first years after the advent of BAV. Valvuloplasty can be safely performed even in unstable patients, but long-term results remain poor. In view of the limited availability of TAVI in Poland, it is reasonable to qualify patients for BAV more often, as it is a relatively safe procedure improving the clinical condition of patients awaiting AVR/TAVI. PMID:26336471

  7. Balloon Pump with Floating Valves for Portable Liquid Delivery

    Directory of Open Access Journals (Sweden)

    Yuya Morimoto


    Full Text Available In this paper, we propose a balloon pump with floating valves to control the discharge flow rates of sample solutions. Because the floating valves were made from a photoreactive resin, the shapes of the floating valves could be controlled by employing different exposure patterns without any change in the pump configurations. Owing to the simple preparation process of the pump, we succeeded in changing the discharge flow rates in accordance with the number and length of the floating valves. Because our methods could be used to easily prepare balloon pumps with arbitrary discharge properties, we achieved several microfluidic operations by the integration of the balloon pumps with microfluidic devices. Therefore, we believe that the balloon pump with floating valves will be a useful driving component for portable microfluidic systems.

  8. IABP在心脏瓣膜病手术治疗中的应用%Intra-aortic Balloon Pump in the Treatment of Valvular Heart Disease Following Heart Surgery.

    Institute of Scientific and Technical Information of China (English)

    任崇雷; 姜胜利; 高长青; 李伯君; 肖苍松


    目的 总结主动脉内球囊反搏泵(intra-aortic balloon pump,IABP)在心脏瓣膜置换术后的应用经验.方法 回顾分析解放军总医院心血管外科2008年10月-2010年8月共施行体外循环瓣膜置换手术450例,共有20例患者于术中或术后应用1ABP治疗,其中男性9例,女性11例,年龄28~72岁,平均年龄54.60±10.94岁,术前诊断为风湿性心脏瓣膜病者12例,心脏术后瓣膜病复发或再发者3例,心内膜炎者2例,先天性心脏瓣膜病者2例,退行性心脏瓣膜病者1例;其中术前冠脉造影明确合并冠心病6例,术前心脏超声检查巨大左心房2例,小左心室6例,左心房大量血栓5例,三尖瓣重度关闭不全并中重度肺动脉高压10例;心功能NYHA分级Ⅱ级1例,Ⅲ级13例、Ⅳ级6例.其中双瓣置换术3例,二尖瓣置换术10例,主动脉瓣置换4例,二尖瓣成形、三尖瓣置换及人工二尖瓣瓣周漏修补各1例;同期冠脉搭桥术4例,心内血栓清除5例.结果 全组20例患者手术体外循环时间174.0±71.5min,心肌阻断时间106.0±43.8min.因术中心脏复苏后不能停体外循环或停机后低心排出量应用IABP 10例,术后因各种原因的低心排出量应用IABP 10例.全组20例患者行IABP辅助治疗时间20~120h,平均治疗时间53.0±28.3h;早期存活17例(85%),死亡3例(15%),死亡原因分别为低心排出量综合征、右心衰竭及多脏器衰竭,无IABP相关并发症.结论 IABP可应用于合并冠心病、小左心室、重度肺动脉高压、心功能减低等重症心脏瓣膜病术后治疗,适用于术中无法脱离体外循环、术后药物无法纠正的低心排出量综合征、围术期因心肌缺血引起的急性心肌梗死、严重心律失常等情况.对有指征的瓣膜置换术后患者积极正确地应用IABP,可改善患者血流动力学指标,提高抢救成功率.%Objective To review and summarize the clinical results and experiences of the intra - aortic balloon

  9. Anticoagulation therapy in intra-aortic balloon counterpulsation:Does IABP really need anti-coagulation?

    Institute of Scientific and Technical Information of China (English)

    JIANG Chen-yang(蒋晨阳); ZHAO Li-li(赵莉莉); WANG Jian-an(王建安); SAN Jiang(单江); MOHAMMOD Balgaith


    Objective: To investigate if intra-aortic balloon pump(IABP) is contraindicated without anticoagulation therapy. Methods: Some 153 IABP patients in the King Abdulaziz Cardiac Center(KSA) were randomly assigned into two groups. Anticoagulation group(Group A) consisted of 71 patients who were given heparin intravenously with target aPTT 50-70 seconds. Non-anticoagulation group(Group B) consisted of 82 patients without intravenous heparin during balloon pumping. Hematological parameters including platelet count, D-dimer, Plasminogen activator inhibitor-1(PAI-1) and fibrinogen degradation products(FDP) were checked respectively at the point of baseline, 24 hours, 48 hours and 24 hours post IABP counterpulsation. Clot deposits on balloon surface, vascular complications from IABP including bleeding and limb ischemia were recorded. Results: Platelet count and PAI-1 level decreased at 24 hours and 48 hours in both groups (P0.05). Three patients in Group A and 2 patients in Group B developed minor limb ischemia(P>0.05). No major limb ischemia in either group. Two patients in Group A suffered major bleeding and required blood transfusion or surgical intervention, whereas no patient had major bleeding in Group B. Eight patients had minor bleeding in Group A, but only 2 patients in Group B(P<0.05). No clot deposit developed on IABP surface in either group. Conclusion: IABP is safe without routine anticoagulation therapy. Selecting appropriate artery approach and early detection intervention are key methods for preventing complications.

  10. Anticoagulation therapy in intra-aortic balloon counterpulsation: Does IABP really need anti-coagulation ?

    Institute of Scientific and Technical Information of China (English)

    蒋晨阳; 赵莉莉; 王建安; 单江; MOHAMMODBalgaith


    Objective: To investigate if intra-aortic balloon pump(IABP) is contraindicated without anticoag-ulation therapy. Methods: Some 153 IABP patients in the King Abdulaziz Cardiac Center(KSA) were random-ly assigned into two groups. Anticoagulation group( Group A) consisted of 71 patients who were given heparin intravenously with target aPTT 50 - 70 seconds. Non-anticoagulation group( Group B) consisted of 82 patients without intravenous heparin during balloon pumping. Hematological parameters including platelet count, D-dimer, Plasminogen activator inhibitor-1 (PAI-1) and fibrinogen degradation products(FDP) were checked respectively at the point of baseline, 24 hours, 48 hours and 24 hours post IABP counterpulsation. Clot deposits on balloon surface, vascular complications from IABP including bleeding and limb ischemia were recorded.Results: Platelet count and PAI-1 level decreased at 24 hours and 48 hours in both groups ( P 0.05) . Three patients in Group A and 2 patients in Group B developed minor limb ischemia( P > 0.05). No major limb ischemia in either group. Two patients in Group A suffered major bleeding and required blood transfusion or surgical intervention, whereas no patient had major bleeding in Group B. Eight patients had minor bleeding in Group A, but only 2 patients in Group B ( P <0.05). No clot deposit developed on IABP surface in either group. Conclusion: IABP is safe without routine anticoagulation therapy. Selecting appropriate artery approach and early detection intervention are key methods for preventing complications.

  11. Latex micro-balloon pumping in centrifugal microfluidic platforms. (United States)

    Aeinehvand, Mohammad Mahdi; Ibrahim, Fatimah; Harun, Sulaiman Wadi; Al-Faqheri, Wisam; Thio, Tzer Hwai Gilbert; Kazemzadeh, Amin; Madou, Marc


    Centrifugal microfluidic platforms have emerged as point-of-care diagnostic tools. However, the unidirectional nature of the centrifugal force limits the available space for multi-step processes on a single microfluidic disc. To overcome this limitation, a passive pneumatic pumping method actuated at high rotational speeds has been previously proposed to pump liquid against the centrifugal force. In this paper, a novel micro-balloon pumping method that relies on elastic energy stored in a latex membrane is introduced. It operates at low rotational speeds and pumps a larger volume of liquid towards the centre of the disc. Two different micro-balloon pumping mechanisms have been designed to study the pump performance at a range of rotational frequencies from 0 to 1500 rpm. The behaviour of the micro-balloon pump on the centrifugal microfluidic platforms has been theoretically analysed and compared with the experimental data. The experimental data show that the developed pumping method dramatically decreases the required rotational speed to pump liquid compared to the previously developed pneumatic pumping methods. It also shows that within a range of rotational speed, a desirable volume of liquid can be stored and pumped by adjusting the size of the micro-balloon.

  12. Application of the table format shift sheet in the shift handover among the intra-aortic balloon pump implantation patients%IABP表格式交接班表在 IABP置入患者中的应用

    Institute of Scientific and Technical Information of China (English)

    桑海燕; 郭惠玲; 刘倩; 赵冬


    目的:探讨主动脉内球囊反搏( IABP)患者交接班表在IABP置入患者交接班中的应用效果。方法以2013年6-12月接受IABP治疗患者7例为对照组,使用统计的口头交接班方式,以2014年1-6月接受IABP治疗患者8例为观察组,使用IABP表格式交接班表,分析两组的效果。结果应用IABP患者交接班表后,观察组护士交接班内容的完整率为100.0%,对患者病情的掌握率为95.0%,均高于对照组(71.6%,70.0%),差异有统计学意义(χ2值分别为35.80,17.32;P<0.01)。观察组应用IABP交接班表后IABP内容交接班时间均短于对照组,差异有统计学意义(P<0.01)。结论应用IABP患者交接班表,将需要交接的重点内容进行罗列,可以帮助护士掌握交接班要点,缩短交接班时间,提高交接班内容完整率,提高护士对患者病情掌握率,提高交接班质量。%Objective To explore the application effect of the table format shift sheet on the shift handover among the intra-aortic balloon pump ( IABP) implantation patients .Methods The important contents of shift handover in IABP implantation patients were listed in the table format shift sheet , and the shift sheet was used in the process of shift in cardiac care unit ( CCU) for the patients with IABP implantation .Results The integrity rate of the shift content and the nurses ’ assurance rate of understanding the patients ’ conditions were respectively 100%and 95.0%after the application of the table format shift sheet , and were 71.6%and 70.0%before the application , and the differences were statistically significant (χ2 =35.80,17.32, respectively;P<0.01 ) .The time of shift after the application was shorter than that before the application , and the difference was statistically significant (P <0.01).Conclusions Application of the table format shift sheet including the important data and details of shift content in

  13. Intra-aortic balloon pumping in myocardial infarction patients with cardiogenic shock and long-term (≧ 10 days) treatment of research%主动脉内球囊反搏术在心肌梗塞并心源性休克长期(≥10d)应用治疗方面的研究

    Institute of Scientific and Technical Information of China (English)

    余天浩; 李瑜辉; 黄丹华


    [目的]主动脉内球囊反搏术被广泛应用于治疗心肌梗塞并心源性休克,然而,使用主动脉内球囊反搏术的安全期及其长期应用可能引起的并发症目前仍未能确定,本研究主要是观察需长期(≥10 d)应用主动脉内球囊反搏术治疗的患者,并预计他们的预后.[方法]88例患者应用主动脉内球囊反搏术治疗,其中41例患者应用长期(≥10 d)主动脉内球囊反搏术治疗,对比长期(≥10 d)治疗患者和常规治疗患者的治疗效果.[结果]IABP长期治疗组(≥10 d)和常规治疗组治疗前除血氧外各项指标均不存在显著差异,治疗后6h、24 h、72 h的心率、收缩压、舒张压、呼吸、血氧均不存在显著差异(P>0.05);相对于治疗前,患者在IABP治疗后6h收缩压、血氧均明显改善(P<0.05),IABP治疗后24 h、72 h心率、呼吸、血氧、收缩压均明显改善(P<0.05);相对于治疗前,患者的平均动脉压、心脏指数、主动脉内舒张压均有提高(P< 0.01);多变量对数回归模型分析提示IABP长期(≥10 d)治疗不影响患者的死亡率;IABP治疗和呼吸支持时间与PCI治疗时间的相关分析提示,越早进行PCI治疗,则应用IABP治疗和呼吸支持时间越短.[结论]主动脉内球囊反搏术的长期(≥10d)应用不影响生存率,是可行和安全的.%[Objective]To observe long-term (≧ 10 days) application of intra-aortic balloon pump in the treatment for patients and predict their prognosis.The intra-aortic balloon pump was used to treat myocardial infarction patients and cardiogenic shock,however,the safe period of intra-aortic balloon pump operation and the complications caused by long-term application were not yet to be determined.[Methods]A total of 88 patients including 71 males,17females,were applied with intra-aortic balloon pump for treatment.Among them,41 patients in the use of long-term (≧10 days) application of intra-aortic balloon pump for treatment.All samples

  14. Effects of intra-aortic balloon pump combined with emergency PCI in AMI patients complicated cardiogenic shock%急诊PCI联合主动脉内球囊反搏对急性心肌梗死合并心源性休克的疗效

    Institute of Scientific and Technical Information of China (English)

    李建伟; 王曼; 谢芳元; 董昕


    Objective: To study clinical efficacy of intra- aortic balloon pump (IABP) combined with emergency percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI) complicated cardiogenic shock. Methods: Clinical data of 16 AMI complicated cardiogenic shock patients undergoing PCI combined with IABP were retrospectively studied. Results: All patients successfully underwent IABP and PCI. IABP duration was 20~190 (70. 6+ 37. 2) h. Bleeding of local puncture sites occurred in three cases (18. 75%) and they were stopped after compression. One case (6.25%) died during admission and there were no other severe complications besides one case death. Conclusion: Intra - aortic balloon pump combined with percutaneous coronary intervention is safe and effective in AMI patients with cardiogenic shock.%目的:探讨经皮冠状动脉介入治疗(PCI)联合主动脉球囊反搏术(IABP)治疗急性心肌梗死(AMI)心源性休克患者的临床疗效.方法:回顾性分析16例联合IABP行PCI治疗的AMI合并心源性休克患者的临床资料.结果:16例患者均成功置入IABP及行PCI术,IABP使用时间20~190 (70.6±37.2)h,3例(18.75%)出现局部穿刺部位出血,经压迫后出血停止,除住院期间死亡1例(6.25%),无重大并发症.结论:对于心源性休克患者,联合主动脉球囊反搏术行经皮冠状动脉介入治疗安全、有效.

  15. Aortic annulus eccentricity before and after transcatheter aortic valve implantation: Comparison of balloon-expandable and self-expanding prostheses

    Energy Technology Data Exchange (ETDEWEB)

    Schuhbaeck, Annika, E-mail: [Department of Cardiology, University of Erlangen, Erlangen (Germany); Weingartner, Christina [Department of Cardiology, University of Gießen, Giessen (Germany); Arnold, Martin; Schmid, Jasmin; Pflederer, Tobias; Marwan, Mohamed [Department of Cardiology, University of Erlangen, Erlangen (Germany); Rixe, Johannes; Nef, Holger [Department of Cardiology, University of Gießen, Giessen (Germany); Schneider, Christian [Department of Radiology, University of Gießen, Giessen (Germany); Lell, Michael; Uder, Michael [Department of Radiology, University of Erlangen, Erlangen (Germany); Ensminger, Stephan [Department of Thoracic and Cardiovascular Surgery, Heart and Diabetes Center NRW, Ruhr-University Bochum, Bad Oeynhausen (Germany); Feyrer, Richard; Weyand, Michael [Department of Cardiothoracic Surgery, University of Erlangen, Erlangen (Germany); Achenbach, Stephan [Department of Cardiology, University of Erlangen, Erlangen (Germany)


    Highlights: • Post-implant geometry of catheter-based aortic valve prostheses is influenced by aortic valve calcification. • Balloon-expandable prostheses are more circular as compared to self-expanding prostheses. • The impact of post-implant geometry on valve function needs to be investigated. - Abstract: Introduction: The geometry of the aortic annulus and implanted transcatheter aortic valve prosthesis might influence valve function. We investigated the influence of valve type and aortic valve calcification on post-implant geometry of catheter-based aortic valve prostheses. Methods: Eighty consecutive patients with severe aortic valve stenosis (mean age 82 ± 6 years) underwent computed tomography before and after TAVI. Aortic annulus diameters were determined. Influence of prosthesis type and degree of aortic valve calcification on post-implant eccentricity were analysed. Results: Aortic annulus eccentricity was reduced in patients after TAVI (0.21 ± 0.06 vs. 0.08 ± 0.06, p < 0.0001). Post-TAVI eccentricity was significantly lower in 65 patients following implantation of a balloon-expandable prosthesis as compared to 15 patients who received a self-expanding prosthesis (0.06 ± 0.05 vs. 0.15 ± 0.07, p < 0.0001), even though the extent of aortic valve calcification was not different. After TAVI, patients with a higher calcium amount retained a significantly higher eccentricity compared to patients with lower amounts of calcium. Conclusions: Patients undergoing TAVI with a balloon-expandable prosthesis show a more circular shape of the implanted prosthesis as compared to patients with a self-expanding prosthesis. Eccentricity of the deployed prosthesis is affected by the extent of aortic valve calcification.

  16. Impact of intra-aortic balloon counterpulsation with different balloon volumes on cardiac performance in humans. (United States)

    Cohen, Marc; Fasseas, Panayotis; Singh, Varinder P; McBride, Ruth; Orford, James L; Kussmaul, William G


    Intra-aortic balloon (IAB) counterpulsation can augment the cardiac output. However, the effect of different IAB volumes on cardiac performance has not been adequately evaluated in humans. Eighty-two patients (52 males [63%]; mean age, 65 +/- 12 years; mean body surface area [BSA], 1.8 +/- 0.2 m(2)) had IAB counterpulsation for cardiogenic shock, refractory angina, and preoperatively for high-risk cardiac surgery. Cardiac hemodynamics were prospectively studied during IAB with inflation volumes of 32 vs. 40 cc. Hemodynamic data collected included aortic pressure, pulmonary artery pressure, systemic and mixed venous oxygen saturations, and cardiac output (by Fick). Transthoracic echocardiography (TTE) was used to obtain both velocity time integrals (VTIs) and the area of the left ventricular outflow tract (LVOT). Left ventricular stroke volume was then calculated as LVOT area x VTI. Cardiac output (CO) determined by the Fick method and VTI did not differ significantly (P = NS) between the two inflation volumes (y = 0.002 + 0.97x). In a subgroup of 33 patients with BSA

  17. Perioperative intra-aortic balloon counterpulsation in a patient with myocardium at risk undergoing urgent noncardiac surgery

    Directory of Open Access Journals (Sweden)

    Tim Nebelsiek


    Full Text Available We are presenting the case of a 76-year-old female scheduled for major abdominal surgery. Her past medical history was remarkable for a three-vessel coronary artery disease, with a severely impaired left ventricular function. She had already undergone complex coronary artery bypass surgery. Currently, she presented with the rare constellation of a hemodynamic relevant and interventionally intractable stenosis of the left subclavian artery proximal to a crucial coronary bypass from left internal mammary artery to the left anterior descending. To protect this patient from perioperative myocardial infarction, an intra-aortic balloon pump was successfully used.

  18. Value discussion of intra-aortic balloon pump in the treatment of my-ocardial infarction combined with cardiogenic shock%主动脉内球囊反搏治疗心肌梗死合并心源性休克的价值探讨

    Institute of Scientific and Technical Information of China (English)



    目的:探讨主动脉内球囊反搏治疗心肌梗死合并心源性休克的临床价值。方法选取本院收治的80例心肌梗死合并心源性休克患者作为研究对象,随机分为两组,各40例,观察组采用主动脉内球囊反搏,对照组采用急诊心脏介入溶栓治疗,比较两组治疗后的心排血量、平均动脉压变化情况及治疗后出血相关并发症。结果观察组心排血量、平均动脉压显著高于对照组,差异有统计学意义(P<0.05),观察组消化道出血、皮下血肿及泌尿道出血的发生率显著低于对照组,差异有统计学意义(P<0.05)。结论主动脉内球囊扩张能有效提高心肌梗死合并心源性休克患者的心排血量及动脉血压,减少出血相关并发症,值得临床重视。%Objective To explore the value of intra-aortic balloon pump in the treatment of myocardial infarction com-bined with cardiogenic shock. Methods 80 cases with myocardial infarction combined with cardiogenic shock were se-lected and randomly divided into two groups,40 cases in each group.The observation group were used intra-aortic bal-loon pump,the control group were used emergency cardiac interventional thrombolytic.Cardiac output,mean arterial pressure changes,and bleeding complications of post-treatment was compared after treatment. Results Cardiac output results and mean arterial pressure in the observation group were significantly higher than those of control group,with statistical difference (P<0.05).The incidence rate of gastrointestinal bleeding,hematoma and urinary tract bleeding were significantly lower than those of control group,with statistical difference(P<0.05). Conclusion Intra-aortic balloon pump for myocardial infarction combined with cardiogenic shock can effectively improve cardiac output and arterial blood pressure and reduce bleeding-related complications,and it is worthy of attention.


    Directory of Open Access Journals (Sweden)

    P. Akbari Asbagh A. Shahmohammadi


    Full Text Available Soon after successful results of balloon valvuloplasty in treatment of congenital pulmonary stenosis, use of this technique for relief of congenital aortic stenosis (AS was attempted in different parts of the world. With the purpose of assessment the value of valvuloplasty in comparison with surgical valvotomy in relief of congenital AS, we retrospectively studied 115 patients with valvar AS, 48 of whom underwent balloon valvuloplasty (mean age 9.63 years, and 67 subjected to surgical aortic valvotomy (mean age 10.32 years, in a six year period from 1991 to 1997 at Rajaie heart hospital. Comparison of balloon valvuloplasty with surgical valvotomy revealed that reduction in the mean pressure gradient in balloon valvuloplasty group was greater than those subjected to surgical valvotomy (73.54 vs. 45.03 mmHg, P < 0.0001. Decreased incidence of aortic insufficiency and mortality in balloon valvuloplasty in comparison with surgical valvotomy are other notable points in this study. Although it is difficult to compare the results of the two procedures and determine their different indications, our successful experience with balloon valvuloplasty for congenital AS and the safety of this procedure encourage us to use this technique for the patients with congenital AS more than ever. These results must be supported by future studies.

  20. Extra-aortic implantable counterpulsation pump in chronic heart failure. (United States)

    Mitnovetski, Sergei; Almeida, Aubrey A; Barr, Althea; Peters, William S; Milsom, F Paget; Ho, Betty; Smith, Julian A


    Extra-aortic counterpulsation for the management of chronic heart failure is a novel approach. We report the use of an extra-aortic implantable counterpulsation pump in the management of a 73-year-old patient with severe heart failure refractory to medical therapy. The implantable counterpulsation pump prolonged his life and greatly improved its quality. The patient lived almost 7 months after the implantation of the device and died of septic complications secondary to gas line infection.

  1. Computed Tomography During Experimental Balloon Dilatation For Calcific Aortic Stenosis. A Look into the Mechanism of Valvuloplasty

    NARCIS (Netherlands)

    C. di Mario (Carlo); L.C.P. van Veen; DE BAAT, L. (LEEN); C.E. Essed; K.J. Beatt (Kevin); O. Leborgne; SERRUYS, P.W. (PATRICK W.)


    textabstractThin‐slice contiguous computed tomographic scanning was performed in four postmortem hearts with calcific aortic valve stenosis (mean weight: 583 ± 78 g; mean age: 65 ± 10 years) before, during, and after balloon valvuloplasty. Balloons of increasing diameter (15–19 mm single balloons, a

  2. 78 FR 79300 - Cardiovascular Devices; Reclassification of Intra-Aortic Balloon and Control Systems for Acute... (United States)


    ... Intra-Aortic Balloon and Control Systems for Acute Coronary Syndrome, Cardiac and Non- Cardiac Surgery... coronary syndrome, cardiac and non- cardiac surgery, or complications of heart failure, a preamendments..., Drug, and Cosmetic Act (the FD&C Act), as amended by the Medical Device Amendments of 1976 (the...

  3. 78 FR 36702 - Cardiovascular Devices; Reclassification of Intra-Aortic Balloon and Control Systems (IABP) for... (United States)


    ...., Holland-Rantos Co. v. United States Department of Health, Education, and Welfare, 587 F.2d 1173, 1174 n.1... debilitating or fatal thromboemboli. Aortic rupture or dissection: Improper sizing or over inflation of the... circulation by the balloon, including obstruction, dissection or perforation; or complications resulting...

  4. Implante transapical de endoprótese valvada balão-expansível em posição aórtica sem circulação extracorpórea Off-pump transapical balloon-expandable aortic valve endoprosthesis implantation

    Directory of Open Access Journals (Sweden)

    Diego Felipe Gaia


    ão.OBJECTIVE: The aortic valve replacement is a routine procedure, and involves replacement of the native valve/prosthesis. In most of the patients who undergo such procedure the risk is acceptable, but in some cases, such risk can justify contraindication. The minimally invasive transcatheter aortic valve implantation without cardiopulmonary bypass (CPB has been shown to be viable, with lower morbidity and mortality. The aim of this study was to develop a catheter-mounted aortic bioprosthesis for implantation without CPB. METHODS: After developing in animals, three patients with high EuroSCORE underwent implantation. Case 1: patients with bioprosthesis dysfunction; Case 2: severe aortic stenosis; Case 3: dysfunction of aortic bioprosthesis. After minithoracotomy and under echocardiographic and fluoroscopic control, a balloon catheter was placed on aortic position and inflated. After, a second balloon with valved endoprosthesis was positioned and released under high ventricular rate. Echocardiographic and angiographic controls were performed and the patients were referred to ICU. RESULTS: In the first case, implantation without CPB was possible with appropriate results. The patient evolved with improvement of ventricular function. After, this patient developed bronchopneumonia, tracheoesophageal fistula and died due to mediastinitis. Autopsy confirmed proper valve positioning and leaflets preservation. The second case showed the device migration after inflation of the balloon, with the need for urgent median sternotomy, CPB and conventional valve replacement. This patient evolved well and was discharged from the ICU on the 14th postoperative day without complications. This patient developed respiratory infection, septic shock and died on the 60th postoperative day. The patient from the third case underwent successful implantation. CONCLUSION: The off-pump transapical implantation of catheter-mounted bioprosthesis was shown to be a feasible procedure. Technical details and learning

  5. 主动脉内球囊反搏在高危患者非体外循环冠状动脉旁路移植术中的应用%Application of Intra-aortic Balloon Pump for High-risk Patients before Off-pump Coronary Artery Bypass Grafting

    Institute of Scientific and Technical Information of China (English)

    丁文军; 魏强; 孙勇新; 史昀青; 王春生


    目的 分析行非体外循环冠状动脉旁路移植术(off-pump coronary artery bypass grafting,OPCAB)的高危患者术前应用主动脉内球囊反搏(intraaortic balloon pump,IABP)的治疗效果,总结IABP的应用及撤机指征.方法 回顾性分析自2008年1月至2011年7月复旦大学附属中山医院102例高危冠心病患者[IABP组,男71例,女31例;年龄(63.0±8.2)岁]在OPCAB术前置入IABP治疗的临床资料,另外选择100例未于术前置入IABP的患者作为对照[对照组,男55例,女45例;年龄(64.1±9.5)岁].监测两组患者手术后有创动脉收缩压(SABP)、有创平均动脉压(MABP)、机械辅助通气时间、住ICU时间、并发症发生情况、IABP辅助时间、围术期死亡等.术后3个月复查心脏超声心动图检测左心室射血分数(LVEF).结果 IABP组患者术后SABP[(95.3±12.2) mm Hgvs.(80.1±11.7) mm Hg; t=8.440,P=0.000]、MABP[(78.9±13.5) mm Hg vs.(52.3±15.1)mm Hg; t=12.410,P=0.000]明显高于对照组;机械辅助通气时间、住ICU时间、正性肌力药物辅助时间较对照组短;室性心律失常、低心排血量、围术期心肌梗死和围术期肾功能不全血液透析的发生较对照组少;围术期死亡率低于对照组[5.9% (6/102) vs.17.0%(17/100),x2=6.180,P=0.020].IABP组随访96例,对照组随访83例,随访时间均为3个月.术后3个月时心脏超声心动图提示IABP组LVEF显著高于对照组(45.3%±12.0% vs.39.1%±8.2%,t=3.950,P=0.000).结论 对具有高危因素的OPCAB患者术前预防性置入IABP、且把握好撤机时机,可降低手术风险,明显提高手术效果,加快患者术后恢复,改善心功能,减少并发症的发生,降低围术期病死率.%Objective To analyze clinical outcomes of intra-aortic balloon pump (IABP) application for high-risk patients before undergoing off-pump coronary artery bypass grafting (OPC AB), and summarize our experience and weaning indications of IABP. Methods We retrospectively analyzed

  6. 间歇性充气压力泵在预防主动脉球囊反搏泵置入病人下肢循环障碍中的应用研究%Application study on intermittent pneumatic pressure pump in prevention of lower limb circulation disorder in pa-tients with aortic balloon pump

    Institute of Scientific and Technical Information of China (English)

    范羽飞; 常芸


    Objective:To probe into the effectiveness of intermittent pneumatic pressure pump for prevention and improvement of lower extremity circulation disorder in patients with aortic balloon pump(IABP).Methods:A total of 76 cases of patients were selected as the research objects who received percutaneous femoral artery puncture IABP and retaining the sheath in CCU from January 2014 to January 201 6 in our hospital.They were randomly divided into two groups,the patients in control group(n =39)did IABP catheter lateral ankle pump motor:ankle flexion and extension,by varus,valgus combination of the “ring”movement,every morning,noon, afternoon,bedtime for 4 times,each time for 100 circles.The patients in observation group(n=37)on the basis of ankle pump motor used the intermittent Airpro 600 pneumatic pressure pump produced by Chongqing li-fotronic medical instrument company,setting the initial inflation pressure at 40 mmHg,then according to the patient’s tolerance to adjust pressure from 80 mmHg to 120 mmHg,once every morning and 30 mins for once. On the second day,fourth day,seventh day after IABP catheter and second days after catheter extubation,the lower limb blood circulation indexes:toe end SpO 2 ,skin color,temperature,feeling,lower leg circumference, foot dorsal artery palpation,dorsal Doppler ultrasound,ankle brachial index(ABI),the patient’s subjective feel-ings.Results:There were statistically significant differences in the subjective feelings of patients between both groups on the second day of IABP (P < 0.01 ).There were statistically significant differences in the toe end SpO 2 ,lower limb temperature,lower leg circumference,and subjective feelings between both groups on the fourth day of catheter(P <0.05 or P <0.01).On the seventh day after catherter,there was statistically signifi-cant difference in toe end SpO 2 ,lower extremity temperature,lower leg circumference,foot dorsal artery palpa-tion,the dorsalis pedis artery Doppler ultrasound and

  7. The Impact of Aortic Occlusion Balloon on Mortality After Endovascular Repair of Ruptured Abdominal Aortic Aneurysms: A Meta-analysis and Meta-regression Analysis

    NARCIS (Netherlands)

    Karkos, C.; Papadimitriou, C.; Chatzivasileiadis, T.; Kapsali, N.; Kalogirou, T.; Giagtzidis, I.; Papazoglou, K.


    INTRODUCTION:We aimed to investigate whether the use of aortic occlusion balloon (AOB) has an impact on mortality of patients undergoing endovascular repair of ruptured abdominal aortic aneurysms (RAAAs).METHODS:A meta-analysis of the English-language literature was undertaken through February 2013.

  8. 急性广泛前壁心肌梗死合并心源性休克患者直接PCI术前联合应用IABP的疗效评估%Intra-aortic balloon pump combined with primary percutaneous coronary intervention for acute extensive anterior myocardial infarction complicated with cardiogenic shock

    Institute of Scientific and Technical Information of China (English)

    曾维英; 陈平; 李仪; 罗燕华


    目的 探讨主动脉内球囊反搏( intra-aortic balloon pump,IABP)支持下行直接经皮冠状动脉介入术( percutaneous coronary intervention,PCI)对急性广泛前壁心肌梗死并心源性休克患者的疗效.方法 选择2008年1月至2012年1月我院收治的急性广泛前壁心肌梗死并心源性休克患者32例,均行直接PCI术,其中20例术前应用IABP的为IABP组,12例未应用IABP的为对照组;观察两组患者术后即时及术后2周心脏左室射血分数( left ventricular ejective fraction,LVEF)值.结果 IABP组及对照组患者术后2周心功能[( 45.4±7.3),(40.5±6.2)]较PCI术后即时[(37.4±7.1),(36.8±6.7 )]均有明显改善(P<0.05),且IABP组患者心功能(45.4±7.3)较对照组(40.5±6.2)改善更为显著(P<0.05).结论 急性广泛前壁心肌梗死并心源性休克患者行直接PCI术前联合应用IABP能更有效地改善患者术后心功能.%Objective To explore the efficacy of intra-aortic balloon pump ( IABP ) combined with percutaneous coronary intervention ( PCI ) for patients with acute extensive anterior myocardial infarction complicated with cardiogenic shock.Methods Among 32 patients with acute extensive anterior myocardial infarction complicated with cardiogenic shock who underwent PCI,20 patients received IABP before PCI ( IABP gronp ) and 12 received no IABP ( control group ).Left ventricular ejective fraction was observed immediately and 2 weeks after PCI in the two groups.Results Two weeks after the procedure,heart function was significantly improved in IABP group [( 37.4 ± 7.1 ),( 45.4 ± 7.3 )]and the control group[ ( 36.8 ± 6.7 ),( 40.5 ± 6.2 )],as compared with that detected immediatedly after the procedure ( P< 0.05 ).Heart function improved more significantly in IABP group than in the control group [( 45.4 ± 7.3 )vs.( 40.5 ± 6.2 ),P < 0.05].Conclusions IABP combined with PCI can effectively improve postoperative left ventricular ejective fraction in patients with acute

  9. Clinical analysis of percutaneous coronary intervention combined with intra-aortic balloon pump in the treatment of acute myocardial infarction complicated with cardiogenic shock%主动脉球囊反搏联合经皮冠状动脉介入治疗急性心肌梗死合并心源性休克的临床分析

    Institute of Scientific and Technical Information of China (English)



    目的 探讨对急性心肌梗死合并心源性休克患者行主动脉球囊反搏联合经皮冠状动脉介入治疗的临床效果.方法 随机选取本院2013年1月至2015年5月收治的急性心肌梗死合并心源性休克患者41例,采用急诊经皮冠状动脉介入治疗(PCI)联合主动脉球囊反搏(IABP)方案对所有患者进行治疗,对治疗前后患者的每小时尿量变化、平均动脉压(MAP)、平均静脉压(CVP)、心脏指数(CI)和肺毛细血管楔压(PCWP)进行观察记录,并对结果进行分析.结果 经过IABP联合急诊PCI治疗后,41例患者的每小时尿量、MAP及CI明显上升,而PCWP、CVP同治疗前相比明显下降,差异有统计学意义(P<0.05).结论 对急性心肌梗死合并心源性休克患者实施IABP联合PCI,能够有效改善患者的心肌功能,对于保障患者的生命安全具有十分重要的临床意义.%Objective To investigate the clinical effect of percutaneous coronary intervention combined with intra-aortic balloon pump in the treatment of patients with acute myocardial infarction complicated with cardiogenic shock.Methods 41 cases of acute myocardial infarction complicated with cardiogenic shock admitted in our hospital from January 2013 to May 2015 were randomly selected.All patients were treated with emergency percutaneous coronary intervention (PCI) combined with intra-aortic balloon pump (IABP).The urine volume change in every hour,average MAP,average CVP,CI,and PCWP were observed and recorded,the observation result was analyzed.Results After 41 patients received IABP and emergency PCI,urine volume per hour,MAP,CI increased significantly,but PCWP,CVP decreased significantly compared with the conditions before treatment,with statistically significant differences (P<0.05).Conclusion IABP combined with PCI can improve myocardial function of patients with acute myocardial infarction complicated with cardiogenic shock,which has very important clinical significance in

  10. Clinical analysis of intra-aortic balloon pump counterpulsation in adjuvant treatment of AMI complicated with cardiogenic shock%主动脉内球囊反搏辅助治疗急性心肌梗死合并心源性休克的临床分析

    Institute of Scientific and Technical Information of China (English)

    崔晓琼; 李彤; 胡晓旻; 张文芳; 刘迎午; 王禹; 张强; 稂与恒


    目的 分析主动脉内球囊反搏(IABP)辅助治疗急性心肌梗死合并心源性休克的临床疗效.方法 选择急性心肌梗死合并心源性休克的老年患者50例,观察置入IABP前后患者血流动力学变化、心功能、IABP并发症及预后情况.结果 与IABP置入前比较,患者置入IABP后平均动脉压、心率、LVEF及心功能指标均得到不同程度的改善,无严重并发症出现,预后良好.结论 IABP辅助治疗急性心肌梗死合并心源性休克可能有效安全.%Objective To analyze clinical efficacy of intra-aortic balloon pump(IABP) counterpulsation in adjuvant treatment of patients with acute myocardial infarction(AMI) complicated with cardiogenic shock. Methods Fifty senile patients with AMI complicated with cardiogenic shock were chosen to observe the hemodynamic changes,the cardiac function,the IABP complication and prognosis before and after applying IABP. Results Compared with before applying IABP, hemodynamic parameters such as MAP,HR,LVEF and the cardiac function were improved in varying degrees after applying IABP,no serious complication appeared and prognosis was good. ConclusionIABP for adjuvant treatment of AMI complicated with cardiogenic shock is safe and effective.

  11. Balloon-expanding stent and delivery system for transcatheter aortic valve implantation:An animal study

    Institute of Scientific and Technical Information of China (English)

    Xiang Chen; Fei-Yu Wang; Guo-Jun Chu; Yu-Feng Zhu; Hong-Wen Tan; Xian-Xian Zhao; Yong-Wen Qin; Jun-Bo Ge


    Objective: To evaluate the feasibility and satefy of transcatheter aortic valve implantation in animals by using a new balloon-expanding valved stent. Methods: The balloon-expandable stent is made from cobalt-based alloy material and designed with a tubular, slotted structure. Fresh bovine pericardium was treated, sutured and fixed on the balloon-expandable stent. Ten healthy sheep (five males and five females), weighing an average of (25.16 ± 1.83) kg, were selected to undergo transcatheter implantation of the valve stents. The function of the valve stent was evaluated by angiography, echocardiography, and histology six months after the procedure. Results: Of the ten experimental sheep, two sheep died during the operation because the higher position of the artificial valve affected the opening of the coronary artery. We successfully implanted the aortic valve stent in other eight sheep;however, one sheep died of heart failure two weeks after the operation due to the lower position of the valve stent. The valve stents were implanted in the desired position in seven sheep. Ascending aortic angiographic and autoptic findings immediately after the operation confirmed the satisfactory location and function of the valved stent. Echocardiography, angiography, and histology at six post-operative months confirmed the satisfactory location and function of the valve stent. Conclusion: We successfully implanted our new valve stent as a replacement of native aortic valve via the transcatheter route with satisfactory outcome. Copyright © 2015, Chinese Medical Association Production. Production and hosting by Elsevier B.V. on behalf of KeAi Communications Co., Ltd. This is an open access article under the CC BY-NC-ND license (

  12. Newly Shaped Intra‐Aortic Balloons Improve the Performance of Counterpulsation at the Semirecumbent Position: An In Vitro Study (United States)

    Kolyva, Christina; Pepper, John R.


    Abstract The major hemodynamic benefits of intra‐aortic balloon pump (IABP) counterpulsation are augmentation in diastolic aortic pressure (P aug) during inflation, and decrease in end‐diastolic aortic pressure (ΔedP) during deflation. When the patient is nursed in the semirecumbent position these benefits are diminished. Attempts to change the shape of the IAB in order to limit or prevent this deterioration have been scarce. The aim of the present study was to investigate the hemodynamic performance of six new IAB shapes, and compare it to that of a traditional cylindrical IAB. A mock circulation system, featuring an artificial left ventricle and an aortic model with 11 branches and physiological resistance and compliance, was used to test one cylindrical and six newly shaped IABs at angles 0, 10, 20, 30, and 40°. Pressure was measured continuously at the aortic root during 1:1 and 1:4 IABP support. Shape 2 was found to consistently achieve, in terms of absolute magnitude, larger ΔedP at angles than the cylindrical IAB. Although ΔedP was gradually diminished with angle, it did so to a lesser degree than the cylindrical IAB; this diminishment was only 53% (with frequency 1:1) and 40% (with frequency 1:4) of that of the cylindrical IAB, when angle increased from 0 to 40°. During inflation Shape 1 displayed a more stable behavior with increasing angle compared to the cylindrical IAB; with an increase in angle from 0 to 40°, diastolic aortic pressure augmentation dropped only by 45% (with frequency 1:1) and by 33% (with frequency 1:4) of the drop reached with the cylindrical IAB. After compensating for differences in nominal IAB volume, Shape 1 generally achieved higher P aug over most angles. Newly shaped IABs could allow for IABP therapy to become more efficient for patients nursed at the semirecumbent position. The findings promote the idea of personalized rather than generalized patient therapy for the achievement of higher IABP therapeutic efficiency

  13. Computational evaluation of aortic occlusion and the proposal of a novel, improved occluder: Constrained endo-aortic balloon occlusion. (United States)

    de Vaal, M H; Gee, M W; Stock, U A; Wall, W A


    Because aortic occlusion is arguably one of the most dangerous aortic manipulation maneuvers during cardiac surgery in terms of perioperative ischemic neurological injury, the purpose of this investigation is to assess the structural mechanical impact resulting from the use of existing and newly proposed occluders. Existing (clinically used) occluders considered include different cross-clamps (CCs) and endo-aortic balloon occlusion (EABO). A novel occluder is also introduced, namely, constrained EABO (CEABO), which consists of applying a constrainer externally around the aorta when performing EABO. Computational solid mechanics are employed to investigate each occluder according to a comprehensive list of functional requirements. The potential of a state of occlusion is also considered for the first time. Three different constrainer designs are evaluated for CEABO. Although the CCs were responsible for the highest strains, largest deformation, and most inefficient increase of the occlusion potential, it remains the most stable, simplest, and cheapest occluder. The different CC hinge geometries resulted in poorer performance of CC used for minimally invasive procedures than conventional ones. CEABO with a profiled constrainer successfully addresses the EABO shortcomings of safety, stability, and positioning accuracy, while maintaining its complexities of operation (disadvantage) and yielding additional functionalities (advantage). Moreover, CEABO is able to achieve the previously unattainable potential to provide a clinically determinable state of occlusion. CEABO offers an attractive alternative to the shortcomings of existing occluders, with its design rooted in achieving the highest patient safety. Copyright © 2016 John Wiley & Sons, Ltd.

  14. Application of intra-aortic balloon pump in acute myocardial infarction complicated with cardiogenic shock%主动脉内球囊反搏在急性心肌梗死合并心源性休克中的应用

    Institute of Scientific and Technical Information of China (English)

    刘颖; 刘心甜; 沈菲; 智红; 王琳


    目的:探讨主动脉内球囊反搏(IABP)在急性心肌梗死(AMI)合并心源性休克中的应用价值.方法:收集88例AMI合并心源性休克患者的临床资料,其中50例行IABP,38例药物治疗,回顾性分析88例患者的治疗效果及安全性.结果:对于AMI并心源性休克患者,应用IABP后可改善血流动力学,使患者的收缩压、心率趋于稳定,左心室射血分数(LVEF)有明显改善,与非IABP组比较,差异有统计学意义(P<0.05);IABP组住院生存时间优于非IABP组(RR =0.402,95%CI:0.175 ~0.921,P=0.031).肢体缺血与出血的发生率2组无统计学差异(P>0.05).结论:对于AMI合并心源性休克的患者,行IABP辅助循环,可改善血流动力学,改善住院生存时间,且相对安全.%Objective:To evaluate the effect of intra-aortic balloon pump (IABP) in acute myocardial infarction (AMI) complicated with cardiogenic shock.Methods:Clinical data of 88 patients with AMI complicated with cardiogenic shock were collected,50 patients receiving IABP support while 38 patients receiving drug treatment.The therapeutic effect and safety were analyzed retrospectively.Results:Stabilization of patients'systolic blood pressure and heart rate,improvement of LVEF were found in IABP group and were more significant when compared with those without IABP (P < 0.05),and the survival time in hospital was superior in patients with IABP than those without IABP (RR =0.402,95% CI:0.175 ~0.921,P =0.031).The incidence of limb ischemia and bleeding showed no significant difference in two groups.Conclusions:IABP support can improve hemodynamic and the survival time in hospital for patients with AMI complicated with cardiogenic shock,and it is safe.

  15. Intra-aortic balloon clamp for safe resternotomy in a patient with a giant aneurysm of sinuses of Valsalva. (United States)

    Zembala, Michal Oscar; Filipiak, Krzysztof; Niklewski, Tomasz; Przybylski, Roman


    Despite advances in surgical techniques and postoperative medical management, the mortality rates for cardiac reoperations remain high. The risk is most commonly associated with failed resternotomy complicated by fatal injury to the myocardium or its structures. This short case report documents the first use of an endoluminal balloon occlusive device in order to prevent aneurysmal sack damage and coronary vessel injury in a patient with a giant aortic aneurysm after failed aortic surgery. The safe aortic occlusion allowed for closed-chest cardioplegia delivery and subsequent aortic unloading, thus facilitating a difficult but uneventful resternotomy.

  16. Have we given up on intra-aortic balloon counterpulsation in post-myocardial infarction cardiogenic shock? (United States)

    Acharji, Subasit; Mathur, Atish; Lakshmanadoss, Umashankar; Prasad, Hari; Singh, Maninder; Kaluski, Edo


    The recently published Intra-aortic Balloon Pump in Cardiogenic Shock II (IABP-SHOCK II) trial concluded that intra-aortic counterpulsation (IACP) does not reduce 30-day mortality in patients with cardiogenic shock (CS) complicating acute myocardial infarction (AMI) for whom early revascularization strategy was planned. The study resulted in downgrading IACP in post-AMI CS patients by certain professional organizations like the European Society of Cardiology. Although this is the largest and most important CS study of this decade, it suffers from considerable shortcomings: (1) time intervals from chest-pain onset or AMI recognition to revascularization, enrollment, and IACP initiation are not disclosed; (2) 86.6% of the treatment arm initiated IACP only post-percutaneous coronary intervention (PCI), and 4.3 % did not receive IACP at all; (3) 17.4% of the control arm crossed over to IACP or other mechanical support, mostly due to protocol violations; (4) there is no adjudication of the mortality events; (5) follow-up is limited to 30 days; and (5) both methodology (especially IACP device size) and quality of IACP are not evaluated and documented. Because the study assessed mostly the efficacy and safety of IACP initiated post-PCI, the study conclusions should not be extrapolated to IACP pre-PCI or during PCI in CS. Moreover, IACP had a favorable effect on the mortality of younger patients. Intra-aortic counterpulsation should remain the first line of mechanical circulatory support for the hemodynamically compromised AMI patients with or without CS who are undergoing primary PCI. Early upgrade to more advanced mechanical circulatory support should be considered for selective suitable candidates who remain in refractory CS despite revascularization and IACP.

  17. Centrifugal pump support for distal aortic perfusion during repair of traumatic thoracic aortic injury. (United States)

    Walls, Joseph T; Curtis, Jack J; McKenney-Knox, Charlotte A; Schmaltz, Richard A


    Paraplegia from ischemic injury of the spinal cord and renal failure from inadequate perfusion of the kidneys may occur from aortic cross-clamping during repair of traumatic thoracic aortic injuries. After Institutional Review Board approval, we retrospectively reviewed the charts of 26 patients surgically treated for traumatic transection of the descending thoracic aorta during a 14 year period (1987-2001), using centrifugal pump (Sarns) support for distal aortic perfusion. The study group comprised 19 males and 7 females, whose ages ranged from 15 to 69 years. For all but 1 patient, who fell from a flagpole, the injuries were incurred in motor vehicle accidents. Aortic cross-clamp time lasted between 5 to 78 min (median = 40 min). Mean arterial pressure ranged from 50 to 80 mm Hg (median = 70 mm Hg). All patients survived operation without developing paraplegia or renal failure. Distal centrifugal pump perfusion during repair of traumatic injury of the descending thoracic aorta is a valuable adjunct during surgical treatment and aids in preservation of spinal cord and renal function.

  18. 急性心力衰竭应用主动脉内球囊反搏患者血小板减少因素分析%Cause analysis of thrombocytopenia in acute heart failure implanted with intra-aortic balloon pump

    Institute of Scientific and Technical Information of China (English)

    房芳; 李宇


    Objective To explore the causes of thrombocytopenia in acute heart failure (AHF) implanted with intra-aortic balloon pump (IABP).Methods Totally 50 cases with AHF implanted with IABP from November 2011 to November 2013 were retrospective enrolled.The time duration of IABP implantion and change of thrombocyte were recorded;the correlations of thrombocytopenia with disease type,size of ballon,gender were analyzed,the influence of thrombocytopenia on hospital mortality rate were assessed.Results The time duration of IABP implantion was (181 ±34) h (32.4-1 136.5 h).There was 27 patients with thrombocytopenia (mild:15 cases,moderate:9 cases,severe:3 cases),the time of the least platelet count was(100 ± 10) h.The incidence of thrombocytopenia in patients with acute myocardial infarction induced AHF was not significantly different from that in patients with other causes induced AHF [51.6% (16/31) vs 57.9% (11/19)] (P > 0.05).The incidence of thrombocytopenia was significantly lower in patients applied with 30 CC balloon than that in patients applied with 40 CC balloon [31.3% (5/16) vs 64.7% (22/34)],was significantly lower in males than that in femals [46.2% (18/39) vs 81.8% (9/11)] (P < 0.05).In 50 patients,17 cases was dead in hospital;the mortality rate in patients with thrombocytopenia was significantly higher than that in patients without thrombocytopenia [48.1% (13/27) vs 17.4% (4/23)] (P <0.05).Conclusion Thrombocytopenia can increase the morality rate in acute heartfailure patients implanted with IABP,which is correlated with the size of implanted balloon and gender.%目的 探讨急性心力衰竭应用主动脉内球囊反搏(IABP)患者血小板减少的原因.方法 回顾性选取首都医科大学附属北京安贞医院2011年11月至2013年11月收治的应用IABP的急性心力衰竭患者50例,记录应用IABP的时间以及应用后患者的血小板变化情况;分析血小板减少和疾病类型、球囊大小、性别的关

  19. An implantable aortic valvo-pump for destination therapy. (United States)

    Qian, Kun-Xi


    To investigate the possibility of a long-term applicable left ventricular assist device, a 23 mm outer diameter and 31 g weight implantable aortic valvo-pump was developed. It consists of a rotor and a stator; the rotor has a driven magnets assemble and an impeller, the stator has a motor coil with iron core and a outflow guide vane. The device locates the position of aortic valve, delivers the blood directly from left ventricle to aorta. Neither connecting conduits nor "bypass" circuits are necessary. Therefore, the device has promisingly better antithrombogenicity than other heart pumps. In hemodynamic testing, the pump can produce a blood flow of 7 l/min volume with 50 mmHg pressure increase at 15,000 rpm rotating speed, and at zero flow rate the pump can maintain a diastolic pressure over 80 mmHg at same rotating speed. For further studies the blood compatibility and the durability of the device are of most importance.

  20. 急性心肌梗死并心源性休克患者早期主动脉内球囊反搏联合急诊介入的疗效观察%Effect of early intra-aortic balloon pumping support combined emergency intervention in patients of acute myocardial infarction complicated with cardiac Shock

    Institute of Scientific and Technical Information of China (English)

    裘毅钢; 李田昌; 陈宇; 李贤峰; 曹毅; 田海涛; 李东韬


    目的:探讨早期主动脉内球囊反搏(IABP)植入在急性心肌梗死(AMI)合并心源性休克(CS)患者救治中的价值。方法140例主动脉内球囊反搏联合急诊经皮管状动脉介入治疗(PCI)治疗的AMI合并CS患者,按照发生CS至IABP入的时间,分为:A组为CS至IABP辅助治疗时间<3 h,B组为>3 h;观察指标为靶血管、冠脉病变情况等,并记录总IABP辅助时间,死亡、急性呼吸衰竭、急性肾功能衰竭等临床事件。结果两组间基线情况、靶血管病变、静脉用药等无统计学差异;A组三支病变比率、无复流发生率低于B组,但无统计学差异;A组总IABP辅助时间、全因病死率低于B组,有统计学差异,P<0.05;A组心源性死亡、急性呼吸发生率、急性肾衰发生率均低于B组,但无统计学差异。结论在AMI合并CS的患者尽早应用IABP联合血运重建可能有助于改善生存率。%Objective To investigate the effect of early Intra-aortic balloon pumping (IABP) support combined emergency intervention in patients of acute myocardial infarction (AMI) complicated with cardiac Shock (CS). Methods Clinical data of AMI complicated with cardiac shock in 140 cases of IABP combine with emergency percutaneous coronary intervention (PCI) admitted in Navy General Hospital of the PLA in between January 2011 and December 2012 were collected and divided into two groups according to the time from CS to IABP. The time interval in group A (n=61) was less than 3 hours and group B (n=79) were more than 3 hours. The target coronary artery, the number of culprit vessel, the total time of IABP treatment, hospital mortality, acute respiratory failure, acute renal failure were observed. Results No statistical significance in the rates of triple vessel disease, no-reflow, cardiogenic death, acute respiratory failure and acute renal failure was found between the two groups even although they all reflected lower in

  1. 急性大面积ST段抬高型心肌梗死患者早期床旁应用主动脉内气囊反搏术预后观察%Observation on the prognosis of early application of bedside intra-aortic balloon pump counterpulsation in patients with acute ST-segment elevation myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    李志娟; 李春燕; 董平栓; 杨旭明; 刘威; 王可; 李治国; 赵玉伟; 靳国青; 李转珍


    目的:研究急性大面积ST段抬高型心肌梗死(STEMI)患者在择期经皮冠状动脉介入治疗(PCI)前尽早床旁应用主动脉内气囊反搏术(IABP)对预后的观察.方法:选取发病12 ~72 h的STEMI患者150例,随机分为2组,IABP组72例,对照组78例,2组均给予规范的药物治疗,IABP组同时床旁应用IABP.2组均于发病10~14d行冠脉造影,必要时行PCI术,评价梗死相关血管PCI术前及术后冠脉血流,术后4周心功能、IABP主要不良心脏事件的发生情况.结果:2组患者PCI术前TIMI血流、PCI术后4周主要不良心脏事件的发生率、左心室射血分数(LVEF)均有显著性差异(P<0.05).结论:对于急性大面积STEMI患者择期行PCI,尽早床旁应用IABP能改善梗死相关血管的TIMI血流,改善心功能,减少主要不良心脏事件的发生率,临床应用安全可行.%Objective: To evaluate the effect of early application of intra-aortic balloon pump counterpulsation (IABP) on prognosis of patients with acute ST-segment elevation myocardial infarction (STEMI) before elective percutaneous coronary interventional (PCI). Methods; One hundred and fifty patients with STEMI were randomly divided into two groups: 72 patients in IABP group and 78 in control group. All patients in IABP group receiving bedside IABP support treatment while patients in control group do not. All patients were performed PCI after 10 to 14 days. The blood flow rate of infart related coronary vessel was observed before and after PCI. The major adverse cardiac events ( MACE) and heart function at 4 weeks were studied. Results; In IABP group, blood flow rate of related coronary vessel, the occurance of MACE at 4 weeks, left ventricle ejection fraction (LVEF) were significant different in two groups (P < 0. 05). Conclusions; Early application of IABP for patients with STEMI before elective PCI is safe and effective, which can reduce the incidence of MACE, and improve heart function.

  2. 急性心肌梗死患者主动脉内球囊反搏术后下呼吸道感染风险及与预后关系%Risk factors for lower respiratory tract infection and its relation to prognosis in patients with acute myocardial infarction received intra-aortic balloon pump counterpulsation

    Institute of Scientific and Technical Information of China (English)

    谢江; 牛丽丽; 崔俊玉; 谭琛


    Objective:To explore the risk factors for lower respiratory tract infection in patients with acute myo-cardial infarction (AMI) complicated with cardiogenic shock treated by intra-aortic balloon pump (IABP) counterpul-sation,as well as its effect on prognosis. Methods:The risk factors for lower respiratory tract infection in 55 patients with AMI complicated with cardiogenic shock receiving IABP were analyzed logistically,and the effect of infection on prognosis was evaluated. Results: With treatment of IABP,43. 6% of the patients developed lower respiratory tract infection. The chance of developing the infection was higher in patients experienced invasive ventilation, blood transfusion, deep vein catheterization and lack of prophylactic use of antibiotics (P<0. 05). The mortality was higher in patients with infection than those without infection (75. 0% vs 38. 7%,P=0. 007). Cardiogenic shock, septic shock and multiple organ dysfunction syndrome were the main causes of death for patients with infections. Conclusion; Invasive ventilation, deep vein catheterization and blood transfusion are positively associated with lower respiratory tract infection, while prophylactic administration of antibiotics may reduce respiratory tract infections.%目的:探讨主动脉内球囊反搏(IABP)救治的急性心肌梗死(AMI)心源性休克患者发生下呼吸道感染的危险因素及对预后的影响.方法:回顾55例接受IABP治疗的AMI心源性休克患者,Logistic回归分析住院期间下呼吸道感染的危险因素,评估感染对预后的影响.结果:43.6% IABP治疗的AMI心源性休克患者发生下呼吸道感染,有创机械通气、输血(血液制品)、未预防性使用抗生素、深静脉置管者发生感染的机会比较大(P<0.05).感染患者病死率明显高于非感染者(75.0% vs 38.7%,P=0.007);心源性休克、感染性休克和多器官功能不全是下呼吸道感染患者主要的死因.结论:下呼吸道感染与有创通气

  3. Balloon valvuloplasty as destination therapy in elderly with severe aortic stenosis:a cardiac catheterization study

    Institute of Scientific and Technical Information of China (English)

    Vasileios Kamperidis; Georgios K Efthimiadis; Georgios Parcharidis; Haralambos Karvounis; Stavros Hadjimiltiades; Antonios Ziakas; Georgios Sianos; Georgios Kazinakis; George Giannakoulas; Sophia-Anastasia Mouratoglou; Athanasia Sarafidou; Ioannis Ventoulis


    Background In the current era of transcatheter aortic valve replacement, there is renewed interest in balloon aortic valvuloplasty (BAV) and invasive hemodynamic evaluation of aortic stenosis (AS). The current report aimed to study the invasive hemodynamics of se-vere AS patients treated with BAV as destination therapy and to identify factors associated with better hemodynamic outcome and prognosis. Methods From 2009 to 2012, 63 high risk elderly patients were treated with BAV as destination therapy for symptomatic severe AS and were all prospectively included in the study. Their hemodynamics were invasively evaluated during catheterization, pre-and post-BAV at the same session. All Post-BAV patients were regularly followed-up. Results The patients (82 ± 6 years, 52%male) had post-BAV aortic valve area index (AVAi) significantly increased and mean pressure gradient (MPG) significantly reduced. During the follow-up of 0.9 (maximum 3.3) years, those with post-BAV AVAi<0.6 cm2/m2 compared with the AVAi≥0.6 cm2/m2 group had significantly higher mortality (60%vs. 28%, log-rank P=0.02), even after adjusting for age, gender, atrial fibrillation, chronic kidney disease, diabetes mellitus, coronary artery disease and EuroSCORE [HR:5.58, 95%confidence interval (CI):1.62−19.20, P=0.006]. The only independent predictor of moderate AS post-BAV was the pre-BAV AVAi increase by 0.1cm2/m2 (OR:3.81, 95%CI:1.33−10.89, P=0.01). Pre-BAV AVAi≥0.39 cm2/m2 could predict with sensitivity 84%and specificity 70%the post-BAV hemodynamic outcome. Conclusions BAV as destination therapy for se-vere AS offered immediate and significant hemodynamic improvement. The survival was significantly better when a moderate degree of AS was present.

  4. Balloon aortic valvuloplasty as a bridge-to-decision in high risk patients with aortic stenosis: a new paradigm for the heart team decision making (United States)

    Saia, Francesco; Moretti, Carolina; Dall'Ara, Gianni; Ciuca, Cristina; Taglieri, Nevio; Berardini, Alessandra; Gallo, Pamela; Cannizzo, Marina; Chiarabelli, Matteo; Ramponi, Niccolò; Taffani, Linda; Bacchi-Reggiani, Maria Letizia; Marrozzini, Cinzia; Rapezzi, Claudio; Marzocchi, Antonio


    Background Whilst the majority of the patients with severe aortic stenosis can be directly addressed to surgical aortic valve replacement (AVR) or transcatheter aortic valve implantation (TAVI), in some instances additional information may be needed to complete the diagnostic workout. We evaluated the role of balloon aortic valvuloplasty (BAV) as a bridge-to-decision (BTD) in selected high-risk patients. Methods Between 2007 and 2012, the heart team in our Institution required BTD BAV in 202 patients. Very low left ventricular ejection fraction, mitral regurgitation grade ≥ 3, frailty, hemodynamic instability, serious comorbidity, or a combination of these factors were the main drivers for this strategy. We evaluated how BAV influenced the final treatment strategy in the whole patient group and in each specific subgroup. Results Mean logistic European System for Cardiac Operative Risk Evaluation (EuroSCORE) was 23.5% ± 15.3%, age 81 ± 7 years. In-hospital mortality was 4.5%, cerebrovascular accident 1% and overall vascular complications 4% (0.5% major; 3.5% minor). Of the 193 patients with BTD BAV who survived and received a second heart team evaluation, 72.6% were finally deemed eligible for definitive treatment (25.4% for AVR; 47.2% for TAVI): 96.7% of patients with left ventricular ejection fraction recovery; 70.5% of patients with mitral regurgitation reduction; 75.7% of patients who underwent BAV in clinical hemodynamic instability; 69.2% of frail patients and 68% of patients who presented serious comorbidities. Conclusions Balloon aortic valvuloplasty can be considered as bridge-to-decision in high-risk patients with severe aortic stenosis who cannot be immediate candidates for definitive transcatheter or surgical treatment. PMID:27582761

  5. Curative effect of early intra-aortic balloon pump implantation on acute myocardial infarction complicating cardiac shock in elderly patients%主动脉内球囊反搏置入时机对老年急性心肌梗死并心源性休克的疗效观察

    Institute of Scientific and Technical Information of China (English)

    裘毅钢; 李田昌; 陈宇; 李贤峰; 曹毅; 田海涛; 王兆君; 王志国; 李东韬


    Objective To investigate the curative effect of early intra-aortic balloon pump (IABP) implantation on acute myocardial infarction (AMI) complicating cardiac shock (CS) in elderly patients.Methods The patients (aged over 65,n=116) were chosen from Jan. 2011 to Mar. 2014, and then divided, according to the duration from attack of CS to IABP implantation, into group A (n=53, duration≤3 h) and group B (n=63, duration>3 h). The revascularization and dopamine administration were observed, and the total IABP auxiliary time, all-cause mortality within 30 d, acute respiratory failure, acute renal failure and major bleeding events were recorded. Results There was no statistical difference in dopamine administration. The average IABP auxiliary time was shorter in group A than that in group B (71.0 hvs. 128.5 h,P<0.01). There was statistical difference in all-cause mortality between 2 groups (15.1%vs. 31.7%,P<0.05). The incidence of cardiac death (13.2%vs 25.4%,P=0.10), acute respiratory failure (26.4%vs. 34.9%,P=0.32), acute renal failure (11.3%vs 20.6%,P=0.18) and major bleeding events (5.7%vs. 11.1%,P=0.29) showed a decreasing trend but without statistical significance.Conclusion The early IABP implantation maybe improve survival rate within 30 d and reduce the incidence of major clinical events in elderly patients with AMI complicating CS.%目的:探讨主动脉内球囊反搏(IABP)置入辅助时机对老年急性心肌梗死合并心源性休克患者临床疗效的影响。方法连续选择自2011年1月~2014年3月心内科收治的116例年龄大于65岁的IABP辅助治疗急性心肌梗死合并心源性休克的患者,按照心源性休克发生至IABP置入的时间,将其分为两组,A组(n=53)为心源性休克至IABP置入时间小于等于3 h,B组(n=63)为大于3 h;观察血运重建、多巴胺使用情况,并记录总IABP辅助时间,30 d内全因死亡、急性呼吸衰竭、急性肾功能衰竭、主要出血事件等临

  6. Therapy strategy of extracorporeal membrane oxygenation (ECMO) combine with intra aortic balloon pump (IABP), continuous renal replacement therapy (CRRT) and respiratory machine in serious condition cardiac surgery cases%危重症心脏外科患者的ECMO辅助技术与IABP、CRRT、呼吸机的相互配合治疗策略

    Institute of Scientific and Technical Information of China (English)

    张海波; 孟旭; 韩杰; 李岩; 贾一新; 许春雷; 曾文; 王坚刚; 艾米儿


    Objective To investigate clinic results of the extracorporeal membrane oxygenation (ECMO) technique combine with Intro aortic balloon pump (IABP),Continuous renal replacement therapy (CRRT),respiratory machine therapy in the serious condition cardiac surgery cases.Methods From 2004 to 2009 all data of the cases received the ECMO therapy were analyzed retrospectively.Results Totally 180 cases were treated with extracorporeal membrane oxygenation (ECMO) technique in this period of time with weaning rate of 68.9% and survival rate of 72.8%.Besides of the of replacing rountine CPB 69 cases,49 cases died in the 111 cases of routine used ECMO cases (survival rate 55.9%).There were 40 cases treated with ECMO combined with IABP in which 23 cases died (survival rate 42.5%).After the first use of IABP 28 cases were treated with ECMO because of hemodynamic instability and 9 died (survival rate 54%).After the first use of ECMO because of severe valve disease or hemodynamic instability after heart transplantation,or emergency cardiopulmonary resuscitation and the IABP was admitted in 12 cases for the small pulse pressure,decreased left ventricular contraction (10 died,survival rate 36.1%).48 cases were treated with ECMO combined with CRRT (total survival rate 40%).In these cases 6 cases were treated with CRRT first and 4 cases died (survival rate 33.3%).And 42 cases received the ECMO first and 25 cases died (survival rate 47.9%).In the total series 19 cases were treated with ECMO combined with IABP,CRRT,respiratory machine and 12 cases died (survival rate 36.1%).Conclusion ECMO is an effective technique for the heart failure after cardiac surgery,the earlier use may bring earlier recovery of the heart function.Combine administration of ECMO,CRRT,IABP and respiratory machine may be adopted for the multiple organs failure cases with attention of the coordinate and weaning orders among the machines.%目的 探讨危重症心脏外科术后患者联合体外膜

  7. SU-C-18C-02: Specifcation of X-Ray Projection Angles Which Are Aligned with the Aortic Valve Plane From a Planar Image of a Valvuloplasty Balloon Inflated Across the Aortic Valve

    Energy Technology Data Exchange (ETDEWEB)

    Fetterly, K; Mathew, V [Mayo Clinic, Rochester, MN (United States)


    Purpose: Transcatheter aortic valve replacement (TAVR) procedures provide a method to implant a prosthetic aortic valve via a minimallyinvasive, catheter-based procedure. TAVR procedures require use of interventional fluoroscopy c-arm projection angles which are aligned with the aortic valve plane to minimize prosthetic valve positioning error due to x-ray imaging parallax. The purpose of this work is to calculate the continuous range of interventional fluoroscopy c-arm projection angles which are aligned with the aortic valve plane from a single planar image of a valvuloplasty balloon inflated across the aortic valve. Methods: Computational methods to measure the 3D angular orientation of the aortic valve were developed. Required inputs include a planar x-ray image of a known valvuloplasty balloon inflated across the aortic valve and specifications of x-ray imaging geometry from the DICOM header of the image. A-priori knowledge of the species-specific typical range of aortic orientation is required to specify the sign of the angle of the long axis of the balloon with respect to the x-ray beam. The methods were validated ex-vivo and in a live pig. Results: Ex-vivo experiments demonstrated that the angular orientation of a stationary inflated valvuloplasty balloon can be measured with precision less than 1 degree. In-vivo pig experiments demonstrated that cardiac motion contributed to measurement variability, with precision less than 3 degrees. Error in specification of x-ray geometry directly influences measurement accuracy. Conclusion: This work demonstrates that the 3D angular orientation of the aortic valve can be calculated precisely from a planar image of a valvuloplasty balloon inflated across the aortic valve and known x-ray geometry. This method could be used to determine appropriate c-arm angular projections during TAVR procedures to minimize x-ray imaging parallax and thereby minimize prosthetic valve positioning errors.

  8. Factors influencing outcomes of intra-aortic balloon counterpulsation in elderly patients

    Institute of Scientific and Technical Information of China (English)

    WU Xue-ping; LIU Hong-wei; ZHAO Xiao-ning; CAO Jian; ZHU Ping


    Background Intra-aortic balloon counterpulsation (IABP) is a mechanical cardiac-assist device that is used for cardiac support.There are no published reports about the use of IABP in eldedy Chinese patients,especially for those over 80 years old.The aim of this study was to describe the clinical outcomes,influencing factors,and complications in patients ≥80 years old and requiring IABP.Methods We performed a retrospective study of 134 consecutive patients who received IABP therapy.Based on age,we defined two groups; those ≥80 years old and those <80 years old.Results The overall mortality was 41.8%.Patients ≥80 years old had higher mortality rates than those <80 years old (47.9% vs.30.2%).Patients ≥80 years old had fewer successful revascularizations (45.8%) and more pulmonary infections(47.9%) than patients <80 years old (60.3% and 30.2%,respectively); these differences were statistically significant.The most common non-cardiac complication was pulmonary infection.Cardiogenic shock and pulmonary infection were risk factors for all-cause,in-hospital mortality,whereas revascularization success was a negative risk factor for the ≥80 years old patients.Conclusions IABP may be successfully and safely employed in patients ≥80 years old,having severe heart disease,with few complications.Patients ≥80 years old who need IABP therapy are less likely to have a successful revascularization and are more likely to develop pulmonary infections than patients <80 years old.

  9. Assessment of the "long sheath" technique for percutaneous aortic balloon valvuloplasty

    NARCIS (Netherlands)

    S. Plante (Sylvain); K.J. Beatt (Kevin); M.J.B.M. van den Brand (Marcel); C. di Mario (Carlo); B. Meier (Bernard); P.W.J.C. Serruys (Patrick)


    textabstractA 100 cm-long 16.5 F valvuloplasty catheter introducer was assessed as an adjunct for percutaneous transluminal aortic valvuloplasty (PTAV) via the femoral artery in 31 patients with severe aortic stenosis. Observed improvements in peak systolic gradient (81.6 +/- 29.9 mm Hg vs. 35.5 +/-

  10. Persistent reduction in left ventricular strain using two-dimensional speckle-tracking echocardiography after balloon valvuloplasty in children with congenital valvular aortic stenosis.

    NARCIS (Netherlands)

    Marcus, K.A.; Korte, C.L. de; Feuth, T.; Thijssen, J.M.; Oort, A.M. van; Tanke, R.B.; Kapusta, L.


    BACKGROUND: The aim of this study was to investige serial changes of myocardial deformation using two-dimensional speckle-tracking echocardiographic (2DSTE) imaging in children undergoing balloon valvuloplasty for congenital valvular aortic stenosis (VAS). METHODS: Thirty-seven children with isolate

  11. Sarns centrifugal pump for repair of thoracic aortic injury: case reports. (United States)

    Walls, J T; Curtis, J J; Boley, T


    A new centrifugal pump (Sarns), originally designed for ventricular assist, was successfully used in two patients during repair of traumatic pseudoaneurysm of the descending thoracic aorta. The distal thoracic aorta was perfused without heparinization to avoid spinal cord and visceral ischemia, reduce afterload on the heart, and avoid clamp injury to the aorta. Distal mean aortic pressure was maintained above 50 mm Hg with a mean pump flow of 1.75 liter/minute. Proposed structural advantages of the Sarns centrifugal pump for perfusion of the distal thoracic aorta without heparin are resistance to thrombus formation, air embolus, and hemolysis.

  12. Physiologic Tolerance of Descending Thoracic Aortic Balloon Occlusion in a Swine Model of Hemorrhagic Shock (United States)


    using a modified Seldinger technique. This permitted transduction of the carotid arterial catheter to enable cartoid- flow monitoring, intra- venous ...ameliorated with resuscitation and critical care . Central aortic pressure and cerebral oxygen delivery is significantly improved by the use of REBOA...minutes of hemorrhage shock Resuscitation Phase Resuscitation with shed blood, intra- venous fluid and inotropes Critical Care Phase Sedation

  13. Cutting balloon angioplasty for in-stent restenosis of the aortic coarctation in a young boy presenting with systemic hypertension of the upper extremities. (United States)

    Lee, Meng-Luen


    An 8.25-year-old boy was incidentally found to have systemic hypertension of the upper extremities. Blood pressures of the upper extremities were 142-150/86-98 mmHg, and those of the lower extremities 110-116/60-66 mmHg. Doppler echocardiography showed in-stent restenosis of the aortic coarctation. Traditional high-pressure balloon angioplasty failed to dilate this inveterate in-stent restenosis. Instead, a cutting balloon angioplasty was performed. The lumen was dilated from 4.80 mm to 7.89 mm. The pressure gradient dropped from 32 mmHg to 9 mmHg. Blood pressures of the upper extremities were 112-116/76-78 mmHg, and those of the lower extremities 100-104/70-72 mmHg. This paper highlights that a cutting balloon angioplasty can serve as a juste milieu to relieve in-stent restenosis of the aortic coarctation when traditional high-pressure balloon angioplasty is debatable.

  14. [Perioperative management of abdominal aortic balloon occlusion in patients complicated with placenta percteta: a case report]. (United States)

    Zeng, Hong; Wang, Yan; Wang, Yang; Guo, Xiang-yang


    When placenta previa complicated with placenta percreta, the exposure of operative field is difficult and the routine methods are difficult to effectively control the bleeding, even causing life-threatening results. A 31-year-old woman, who had been diagnosed with a complete type of placenta previa and placenta percreta with bladder invasion at 34 weeks gestation. Her ultrasound results showed a complete type of placenta previa and there was a loss of the decidual interface between the placenta and the myometrium on the lower part of the uterus, suggestive of placenta increta. For further evaluation of the placenta, pelvis magnetic resonance imaging was performed, which revealed findings suspicious of a placenta percreta. She underwent elective cecarean section at 36 weeks of gestation. Firstly, two ureteral stents were placed into the bilateral ureter through the cystoscope. After the infrarenal abdominal aorta catheter was inserted via the femoral artery (9 F sheath ), subarachnoid anesthesia had been established. A healthy 2 510 g infant was delivered, with Apgar scores of 10 at 1 min and 10 at 5 min. Immediately after the baby was delivered, following which there was massive haemorrhage and general anaesthesia was induced. The balloon catheter was immediately inflated until the wave of dorsal artery disappeared. With the placenta retained within the uterus, a total hysterectomy was performed. The occluding time was 30 min. The intraoperative blood loss was 2 500 mL. The occluding balloon was deflated at the end of the operation. The patient had stable vital signs and normal laboratory findings during the recovery period and the hemoglobin was 116 g/L. She was discharged six days after delivery without intervention-related complications. This case illustrates that temporary occlusion of the infrarenal abdominal aorta using balloon might be a safe and effective treatment option for patients with placenta previa complicated with placenta percreta, who were at high

  15. Cardiovascular devices; reclassification of intra-aortic balloon and control systems for acute coronary syndrome, cardiac and non-cardiac surgery, or complications of heart failure; effective date of requirement for premarket approval for intra-aortic balloon and control systems for septic shock or pulsatile flow generation. Final order. (United States)


    The Food and Drug Administration (FDA) is issuing a final order to reclassify intra-aortic balloon and control system (IABP) devices when indicated for acute coronary syndrome, cardiac and non-cardiac surgery, or complications of heart failure, a preamendments class III device, into class II (special controls), and to require the filing of a premarket approval application (PMA) or a notice of completion of a product development protocol (PDP) for IABPs when indicated for septic shock or pulsatile flow generation.

  16. World-first implantable aortic valvo-pump (IAVP) with sufficient haemodynamic capacity. (United States)

    Qian, K X; Wang, D F; Topaz, S; Zeng, P; Ru, W M; Yuan, H Y; Zwischenberg, J B


    For better anatomic and physiologic fitting, a novel implantable aortic valvo-pump (IAVP) has been developed. A valvo-pump is a micro axial flow impeller pump, which has the same dimensions and function, as well as the same location, of a valve. Therefore, IAVP needs no inlet and outlet tubes, no additional anatomic occupation, and has less physiologic disturbance to natural circulation compared with the traditional bypass left ventricular assist device (LVAD). The device has a stator and a rotor. The stator consists of a motor coil with an iron core and an outflow guide vane; the rotor includes driven magnets and impeller. There is neither bearing nor strut in both the pump and the motor. In order to reduce the attractive force between the rotor and the stator, so as to enhance the durability of the performance, the rotor magnets were minimized without reducing the driving torque and efficiency of the motor. The impeller vane was designed according to a three-dimensional and analytical method, for preventing stasis and turbulence. The largest outer diameter is 24.7 mm and the length at this point is 12.4 mm. The total weight is 40 g (including the rotor of 11 g). The consumed power is 7 W (14 V x 0.5 A) at 15 000 rpm. This rotating speed stays unchanged during haemodynamic testing together with a pulsatile centrifugal pump, which imitates a failing ventricle. The maximal flow cross IAVP reaches over 10 l min(-1) and the pressure head at 0 l min(-1) can be as large as 80 mmHg. At flow rate of 4 - 8 l min(-1), IAVP enlarges the flow c. 1 l min(-1) and meanwhile increases the pressure about 10 mmHg. The pressure pulsatility generated by the pulsatile centrifugal pump remains 40 mmHg after passing IAVP. By first animal experimental trial the device was sewed in aortic position of an 80 kg pig without harm to adjacent tissue and organs. IAVP promises to be a viable alternative to natural donor heart for heart transplantation in the future.

  17. Initial hydrodynamic study on a new intraaortic axial flow pump: Dynamic aortic valve

    Institute of Scientific and Technical Information of China (English)


    Rotary blood pumps have been researched as implantableventricular assist devices for years. To further reduce the complex of implanted axial pumps, the authors proposed a new concept of intraaortic axial pump, termed previously as "dynamic aortic valve (DAV)". Instead of being driven by an intraaortic micro-electric motor, it was powered by a magnetic field from outside of body. To ensure the perfusion of coronary artery, the axial flow pump is to be implanted in the position of aortic valve. It could serve as either a blood pump or a mechanical valve depending on the power input. This research tested the feasibility of the new concept in model study. A column, made from permanent magnet, is jointed to an impeller in a concentric way to form a "rotor-impeller". Supported by a hanging shaft cantilevered in the center of a rigid cage, the rotor-impeller can be turned by the magnetic field in the surrounding space. In the present prototype, the rotor is 8 mm in diameter and 15 mm in length, the impeller has 3 vanes with an outer diameter of 18 mm. The supporting cage is 22 mm in outer diameter and 20 mm in length. When tested, the DAV prototype is inserted into the tube of a mock circuit. The alternative magnetic field is produced by a rotating magnet placed side by side with the rotor-impeller at a distance of 30 mm. Once the alternative magnetic field is presented in the surrounding space, the DAV starts to turn, leading to a pressure difference and liquid flow in the tube. The flow rate or pressure difference is proportioned to rotary speed. At the maximal output of hydraulic power, the flow rate reached 5 L/min against an afterload of 100 mmHg. The maximal pressure difference generated by DAV at a rotation rate of 12600 r/min was 147 mmHg. The preliminary results demonstrated the feasibility of "DAV", further research on this concept is justifiable.

  18. 经股动脉球囊扩张式主动脉瓣置换术的初步经验%Aortic valve replacement via transfemoral balloon dilation: an initial experience

    Institute of Scientific and Technical Information of China (English)

    陆清声; 景在平; 洪毅; 吴宏; 王志农; 李卫萍; 张勇学; 李南; 马宇; 秦永文


    Objective To discuss the feasibility of treating patients with severe aortic valve stenosis by aortic valve replacement via transfemoral balloon dilation. Methods Three patients with severe aortic valve stenosis, who could not tolerate traditional open surgery, were chosen to receive aortic valve replacement via transfemoral balloon dilation. Results All the three operations were successfully done by transfemoral approach, including one assisted by transapical puncture. The aortic valve function of patients was improved, and there was no related complication or death. Conclusion Aortic valve replacement via transfemoral balloon dilation can be used for treatment of Chinese patients with severe aortic valve stenosis; but which demands more detailed preoperative preparation, evaluation, and surgical manipulation.%目的 探讨经股动脉球囊扩张式主动脉瓣置换术治疗严重主动脉瓣狭窄患者的可行性.方法 选取3例严重主动脉瓣钙化狭窄的患者,术前评估无法耐受传统开放手术,行经股动脉球扩式主动脉瓣置换术.结果 3例均经股动脉完成,其中1例经心尖穿刺辅助完成.3例手术全部成功,术后患者主动脉瓣功能显著改善,无并发症,无死亡.结论 经股动脉球扩式主动脉瓣置换术可用于国人严重主动脉瓣狭窄患者,但在术前准备与评估、术中操作等方面提出了更高的要求.

  19. Initial hydrodynamic study on a new intraaortic axial flow pump: Dynamic aortic valve

    Institute of Scientific and Technical Information of China (English)

    LI; Guorong


    [1]Portner, P. M., Oyer, P. E., Pennington, D. G. et al., Implantable electrical left ventricular assist system: bridge to trans-plantation and the future, Ann. Thorac. Surg., 1989, 47: 142.[2]Pennington, D. G., McBride, L. R. et al., Bridging to heart transplantation with circulatory support devices, J. Heart Transplant, 1989, 8: 116.[3]Westaby, S., Katsumata, T., Evans, R. et al., The Jarvik 2000 Oxford system: increasing the scope of mechanical circulatory support, J. Thorac. Cardiovasc. Surg., 1997, 114: 467.[4]Thomas, D. C., Butler, K. C., Taylor, L. P. et al., Progress on development of the Nimbus-University of Pittsburgh axial flow left ventricular assist system, ASAIO J., 1998, 44: M521.[5]Levin, H. R., Oz, M. C., Paker, M. et al., Reversal of chronic ventricular dilation in patients with end stage cardiomyopathy by prolonged mechanical unloading, Circulation, 1995, 91: 2717.[6]Frazier, O. H., Benedict, C. R., Radovancevic, B. et al., Improved left ventricular function after chronic left ventricular offloading, Ann. Thorac. Surg., 1996, 62: 675.[7]Li, G. R., Zhu, X. D., Wang, J. H. et al., China Patent, Publication Number: 1168263, 1997.[8]Li, G. R., Zhu, X. D., Hu, S. S. et al., Preliminary study of a new concept for left ventricular assistance Dynamic Aortic Valve, J. Biomed. Eng. (in Chinese), 1999, 16(1): 116.[9]Lee, W. H. Jr., Krumbhaar, D., Fonkalstrud, E. W. et al., Denaturation of plasma proteins as a cause of morbidity and death after intracardiac operations, Surgery, 1961, 50: 29.[10] Kalter, R. D., Saul, C. M., Wetstein, L. et al., Cardiopulmonary bypass associated hemostalic abnormalities, J. Thorac. Cardiovasc. Surg., 1979, 77: 427.[11] Ross, J. Jr., Braunwald, E., The study of left ventricular function in man by increasing resistance to ventricular ejection with angiotensin, Circulation, 1964, 29: 739.[12] Mitamura, Y., Yozu, R., Tanka, T. Y. et al., Toward an implantable axial intracardiac blood

  20. Buddy balloon for TAVI. (United States)

    Balkin, Jonathan; Silberman, Shuli; Almagor, Yaron


    Percutaneous transfemoral aortic valve replacement is a new rapidly evolving technique that has made significant progress in recent years. The technology is however limitted and in some cases has resulted in failure to deliver the prosthetic valve. We describe a new technique using a buddy balloon, from the contralateral femoral artery, to assist in crossing the native aortic valve in those cases where extreme calcification and or tortuosity have caused the delivery system to hang up on the aortic wall. The technique is easily applied and facilitates the success of the procedure in cases which may otherwise have to be converted to open surgical aortic valve replacement.

  1. Nursing cooperation for patients with severe aortic stenosis receiving transcatheter aortic valve replacement using balloon-expandable aortic valve stent%球扩式主动脉瓣支架治疗严重主动脉瓣狭窄的手术配合

    Institute of Scientific and Technical Information of China (English)

    张峥; 高嵩芹; 王馨; 毛燕君


    Objective To discuss the nursing cooperation for patients with severe aortic stenosis who are receiving transcatheter aortic valve replacement using balloon-expandable aortic valve stent. Methods Percutaneous interventional transcatheter aortic valve replacement was employed in 9 patients with severe aortic stenosis. Active preoperative preparation, sufficient psychological care, close observation of vital signs and effective surgery cooperation during the operation were carried out. The clinical results were analyzed. Results Successful operation was accomplished in all the nine patients. After the surgery, all patients were in good condition, and no nursing-related complications occurred. Conclusion Correct understanding of the cooperation with the procedure of transcatheter aortic valve replacement using balloon-expandable aortic valve stent, excellent preoperative psychological care and active preoperative preparation, etc. are the most important things to ensure a successful surgery.%目的:探讨球扩式主动脉瓣支架经导管治疗主动脉瓣狭窄的手术配合方法。方法对9例严重退行性主动脉瓣狭窄患者行经导管介入手术治疗,积极术前准备,充分的心理护理,术中密切观察生命体征,积极配合手术。结果9例手术均顺利完成,患者术后生存良好,无护理相关并发症。结论介入手术室护士正确掌握经导管主动脉瓣膜置换术的手术配合方法,术前做好患者的心理护理以及各项术前准备,术中与医师密切配合,是手术成功的保证。

  2. Percutaneous Balloon Angioplasty for Severe Native Aortic Coarctation in Young Infants Less Than 6 Months: Medium-to Long-term Follow-up

    Institute of Scientific and Technical Information of China (English)

    Lan He; Fang Liu; Lin Wu; Chun-Hua Qi; Li-Feng Zhang; Guo-Ying Huang


    Background:Although balloon angioplasty (BA) has been performed for more than 20 years,its use as a treatment for native coarctation of the aorta (CoA) during childhood,especially in young infants,remains controversial.This study aimed to assess the effects and potential role of percutaneous transcatheter BA for native CoA as an alternative therapy to surgical repair in young infants.Methods:The 37 patients aged from 6 days to 6 months with severe CoA in congestive heart failure or circulatory shock were admitted for BA.Patient's weight ranged from 2.4 to 6.1 kg.All 37 patients were experiencing cardiac dysfunction,and eight patients were in cardiac shock with severe metabolic acidosis.Eleven patients had an isolated CoA,whereas the others had a CoA associated with other cardiac malformations.Cardiac catheterization and aortic angiography were performed under general anesthesia with intubation.Transfemoral arterial approaches were used for the BA.The size of the balloon ranged from 3 mm × 20 mm to 8 mm × 20 mm,and a coronary artery balloon catheter was preferred over a regular peripheral vascular balloon catheter.Results:The femoral artery was successfully punctured in all but one patient,with that patient undergoing a carotid artery puncture.The systolic peak pressure gradient (PG) across the coarctation was 41.0 ± 16.0 mmHg (range 13-76 mmHg).The mean diameter of the narrowest coarctation site was 1.7 ± 0.6 mm (range 0.5-2.8 mm).All patients had successful dilation;the PG significantly decreased to 13.0 ± 1 1.0 mmHg (range 0-40 mmHg),and the diameter of coarctation significantly improved to 3.8 ± 0.9 mm (range 2.5-5.3 mm).No intraoperative complications occurred for any patients.However,in one case that underwent a carotid artery puncture,a giant aneurysm formed at the puncture site and required surgical repair.The following observations were made during the follow-up period from 6-month to 7-year:(1) The PG across the coarctation measured by

  3. A Novel Fluoroscopy-free, Resuscitative Endovascular Aortic Balloon Occlusion System in a Model of Hemorrhagic Shock (United States)


    0.755 Female 8 ( 100 %) 8 ( 100 %) n/a Physiologic SBP , mm Hg 94 (37) 81 (10) 0.180 MAP, mm Hg 65.1 (10.4) 64.3 (6.4) 0.895 HR, beats/min 81 (8) 93 (13...CBS and PBS groups (35 [8] vs. 34 [5]; p = 0.89). Accurate balloon positioning and inflation occurred in 100 % of the CBS and 88% of the PBS group...main body was 100 cm, consisting of a semistiff 0.035-inch core wire extending 20 cm beyond the trail end of the device. The lead or insertion end

  4. Myxomavirus anti-inflammatory chemokine binding protein reduces the increased plaque growth induced by chronic Porphyromonas gingivalis oral infection after balloon angioplasty aortic injury in mice.

    Directory of Open Access Journals (Sweden)

    Alexandra R Lucas

    Full Text Available Thrombotic occlusion of inflammatory plaque in coronary arteries causes myocardial infarction. Treatment with emergent balloon angioplasty (BA and stent implant improves survival, but restenosis (regrowth can occur. Periodontal bacteremia is closely associated with inflammation and native arterial atherosclerosis, with potential to increase restenosis. Two virus-derived anti-inflammatory proteins, M-T7 and Serp-1, reduce inflammation and plaque growth after BA and transplant in animal models through separate pathways. M-T7 is a broad spectrum C, CC and CXC chemokine-binding protein. Serp-1 is a serine protease inhibitor (serpin inhibiting thrombotic and thrombolytic pathways. Serp-1 also reduces arterial inflammation and improves survival in a mouse herpes virus (MHV68 model of lethal vasculitis. In addition, Serp-1 demonstrated safety and efficacy in patients with unstable coronary disease and stent implant, reducing markers of myocardial damage. We investigate here the effects of Porphyromonas gingivalis, a periodontal pathogen, on restenosis after BA and the effects of blocking chemokine and protease pathways with M-T7 and Serp-1. ApoE-/- mice had aortic BA and oral P. gingivalis infection. Arterial plaque growth was examined at 24 weeks with and without anti-inflammatory protein treatment. Dental plaques from mice infected with P. gingivalis tested positive for infection. Neither Serp-1 nor M-T7 treatment reduced infection, but IgG antibody levels in mice treated with Serp-1 and M-T7 were reduced. P. gingivalis significantly increased monocyte invasion and arterial plaque growth after BA (P<0.025. Monocyte invasion and plaque growth were blocked by M-T7 treatment (P<0.023, whereas Serp-1 produced only a trend toward reductions. Both proteins modified expression of TLR4 and MyD88. In conclusion, aortic plaque growth in ApoE-/- mice increased after angioplasty in mice with chronic oral P. gingivalis infection. Blockade of chemokines, but not

  5. 球扩式主动脉瓣腔内置换术治疗五例主动脉瓣狭窄经验%Balloon-dilated endovascular replacement of aortic valve for severe aortic stenosis: preliminary experience in five cases

    Institute of Scientific and Technical Information of China (English)

    陆清声; 洪毅; 吴宏; 王志农; 李卫萍; 张勇学; 李南; 马宇; 秦永文


    Objective To discuss the feasibility of balloon-dilated endovascular replacement of aortic valve for the treatment of severe aortic stenosis. Methods Five patients with severe aortic stenosis were selected for this study. Preoperative evaluation of these patients' clinical conditions indicated that these five patients were unable to tolerate a traditional open cardiovascular surgery. Via femoral artery access balloon-dilated endovascular replacement of aortic valve was carried out in all the five patients. The results were analyzed. Results The procedure was accomplished via femoral artery access in all the five patients. In one patient the operation was successfully finished with the auxiliary help of trans - cardiac apex puncturing. Technical success was achieved in all the five patients. After the operation the functioning of the aortic valve was greatly improved. Neither complications nor death occurred in all patients. Conclusion Balloon-dilated endovascular replacement of aortic valve can be safely used for the treatment of severe aortic stenosis in Chinese patients, although more strict preoperative preparation, precise evaluation and careful management during operation are demanded.%目的 探讨球扩式主动脉瓣腔内置换术治疗严重主动脉瓣狭窄患者的可行性.方法 选取5例术前评估无法耐受传统开放手术的严重主动脉钙化狭窄患者,行经股动脉球扩式主动脉瓣腔内置换术.结果 5例均经股动脉完成,其中1例经心尖穿刺辅助完成,5例手术全部成功,术后患者主动脉瓣功能显著改善,无并发症,无死亡.结论 球扩式主动脉瓣腔内置换术可用于严重主动脉瓣狭窄患者,但在术前准备、评估、术中操作等方面提出了更高的要求.

  6. A two years outcome analysis of patients on intra-aortic balloon pump in a tertiary care center

    Directory of Open Access Journals (Sweden)

    Bajan K


    Full Text Available AIMS: To analyze data of patients with IABP insertion with respect to severity of illness, complications and outcome. MATERIALS AND METHODS: A retrospective study conducted on 70 patients over 2 years. Patients were divided into Group 1, emergent insertion and Group 2, elective insertion. They were further analyzed for degree of cardiac dysfunction [ventricular performance assessed by 2-D echocardiography and dose of inotropes required], location [Intensive Care Unit (ICU, Operating Room (OR or Cath lab] and occurrence of complications [thrombocytopenia, worsening renal parameters, and thrombo-embolic phenomena]. RESULTS: 29 patients underwent emergent insertion and 41 patients had elective insertion. Indications were cardiogenic shock- 24 (34.28% patients; pulmonary edema 7 (10% patients; peri-operatively 29 (41.42%patients; and for cath lab support 10 (14%patients. Most of the patients were also on inotropes: dopamine=48(82.75%, epinephrine=40(68.96%, norepinephrine=7(12.06% and dobutamine=6(10.34%. Common complications noted were thrombocytopenia in 41 patients and azotemia in 30 patients. Three patients (37.5% required embolectomy and one later needed an amputation. Twenty three patients died . The mortality rate was highest in patients with an ejection fraction < 20% (71.42%. Mean duration of IABP was 60 hours. CONCLUSIONS: IABP was an effective tool for circulatory support for a range of indications.

  7. Pumpkin Balloon


    Nishimura, Jun; 西村, 純


    The Pumpkin shaped balloons, which are the extreme case of the heart-type balloons had been studied as one of the promising candidate of the super pressure balloons. Here, detailed studies for the features of the pumpkin balloons are described, particularly by comparing with those of the spherical shaped super pressure balloons.

  8. Subsidiary therapeutic efficacy of balloon pump support in rescuing patients with cardiogenic shock%球囊反搏术在心源性休克患者抢救中的辅助作用

    Institute of Scientific and Technical Information of China (English)

    侯毅; 马友妮


    目的 评价主动脉内球囊反搏术(IABP)在急性心肌梗死合并心源性休克患者抢救中的辅助作用.方法 将同一时期在我院进行抢救的72例急性心肌梗死合并心源性休克患者按照是否行急诊IABP循环支持治疗分为IABP组(36例)和对照组(36例),两组均行经皮冠状动脉介入治疗及常规用药治疗;比较两组患者术后1周、4周、3个月主要心血管不良事件(MACE)的发生率及术后1周的左心室功能.结果 两组患者术后的左心室功能和MACE发生率存在差异,IABP组术后1周的左心室功能明显优于对照组[(42.6±8.1)%vs(39.8±7.9)%,P<0.05],IABP组1周、4周和3个月的死亡率均低于对照组(30.6% vs 55.6%,38.9% vs 63.9%,47.2% vs 75.0%,均P<0.05).结论 主动脉内球囊反搏术在急性心肌梗死合并心源性休克患者抢救中能有效改善患者左心室功能及减少主要心血管不良事件的发生率,有效改善心源性休克患者的预后.%Objective To assess the subsidiary therapeutic efficacy of intra-aortic balloon pump (IABP) support in rescuing patients with acute myocardial infarction (AMI) complicated by cardiogenic shock (CS).Methods Thirty-six patients receiving emergency PCI with IABP support were enrolled as the IABP group,and 36 patients receiving emergency PCI without IABP support at the same time were selected as the control group.The rates of major adverse cardiac events (MACE) were evaluated in the two groups one week,4 weeks and 3 months after the operation,respectively.The left ventricular function was also evaluated.Results There was significant difference in the left ventricular function and the rates of MACE between the two groups.The left ventricular function in the first week of the IABP group was better than that in the control group [(42.6±8.1)% vs (39.8±7.9)%,P<0.05],and the mortality rates in the first week,the forth week and the third month of the LABP group were lower than those

  9. Emergency Abdominal Aortic Aneurysm Repair in a Patient with Failing Heart: Axillofemoral Bypass Using a Centrifugal Pump Combined with Levosimendan for Inotropic Support

    Directory of Open Access Journals (Sweden)

    Pavel Michalek


    Full Text Available We describe the case of an 83-year-old patient requiring repair of a large symptomatic abdominal aortic aneurysm (AAA. The patient was known to have coronary artery disease (CAD with symptoms and signs of significant myocardial dysfunction, left-heart failure, and severe aortic insufficiency. The procedure was performed with the help of both mechanical and pharmacological circulatory support. Distal perfusion was provided by an axillofemoral bypass with a centrifugal pump, with dobutamine and levosimendan administered as pharmacological inotropic support. The patient's hemodynamic status was monitored with continuous cardiac output monitoring and transesophageal echocardiography. No serious circulatory complications were recorded during the perioperative and postoperative periods. This paper suggests a potential novel approach to combined circulatory support in patients with heart failure, scheduled for open abdominal aortic aneurysm repair.

  10. Development of a balloon volume sensor for pulsating balloon catheters. (United States)

    Nolan, Timothy D C; Hattler, Brack G; Federspiel, William J


    Helium pulsed balloons are integral components of several cardiovascular devices, including intraaortic balloon pumps (IABP) and a novel intravenous respiratory support catheter. Effective use of these devices clinically requires full inflation and deflation of the balloon, and improper operating conditions that lead to balloon under-inflation can potentially reduce respiratory or cardiac support provided to the patient. The goal of the present study was to extend basic spirographic techniques to develop a system to dynamically measure balloon volumes suitable for use in rapidly pulsating balloon catheters. The dynamic balloon volume sensor system (DBVSS) developed here used hot wire anemometry to measure helium flow in the drive line from console to catheter and integrated the flow to determine the volume delivered in each balloon pulsation. An important component of the DBVSS was an algorithm to automatically detect and adjust flow signals and measured balloon volumes in the presence of gas composition changes that arise from helium leaks occurring in these systems. The DBVSS was capable of measuring balloon volumes within 5-10% of actual balloon volumes over a broad range of operating conditions relevant to IABP and the respiratory support catheter. This includes variations in helium concentration from 70-100%, pulsation frequencies from 120-480 beats per minute, and simulated clinical conditions of reduced balloon filling caused by constricted vessels, increased driveline, or catheter resistance.

  11. Valve-in-valve implantation with a 23-mm balloon-expandable transcatheter heart valve for the treatment of a 19-mm stentless bioprosthesis severe aortic regurgitation using a strategy of "extreme" underfilling. (United States)

    Chevalier, Florent; Leipsic, Jonathon; Généreux, Philippe


    We report a case of valve-in-valve (ViV) implantation by transfemoral approach with a 23-mm balloon-expandable prosthesis inside a stentless 19-mm acutely degenerated bioprosthesis, using a strategy of "extreme" underfilling. A 74-year-old patient presented to our institution in cardiogenic shock. An initial transesophageal echocardiography (TEE) showed severe central aortic regurgitation (AR) due to a torn leaflet. She was deemed inoperable and considered for urgent transcatheter aortic valve replacement. Given the fairly small true internal diameter, a strategy of 3-cc underfilling of a 23-mm transcatheter heart valve (THV) was planned. However, the final implantation was performed with 5-cc underfilling due to the incapacity to deliver the entire amount of fluid contained in the inflation syringe. TEE guidance confirmed the successful positioning and deployment of the prosthesis, with no AR and a mean gradient of 25 mm Hg. While implantation of a smaller prosthesis (20 mm) was debated during the Heart Team discussion, the risk of valve embolization due to inadequate anchoring inside the stentless prosthesis led to the selection of a 23-mm THV. At 6-month follow-up, the patient was in NYHA class I, with no AR and a mean gradient of 28 mm Hg. We report for the first time the use of in vivo THV with 5-cc underfilling with no acute or short-term structural failure, and the first ViV implantation by transfemoral approach with a 23-mm balloon-expandable prosthesis inside a stentless 19-mm bioprosthesis. The current report presents the challenges related to ViV implantation inside a small stentless bioprosthesis and offers practical ways to overcome them. © 2014 Wiley Periodicals, Inc.


    Institute of Scientific and Technical Information of China (English)


    Objective To compare the effects of ouabain and digoxin on both the systolic blood pressure and sodium pump α-subunit isoforms gene expression in the aortic smooth muscle of rats. Methods Normal SpragueDawley rats were injected with ouabain (20μg·kg-1 ·d-1 ,i. p),digoxin (32 μg·kg-1 ·d-1,i. p)and normal saline once a day, respectively, and indirect systolic blood pressure was recorded once a week. Six weeks later,all the rats were killed and sodium pump α1-,α2-,and α3-subunit mRNA levels were detected in the aortic smooth muscle with reverse transcription polymerase chain reaction(RT-PCR) method. Results The systolic blood pressure of rats infused with ouabain increased significantly at the end of week 6 [132. 6± 9. 0 mmHg (1 mmHg = 0. 133 kPa)vs 115. 7±8.2mmHg, P <0. 01] ,while no difference of blood pressure was found between digoxin group and NS group (P>0.05).The expression of sodium pump α-subunit isoforms in aortic smooth muscle was regulated by either ouabain or digoxin:both ouabain and digoxin increased α1- and α3-subunit expression, α2-subunit decreased in digoxin group but unchanged in ouabain group. Conclusion These results suggest that both ouabain and digoxin could regulate sodium pump α-subunit isoform expression, which might be related to the physiological roles of endogenous ouabain and might be responsible for the difference between the pharmacological and toxicological effects of ouabain and digoxin,including their effects on blood pressure.

  13. Balloon valvuloplasty for congenital aortic valve stenosis in children%经皮球囊瓣膜成形术治疗儿童主动脉瓣狭窄的临床疗效观察

    Institute of Scientific and Technical Information of China (English)

    吴琳; 齐春华; 何岚; 刘芳; 陆颖; 黄国英


    Objective To evaluate the efficacy and safety of percutaneous balloon aortic valvuloplasty(PBAV) for congenital aortic valve stenosis in children.Method This is a retrospective clinical study including 14 children treated with PBAV for congenital aortic valve stenosis from October 2006 to December 2012 in our institute.During clinical follow-up,aortic residual stenosis and restenosis,left ventricular function and the procedure-related complications,including the approach artery injury,and aortic regurgitation were particularly assessed.Result A total of 14 patients consisting of 12 boys and 2 girls underwent the procedure,with mean age (17.1 ± 10.5) months (range from 8 days to 6 years) and the mean body weight (8.9 ± 5.5) kg (range from 1.9 kg to 23.0 kg).The indication for PBAV was a Doppler-derived peak instaneous gradient of ≥75 mmHg(1 mmHg =0.133 kPa) or a smaller gradient with signs of severe left ventricular dysfunction or left ventricular strain on the ECG.The mean ratio of balloon-annulus was 0.92 ± 0.09 (range from 0.75 to 1.09).The catheter-measured peak systolic valve gradient was successfully relieved in all the patients,decreasing from (69 ± 26) mmHg to (29 ± 13) mmHg immediately after balloon valvuloplasty (t =7.628,P =0.000).The Doppler-derived peak and mean gradient decreased from (95 ±21) mmHg and (50 ±7) mmHg to (49 ± 16) mmHg and (24 ± 11) mmHg,respectively(t =7.630,10.401 ; P =0.000,0.000).The mean follow-up period was 1 day to 61 months.At follow-up,2 patients (2/14,14%) underwent the second balloon valvuloplasty for the significant restenosis,and both showed successful relief of restenosis,however 1 patient required surgical Ross procedure due to significant recurrent systolic pressure gradient and moderate aortic regurgitation 4 years after the second balloon valvuloplasty.Among the 3 young infants who presented with congestive heart failure before intervention,1 died 1 day after the procedure,the other 2 patients had improved

  14. 新型带瓣膜主动脉瓣球囊扩张支架的研制及测试%A novel balloon-expandable valved stents for transcatheter aortic valve implantation: preparation and testing

    Institute of Scientific and Technical Information of China (English)

    陈翔; 谭洪文; 张志钢; 朱玉峰; 赵仙先; 秦永文; 马丽萍


    Objective To evaluate the functions of a new balloon-expandable valved stent for transcatheter aortic valve implantation and the delivery system,so as to provide evidence for future animal study.Methods A new tube-like balloonexpandable valved stent was designed and made of cobalt-base alloys.Bovine pericardium was sutured by hand into the stent to prepare valved aortic stent,which was placed on the instrument to test the pulsating flow and fatigue property of prosthetic valve.The valved stent,which was compressed on a balloon catheter and pulled into a delivery sheath,was placed in the native aortic valve of isolated goat heart via the ascending aorta,and water was injected into the ascending aorta by a silicon tube to evaluate the competence of the prosthetic heart valves.Results Plusating flow examination showed that the artificial valve opened and closed well,without noticeable reflow,and accorded with human physiology.The prosthetic heart valves also performed well in the testing of fatigue property.The valved stent could be stably placed in the native valves of goat heart by delivery sheath,and the prosthetic heart valves showed satisfactory function.Conclusion The aortic valved stent is welldesigned and has satisfactory function.It can be used for animal study of transcathetcr aortic valve implantation.%目的 通过体外测试评价新型带瓣膜主动脉瓣球囊扩张支架及输送装置的各项性能,为下一步动物体内实验提供依据.方法 支架材料采用钴基合金,设计成圆柱形网状结构.人工瓣膜取材于经处理的新鲜牛心包,将人工瓣膜缝合在支架上制成带瓣膜主动脉支架.使用人工心脏瓣膜脉动流测试仪和人工心脏瓣膜加速疲劳测试仪,分别对带瓣膜支架瓣叶材料脉动流和人工瓣膜耐疲劳情况进行测试.将带瓣膜支架压缩至自行研制的输送装置的球囊上,取离体羊心脏标本,经升主动脉将支架直视下置入

  15. Controlling methods of a newly developed extra aortic counter-pulsation device using shape memory alloy fibers. (United States)

    Hashem, Mohamed O; Yamada, A; Tsuboko, Y; Muira, H; Homma, D; Shiraishi, Y; Yambe, T


    Diastolic counter-pulsation has been used to provide circulatory augmentation for short term cardiac support. The success of intra-aortic balloon pump (IABP) therapy has generated interest in long term counter-pulsation strategies to treat heart failure patients. The authors have been developing a totally implantable extra aortic pulsation device for the circulatory support of heart failure patients, using 150 µm Ni-Ti anisotropic shape memory alloy (SMA) fibers. These fibers contract by Joule heating with an electric current supply. The special features of our design are as follow: non blood contacting, extra aortic pulsation function synchronizing with the native heart, a wrapping mechanical structure for the aorta in order to achieve its assistance as the aortomyoplsty and the extra aortic balloon pump. The device consisted of rubber silicone wall plates, serially connected for radial contraction. We examined the contractile function of the device, as well as it controlling methods; the phase delay parameter and the pulse width modulation, in a systemic mock circulatory system, with a pneumatically driven silicone left ventricle model, arterial rubber tubing, a peripheral resistance unit, and a venous reservoir. The device was secured around the aortic tubing with a counter-pulsation mode of 1:4 against the heartbeat. Pressure and flow waveforms were measured at the aortic outflow, as well as its driving condition of the contraction phase width and the phase delay. The device achieved its variable phase control for co-pulsation or counter-pulsation modes by changing the phase delay of the SMA fibers. Peak diastolic pressure significantly augmented, mean flow increased (p<0.05) according to the pulse width modulation. Therefore the newly developed extra aortic counter-pulsation device using SMA fibers, through it controlling methods indicated its promising alternative extra aortic approach for non-blood contacting cardiovascular circulatory support.

  16. Application of intra-aortic balloon counterpulsation in patients with acute myocardial infarction complicated right heart failure%主动脉内球囊反搏在急性心肌梗死并右心衰竭中的应用

    Institute of Scientific and Technical Information of China (English)

    张治平; 刘成伟; 吴明祥; 许志勇; 杨遇春; 陈国洪; 苏晞


    目的:探讨主动脉内球囊反搏(IABP)在急性心肌梗死并右心衰竭中应用的价值.方法:69例急性心肌梗死并心源性休克行IABP辅助循环治疗患者中急性右心衰竭12例(17.4%),回顾性分析此12例患者临床资料,病人年龄(64.1±9.7)岁,IABP辅助循环治疗时间15~288 h,(95±76)h,9例(75%)行经皮冠状动脉介入术(PCI).结果:12例患者住院期间主要并发症包括:出血3例(25%),肢体缺血1例(8.3%),急性肾功能衰竭2例(16.7%),多器官功能衰竭1例(8.3%).1例死于多器官功能衰竭,其余11例(91.7%)成功撤除IABP辅助循环,病情好转出院.结论:急性心肌梗死并严重右心衰竭死亡率高,在常规治疗疗效不佳时,主动脉内球囊反搏辅助循环治疗可能有益.%Objective: To study application of intra-aortic balloon pump (IABP) in patients with acute myocardial infarction (AMI) complicated right heart failure. Methods: There were 12 (17. 4%) cases with acute right heart failure among 69 patients with AMI complicated cardiogenic shock undergoing IABP auxiliary circulation treatment, clinical data of the 12 patients were retrospectively analyzed. Mean age of the 12 patients was (64. 1 ± 9. 7) yearsold, duration of auxiliary circulation treatment with IABP was 15~288 (95 ± 76) h. And there were nine (75%) patients undergoing percutaneous coronary intervention (PCI). Results: Main complications of 12 patients during admission included bleeding (n = 3, 25%), limb ischemia (n= 1, 8.3%), acute renal failure (n = 2, 16. 7%) and multi - organ failure (n = 1, 8. 3%). Except one case died from multi-organ failure, IABP was successfully removed in other 11 (91. 7%) patients and their condition improved, all discharged from hospital. Conclusion: There is high mortality rate in acute myocardial infarction complicated severe right heart failure. Intra-aortic balloon pump may be beneficial for treatment when effect of routine therapy is poor.

  17. 主动脉内球囊反搏术的工作原理及应用%Intra Aortic Balloon Counterpulsation work Principle and Application

    Institute of Scientific and Technical Information of China (English)



    目前,主动脉内球囊反搏术已广泛应用于急性心肌梗死、严重不稳定型心绞痛、急诊介入治疗并发的心源性休克、重度心力衰竭、外科手术后低心排血量综合征等的治疗中,在上述重症心血管疾病的救治中发挥着越来越重要的作用.%At present,the intra aortic baloon counterpulsation has been widely used in acute myocardial infarction, severe unstable angina,emergency interventional therapy in the treatment of complicated with cardiogenic shock,congestive heart failure,after surgical treatment of low cardiac output syndrome treated etc.,plays a more and more important role in the treatment of severecardiovascular in the disease.

  18. Aortic insufficiency (United States)

    ... page, please enable JavaScript. Aortic insufficiency is a heart valve disease in which the aortic valve does not close ... aortic insufficiency Images Aortic insufficiency References Carabello BA. Valvular heart disease. In: Goldman L, Schafer AI, eds. Goldman's Cecil ...

  19. Off-Pump Coronary Bypass Grafting Causing Stunned Myocardium

    Directory of Open Access Journals (Sweden)

    Feridoun Sabzi


    Full Text Available The term “stunned myocardium” refers to abnormalities in the myocardial function following reperfusion and is common in on-pump coronary artery bypass grafting (CABG and is exceedingly rare in off- pump CABG. A 53-year-old man presented with unstable angina due to the severe stenosis of the left anterior descending coronary artery (LAD and the obtuse marginal. Laboratory findings and Chest X-ray revealed nothing abnormal. The intraoperative course was uneventful. The patient left the operating room without any inotropic support. Six hours later, however, he developed low cardiac output .At exploration, cardiac tamponade was excluded and flowmetry showed that the graft had adequate function. Cardiac enzymes were normal. High-dose adrenalin and Dobutamine were administrated and an intra-aortic balloon pump was used. After hemodynamic stabilization, the patient left the Intensive Care Unit without an intra-aortic balloon pump and inotropic support. On the fifth postoperative day, coronary angiography showed patent grafts and correct anastomotic sites. On the seventh postoperative day, the akinetic lateral wall of the left ventricle changed to dyskinesia. Finally after hospital discharge on the thirtieth postoperative day, an echocardiogram showed normal left ventricular function without regional wall motion abnormalities

  20. PUMPS (United States)

    Thornton, J.D.


    A pump is described for conveving liquids, particure it is not advisable he apparatus. The to be submerged in the liquid to be pumped, a conduit extending from the high-velocity nozzle of the injector,and means for applying a pulsating prcesure to the surface of the liquid in the conduit, whereby the surface oscillates between positions in the conduit. During the positive half- cycle of an applied pulse liquid is forced through the high velocity nozzle or jet of the injector and operates in the manner of the well known water injector and pumps liquid from the main intake to the outlet of the injector. During the negative half-cycle of the pulse liquid flows in reverse through the jet but no reverse pumping action takes place.

  1. The role of resuscitative endovascular balloon occlusion of the aorta (REBOA) as an adjunct to ACLS in non-traumatic cardiac arrest: A review of key concepts, physiology, current evidence, and future directions. (United States)

    Daley, James; Morrison, Jonathan James; Sather, John; Hile, Lisa


    Non-traumatic cardiac arrest is a major public health problem that carries an extremely high mortality rate. If we hope to increase the survivability of this condition, it is imperative that alternative methods of treatment are given due consideration. Balloon occlusion of the aorta can be used as a method of circulatory support in the critically ill patient. Intra-aortic balloon pumps have been used to temporize patients in cardiogenic shock for decades. More recently, resuscitative endovascular balloon occlusion of the aorta (REBOA) has been utilized in the patient in hemorrhagic shock or cardiac arrest secondary to trauma. Aortic occlusion in non-traumatic cardiac arrest has the effect of reducing the vascular volume that the generated cardiac output is distributed across. This augments myocardial and cerebral perfusion, increasing the probability of a return to a good quality of life for the patient. This phenomenon has been the subject of numerous animal studies dating back to the early 1980s; however, the human evidence is limited to several small case series. Animal research has demonstrated improvements in cerebral and coronary perfusion pressure during ACLS that lead to statistically significant differences in mortality. Several case series in humans have replicated these findings, suggesting the efficacy of this procedure. The objectives of this review are to: 1) introduce the reader to REBOA 2) review the physiology of NTCA and examine the current limitations of traditional ACLS 3) summarize the literature regarding the efficacy and feasibility of aortic balloon occlusion to support traditional ACLS.

  2. Interventional treatment of common congenital heart diseases: the common view of Chinese medical experts.Part Four:Percutaneous balloon valvuloplasty for pulmonary and aortic valve stenosis%常见先天性心脏病介入治疗中国专家共识四、经皮球囊肺动脉瓣与主动脉瓣成形术

    Institute of Scientific and Technical Information of China (English)



    经皮球囊肺动脉瓣成形术已成为肺动脉瓣狭窄的首选治疗方法,先天性主动脉瓣狭窄亦可通过球囊扩张方法得到缓解.典型肺动脉瓣狭窄跨瓣压差≥ 40 mmHg,主动脉瓣狭窄跨瓣压差≥ 60 mmHg是球囊成形术的适应证.球囊成形术成功的关键在于谨慎选择合适的患者,熟练地掌握操作方法,严格挑选球囊的类型、大小和长度,避免损伤腱索和瓣膜周围组织.新生儿和婴幼儿的球囊扩张风险较大,要注意减少并发症的发生.%Percutaneous balloon valvuloplasty has become the treatment of first choice for pulmonary valve stenosis. Congenital aortic valve stenosis can also be relieved by percutaneous balloon dilatation.Percutaneous valvuloplasty is indicated for patients with isolated pulmonary valve stenosis when the transvalvular peak systolic pressure gradient is over 40 mmHg and for patients with aortic valve stenosis when the pressure gradient exceeds 60 mmHg. A careful selection of patients, standardized procedure,individualized selection of the balloon type , size and length, and careful avoidance of any damage to chorda tendineae and to surrounding tissue are keys to achieving a successful procedure. Balloon valvuloplasty should be selectively performed in new-born and in infant since complications of the procedure are inversely related to age. (J Intervent Radiol, 2011, 20: 253-260)

  3. Aortic dissection (United States)

    ... linked to aortic dissection include: Bicuspid aortic valve Coarctation (narrowing) of the aorta Connective tissue disorders (such ... failure Aneurysm Aortic insufficiency Blood clots Cardiac tamponade Coarctation of the aorta Hardening of the arteries High ...

  4. [Congenital aortic stenosis]. (United States)

    Yamaguchi, M


    Recent advances in and controversies concerning the management of children with congenital valvular aortic stenosis are discussed. In neonates with critical aortic stenosis, improved survival has recently been reported after surgical open valvotomy and balloon valvuloplasty, although it is difficult at this point to compare the results of the two procedures and determine their differential indications. Good results have also been achieved after extended aortic valvuloplasty for recurrent aortic stenosis and/or insufficiency, but the length of follow-up in these patients is still short. The technique first reported in 1991 for bilateral enlargement fo a small annulus permits the insertion of an aortic valve 3-4 sizes larger than the native annulus. It entails no risk of distorting the mitral valve, damaging the conduction system or important branches of the coronary arteries, or resulting in left ventricular dysfunction. The Ross procedure is now widely applied in the West, with reports of early mortality rates of less than 5% and event-free survival rates of 80-90% during follow-up of 4-8 years. Longer follow-up and continued careful evaluation are required to resolve the issue of possible dilatation and subsequent neoaortic valve dysfunction and pulmonary stenosis due to allograft degeneration after pulmonary autograft root replacement in children.

  5. Influence of cardiogenic shock with or without the use of intra-aortic balloon pump on mortality in patients with ST-segment elevation myocardial infarction

    Directory of Open Access Journals (Sweden)

    Jesper Khedri Jensen


    Conclusion: Patients with STEMI and cardiogenic shock had substantial short- and long-term mortality that may be improved with IABP implantation. More studies on use of IABP in such patients are warranted.

  6. Aortic Counterpulsation Therapy in Patients with Advanced Heart Failure: Analysis of the TBRIDGE Registry

    Directory of Open Access Journals (Sweden)

    Cristiano Guedes Bezerra


    Full Text Available Abstract Background: The use of aortic counterpulsation therapy in advanced heart failure is controversial. Objectives: To evaluate the hemodynamic and metabolic effects of intra-aortic balloon pump (IABP and its impact on 30-day mortality in patients with heart failure. Methods: Historical prospective, unicentric study to evaluate all patients treated with IABP betwen August/2008 and July/2013, included in an institutional registry named TBRIDGE (The Brazilian Registry of Intra-aortic balloon pump in Decompensated heart failure - Global Evaluation. We analyzed changes in oxygen central venous saturation (ScvO2, arterial lactate, and use of vasoactive drugs at 48 hours after IABP insertion. The 30-day mortality was estimated by the Kaplan-Meier method and diferences in subgroups were evaluated by the Log-rank test. Results: A total of 223 patients (mean age 49 ± 14 years were included. Mean left ventricle ejection fraction was 24 ± 10%, and 30% of patients had Chagas disease. Compared with pre-IABP insertion, we observed an increase in ScvO2 (50.5% vs. 65.5%, p < 0.001 and use of nitroprusside (33.6% vs. 47.5%, p < 0.001, and a decrease in lactate levels (31.4 vs. 16.7 mg/dL, p < 0.001 and use of vasopressors (36.3% vs. 25.6%, p = 0.003 after IABP insertion. Thirty-day survival was 69%, with lower mortality in Chagas disease patients compared without the disease (p = 0.008. Conclusion: After 48 hours of use, IABP promoted changes in the use of vasoactive drugs, improved tissue perfusion. Chagas etiology was associated with lower 30-day mortality. Aortic counterpulsation therapy is an effective method of circulatory support for patients waiting for heart transplantation.

  7. Obesity and gastric balloon

    Directory of Open Access Journals (Sweden)

    Mohammed I Yasawy


    Full Text Available Background: The obesity epidemic, which is among the most common nutritional disorders, is rising rapidly worldwide. It leads to several health problems such as metabolic disorders, stroke, and even cancer. Efforts to control obesity with exercise and diet have a limited value in obese patients and different approaches to do this have been tried. In this paper, we share our experience with bioenteric intragastric balloon (BIB in treating obesity: Its safety, tolerability, and its efficacy in weight reduction. Materials and Methods: From January 2009 to September 2012, a total of 190 gastric balloons was inserted on patients at the endoscopy unit in King Fahd Hospital of the University, Al-Khobar. This is an evaluation of the first 100 patients. All the patients had a body mass index of over 30 kg/m 2 and were within the age range of 17-55 with a mean age of 32 years. After consent, preballoon investigation tests and anesthesia evaluation, BIB was inserted under monitored anesthesia care sedation in the endoscopy suite. The balloon was filled with 500-700 mls of stained saline. All patients′ were given an analgesic and antiemetic for a week and antisecretory proton pump inhibitor′s for 6 months. Diet and the importance of the exercise were part of the preballoon insertion phase and protocol. The balloon was removed after 6-12 months. Results: The weight loss response to BIB in the 100 patients are classified into four groups: In the uncooperative, noncompliant patients - the maximum weight loss was 7 kg, while in the most compliant patients the weight loss reached up to 39 kg. In addition, there was significant improvement into diabetes mellitus, hypertension, dyslipidemia, and fatty liveras. Its safety and tolerability were extremely acceptable. Conclusion: Our data indicates that in well-selected patients, BIB is an effective device, which with minimum complications helps to achieve body weight loss and resolve many obesity related

  8. Proteção medular em cirurgia da aorta descendente com uso de "bio-pump" e exsangüinação controlada Spinal protection during descending aortic surgery

    Directory of Open Access Journals (Sweden)

    Henrique Murad


    Full Text Available Os autores utilizam como método de proteção medular em cirurgia de aorta descendente, circulação extracorpórea átrio esquerdo-femoral esquerda, com baixa dose de heparina (1 mg/kg, bomba centrífuga (bio-pump e exsangüinação controlada. Operaram 4 doentes com esta metodologia sem que houvesse mortalidade, paraplegia ou sangramento excessivo.The authors have used for spinal cord protection during descending aortic surgery, partial extracorporeal circulation from left atrium to left femoral artery, low dose of heparin (1 mg/kg, centrifugal pump (bio-pump and controlled exsanguination. They have operated upon with this methodology 4 patients without mortality, paraplegia or excessive bleeding.

  9. Vascular Rupture Caused by a Molding Balloon during Endovascular Aneurysm Repair: Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Hee Young; Do, Young Soo; Park, Hong Suk; Park, Kwang Bo [Dept. of Radiology, Samsugn Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Kim, Young Wook; Kim, Dong Ik [Dept. of Surgery, Samsugn Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)


    Endovascular aneurysm repair (EVAR) has been accepted as an alternative to traditional open surgery in selected patients. Despite the minimally invasiveness of this treatment, several complications may occur during or after EVAR. Complications include endoleak, aortic dissection, distal embolism, or iatrogenic injury to the access artery. However, there are few reports on the vascular rupture caused by a molding balloon during EVAR. We report two cases of infrarenal abdominal aortic aneurysms complicated by procedure-related aortic or iliac artery rupture by the molding balloon during EVAR. In our cases, we observed suddenly abrupt increase of the diameter of the endograft during balloon inflation, because we inflated the balloon rapidly. In conclusion, careful attention must be paid during inflation of the molding balloon to prevent vascular rupture.

  10. "I see the light!" trans-carotid balloon valvuloplasty in neonates and small infants utilizing continuous trans-esophageal echo guidance. (United States)

    Lucas, Victor


    Continuous echo guidance may add to the safety of neonatal aortic balloon valvuloplasty Trans-carotid access is an alternative route to aortic balloon valvuloplasty in neonates Proof of preferred procedure (surgical or catheter based), procedure setting, and access site remains elusive as the disease is infrequent and single center experience remains small.


    Institute of Scientific and Technical Information of China (English)


    @@ COARCTATION of the aorta (CoA) is a congenital heart defect involving a narrowing of the aorta. The narrowed segment called coarctation is most likely to happen in the segment just after the aortic arch. The narrowing can be removed by surgery or sometimes by a nonsurgical balloon dilation. However, aortic coarctation may recur even after successful surgery or balloon dilation. Fortunately, coarctation can now be treated with nonsurgical balloon dilation associated with implanting a stent using cardiac catheterization. Herein we reported our experience in a 19-year-old boy with CoA who underwent successful covered Cheatham-Platinum (CP) stent implantation for the coarctation.

  12. On-pump fibrillating heart mitral valve replacement with the SAPIEN™ XT transcatheter heart valve. (United States)

    Ferrari, Enrico; Niclauss, Lars; Locca, Didier; Marcucci, Carlo


    In some high-risk patients, standard mitral valve replacement can represent a challenging procedure, requiring a risky extensive decalcification of the annulus. In particular, high-risk redo patients and patients with a previously implanted transcatheter aortic valve, who develop calcific mitral disease, would benefit from the development of new, minimally invasive, transcatheter or hybrid techniques for mitral valve replacement. In particular, mixing transcatheter valve therapies and well-established minimally invasive techniques for mitral replacement or repair can help in decreasing the surgical risk and the technical complexity. Thus, placing transcatheter, balloon-expandable Sapien™ XT stent-valves in calcified, degenerated mitral valves through a right thoracotomy, a left atriotomy and on an on-pump fibrillating heart, represents an attractive alternative to standard surgery in redo patients, in patients with concomitant transcatheter aortic stent-valves in place and in patients with a high-risk profile. We describe this hybrid technique in detail.

  13. In vivo assessment of a new method of pulsatile perfusion based on a centrifugal pump. (United States)

    Herreros, Jesús; Ubilla, Matías; Berjano, Enrique J; Vila-Nuñez, Juan E; Páramo, José A; Sola, Josu; Mercé, Salvador


    The aim of this study was to assess platelet dysfunction and damage to organs after extracorporeal circulation using a pump based on a new method that adds a pulsatile flow to the continuous flow provided by a centrifugal pump. The continuous component of the total flow (2-3 L/min) is created by a Bio-Pump centrifugal pump, while the pulsatile component is created by the pulsating of an inner membrane pneumatically controlled by an intra-aortic counterpulsation balloon console (systolic volume of 37.5 mL in an asynchronous way with a frequency of 60 bpm). Six pigs were subjected to a partial cardiopulmonary bypass lasting 180 min and were sacrificed 60 min after extracorporeal circulation was suspended. The hematological study included the measurement of hematocrit, hemoglobin, leukocytes, and platelet function. The new pump did not significantly alter either platelet count or platelet function. In contrast, hematocrit and hemoglobin were significantly reduced during extracorporeal circulation (approximately 5% P = 0.011, and 2 g/dL P = 0.01, respectively). The leukocyte count during extracorporeal circulation showed a tendency to decrease, but this was not significant. In general, the short-term use of the new pump (4 h) did not cause any serious morphological damage to the heart, lung, kidney, or liver. The results suggest that the hemodynamic performance of the new pump is similar to a conventional centrifugal pump and could therefore be appropriate for use in extracorporeal circulation.

  14. Transcatheter aortic valve repair for management of aortic insufficiency in patients supported with left ventricular assist devices. (United States)

    Pal, Jay D; McCabe, James M; Dardas, Todd; Aldea, Gabriel S; Mokadam, Nahush A


    The development of new aortic insufficiency after a period of support with a left ventricular assist device can result in progressive heart failure symptoms. Transcatheter aortic valve repair can be an effective treatment in selected patients, but the lack of aortic valve calcification can result in unstable prostheses or paravalvular leak. We describe a technique of deploying a self-expanding CoreValve (Medtronic, Minneapolis, MN, USA) into the aortic annulus, followed by a balloon-expandable SAPIEN-3 (Edwards, Irvine, CA, USA).


    Institute of Scientific and Technical Information of China (English)



    [Objective] To investigate the aortic balloon counterpulsation combined with mechanical ventilation in treat-menl of acute myocardiaT infarction with cardiogenic shock. [Methods] From August 2010 to May 2011, 39 cases of acute myocardial infarction with cardiogenic shock in our department were treated, we combined aortic balloon counterpulsation and mechanical ventilation in their treatment, then retrospectively analyzed the clinical data of patients. [Results] 39 cases of a-cute myocardial infarction complicated by cardiogenic shock recovered and were discharged in 12 cases, the treatment efficiency was 30.8%; 27 vases died in the hospital, the mortality tale was 69.2%.Mean arterial pressure, arterial partial pressure of oxygen and pH of 12 recovered and discharged cases were significantly higher after treatment than those before treatment, but ceo- ■ tral venous pressure was significantly lower after treatment than that before treatment, with significant difference (P< 0.05).Tbe death causes of 27 patients included multiple organ failure in 16 cases, severe infection in 5 cases, ventricular septal perforation in 4 cases, papillary muscle rupture in 3 cases, left ventricular free wall rupture in 1 case. [Conclusion], The application of intra -aortic balloon counterpulsation combined with mechanical ventilation in treatment of acute myocardial infarction with cardiogenic shock has a certain effect, but the mortality rate is still high; multiple organ failure in acute myocardial infarction complicated by cardiogenic shock patients is the main cause of death.%[目的]探讨主动脉球囊反博联合机械通气治疗急性心肌梗死合并心源性休克的疗效.[方法] 2010年8月~2011年5月期间,某科共收治急性心肌梗死合并心源性休克患者39例,联合应用主动脉球囊反博与机械通气对他们进行治疗,现回顾分析上述患者的临床资料.[结果]① 39例急性心肌梗死合并心源性休克患者康复出院12

  16. The nursing of use breathing machine adjuvant therapy acute myocardial infarction complicated by cardiogenic shock after intra-aortic balloon counterpulsation.%主动脉球囊反搏术后应用呼吸机辅助治疗急性心肌梗死合并心源性休克患者的护理

    Institute of Scientific and Technical Information of China (English)



    目的:探讨主动脉球囊反搏术后应用呼吸机辅助治疗急性心肌梗死合并心源性休克患者的效果及护理方法.方法:回顾分析我院21例急性心肌梗死合并心源性休克患者主动脉球囊反搏术后应用呼吸机辅助治疗的护理措施.结果:急性心肌梗死合并心源性休克患者经过积极的抢救治疗,16例患者好转出院,3例患者抢救无效死亡,2例患者家属签字放弃抢救,自动出院.救治成功率为76.19%.结论:急性心肌梗死患者应用主动脉球囊反搏治疗具有良好的近期疗效,及时使用呼吸机辅助治疗,给予积极有效的预防治疗护理措施,能降低死亡率,提高救治成功率,促进患者康复.%Objective: To investigate the effect and nursing method of use breathing machine adjuvant therapy acute myocardial infarction( AMI) complicated by cardiogenic shock after intra - aortic balloon counterpulsation( IABP ) . Methods: Retrospective analyzed the nursing measures of 21 cases of myocardial infarction( AMI ) complicated by cardiogenic shock patients use intra - aortic balloon counterpulsation and breathing machine adjuvant therapy. Results:The patient of acute myocardial infarction( AMI) complicated by cardiogenic shock after the emergency treatment, 16 cases were cured, 3 cases were dead. , 2cases were amel iorated. The successful rate of rescue was 76.19%. Conclusion:IABP therapy for acute myocardial infarction patients have a good short -term curative effect, cardigenic shock is the severe complications of acute myocardial infarction( AMI), there was high morbidity, timely treatment by breathing machine and actively adopted effective measures can reduced mortality rate and improve the success rate, and will promote the patient soon to be restored to health.

  17. Aortic stenosis (United States)

    ... Images Aortic stenosis Heart valves References Carabello BA. Valvular heart disease. In: Goldman L, Schafer AI, eds. Goldman's Cecil ... ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/ ...

  18. Implantation of the CoreValve percutaneous aortic valve. (United States)

    Lamarche, Yoan; Cartier, Raymond; Denault, André Y; Basmadjian, Arsène; Berry, Colin; Laborde, Jean-Claude; Bonan, Raoul


    Surgical aortic valve replacement is the only recommended treatment for significant aortic valve stenosis. Percutaneous aortic valve replacement appears to be a novel option for high-risk patients. We report the implantation of the ReValving system (CoreValve, Paris, France) in a 64-year-old woman who was refused aortic valve replacement surgery for critical aortic stenosis and left ventricular dysfunction because of severe pulmonary fibrosis. After anesthesia, the patient was put on femorofemoral cardiopulmonary bypass, and underwent a balloon valvuloplasty with subsequent retrograde aortic valve replacement by the ReValving system. Transesophageal echocardiographic monitoring of the patient's hemodynamics showed immediate improvements of the valvular area and left ventricular ejection fraction and only traces of paravalvular leaks. The patient was easily weaned from ventilation and resumed activity soon after the surgery. A multidisciplinary approach is presently necessary to offer a reliable and safe procedure.

  19. Abdominal Aortic Aneurysm (AAA) (United States)

    ... News Physician Resources Professions Site Index A-Z Abdominal Aortic Aneurysm (AAA) Abdominal aortic aneurysm (AAA) occurs when atherosclerosis ... an abdominal aortic aneurysm treated? What is an abdominal aortic aneurysm? The aorta, the largest artery in the body, ...

  20. GHOST balloons around Antarctica (United States)

    Stearns, Charles R.


    The GHOST balloon position as a function of time data shows that the atmospheric circulation around the Antarctic Continent at the 100 mb and 200 mb levels is complex. The GHOST balloons supposedly follow the horizontal trajectory of the air at the balloon level. The position of GHOST balloon 98Q for a three month period in 1968 is shown. The balloon moved to within 2 deg of the South Pole on 1 October 1968 and then by 9 December 1968 was 35 deg from the South Pole and close to its position on 1 September 1968. The balloon generally moved from west to east but on two occasions moved in the opposite direction for a few days. The latitude of GHOST balloons 98Q and 149Z which was at 200 mb is given. Both balloons tended to get closer to the South Pole in September and October. Other GHOST balloons at the same pressure and time period may not indicate similar behavior.

  1. Neonate Aortic Stenosis: Importance of Myocardial Perfusion in Prognosis

    Directory of Open Access Journals (Sweden)

    Marco Aurélio Santos


    Full Text Available OBJECTIVE: To analyze our experience with percutaneous aortic balloon valvuloplasty in newborn infants with aortic stenosis, emphasizing the extraordinary importance of myocardial perfusion.METHODS: Over a 10-year-period, 21 neonates underwent percutaneous aortic balloon valvuloplasty. Age ranged from 2 to 27 days, weight ranged from 2.2 to 4.1 kg and 19 were males. All patients presented with congestive heart failure that could not be treated clinically. The onset of symptoms in the first week of life occurred in 9 patients considered as having critical aortic stenosis. Severe aortic stenosis occurred in 12 patients with the onset of symptoms in the second week of life.RESULTS: Mortality reached 100% in the patients with critical aortic stenosis. The procedure was considered effective in the 12 patients with severe aortic stenosis. Vascular complications included the loss of pulse in 12 patients and rupture of the femoral artery in 2 patients. Cardiac complications included acute aortic regurgitation in 2 patients and myocardial perforation in one. In an 8.2±1.3-year follow-up, 5 of the 12 patients died (2 patients due to septicemia and 3 patients due to congestive heart failure. Five of the other 7 patients underwent a new procedure and 2 required surgery.CONCLUSION: Percutaneous aortic valvuloplasty in neonates is not an effective procedure in the 1st week of life, because at this age the common presentation is cardiogenic shock. It is possible that, in those patients with critical aortic stenosis, dilation of the aortic valve during fetal life may change the prognosis of its clinical outcome.

  2. Clefting in pumpkin balloons (United States)

    Baginski, F.; Schur, W.

    NASA's effort to develop a large payload, high altitude, long duration balloon, the Ultra Long Duration Balloon, focuses on a pumpkin shape super-pressure design. It has been observed that a pumpkin balloon may be unable to pressurize into the desired cyclically symmetric equilibrium configuration, settling into a distorted, undesired stable state instead. Hoop stress considerations in the pumpkin design leads to choosing the lowest possible bulge radius, while robust deployment is favored by a large bulge radius. Some qualitative understanding of design aspects on undesired equilibria in pumpkin balloons has been obtained via small-scale balloon testing. Poorly deploying balloons have clefts, but most gores away from the cleft deploy uniformly. In this paper, we present models for pumpkin balloons with clefts. Long term success of the pumpkin balloon for NASA requires a thorough understanding of the phenomenon of multiple stable equilibria and means for quantitative assessment of measures that prevent their occurrence. This paper attempts to determine numerical thresholds of design parameters that distinguish between properly deploying designs and improperly deploying designs by analytically investigating designs in the vicinity of criticality. Design elements which may trigger the onset undesired equilibria and remedial measures that ensure deployment are discussed.

  3. Comparison of the Assisting Function Between a New Paraaortic Counterpulsation Device and Intraaortic Balloon Pump in Acute Severe Heart Failure in Sheep%新型主动脉旁与主动脉内球囊反搏对羊重度急性心力衰竭辅助的实验研究

    Institute of Scientific and Technical Information of China (English)

    张杰民; 刘晓程; 赵龙; 郭龙辉


    Objective To compare the assisting function between a new paraaortic counterpulsation device (PACD) and the intraaortic balloon pump (IABP) in acute severe heart failure in sheep. Methods Eight healthy adult small fat-tailed sheep were chosen in our study. The self-made PACD (with a stroke volume of 55 ml) was anastomosed to the descending aorta through a valveless graft, and an intraaortic balloon (with a stroke volume of 40 ml) was placed in the descending aorta for the purpose of counterpulsation assisting. Acute severe heart failure model was established by snaring coronary artery branches. The hemodynamic changes of both devices were recorded during,before and after the counterpulsation assisting. Results Eight heart failure sheep models were successfully set up.Cardiac output (CO), pulmonary capillary wedge pressure (PCWP), mean arterial pressure (MAP) and left ventricular end diastolic presssure (LVEDP) after the heart failure were significantly different compared with basic value (t= -8. 466, 34. 083, 25. 767, -5. 219, P=0. 000). After IABP and PACD assisting, the mean aortic diastolic pressure (MADP) didn't significantly or did increase (38. 34±7. 13 mm Hg vs. 38.42±6.81 mm Hg, P=0.418;38.34±7.13 mm Hg vs. 54.14± 10. 13 mm Hg, P=0. 001), and the degree of increasing between the two methods showed a significant difference (P = 0. 010); LVEDP didn't significantly decrease ( 7.43 ± 2. 54 mmHg vs. 7.32 ±2. 14 mm Hg, P=0. 498; 7.43±2.54 mm Hg vs. 6.53± 1.91 mm Hg, P=0. 821), and there was no significant difference between the two methods in the change (P=0. 651) ; the coronary sinus flow (CSF) didn't significantly or did increase (86.63±7.71 ml/min vs. 87. 04±6.53 ml/min, P=0. 981; 86.63±7. 71 ml/min vs. 110. 52±11. 03 ml/min, P=0.000), and there was a significant difference in the change of CSF between the two methods (P=0. 000). IABP didn' t significantly decrease the left carotid artery flow (LCAF) ( 131.07± 21.26 ml/min vs. 128.36±20.38 ml

  4. Bicuspid Aortic Valve (United States)


    aortic valvular disease, endocarditis, ascending aortic aneurysm and aortic dissection.1-4 There is also an association of BAV with coarctation of...for aortic aneurysm , patients with BAV appear to have additional risks for aortic disease. Nistri et al.12 reported significant aortic root...Congenital heart disease in patients with Turner’s syndrome. Italian study group for Turner syndrome (ISGTS). J Pediatr 1998; 133:688-692. 7. Schmid

  5. Aortic Stenosis. (United States)

    Bakaeen, Faisal G; Rosengart, Todd K; Carabello, Blase A


    This issue provides a clinical overview of aortic stenosis, focusing on screening, diagnosis, treatment, and practice improvement. The content of In the Clinic is drawn from the clinical information and education resources of the American College of Physicians (ACP), including MKSAP (Medical Knowledge and Self-Assessment Program). Annals of Internal Medicine editors develop In the Clinic in collaboration with the ACP's Medical Education and Publishing divisions and with the assistance of additional science writers and physician writers.

  6. Apical ballooning syndrome complicated by acute severe mitral regurgitation with left ventricular outflow obstruction – Case report

    Directory of Open Access Journals (Sweden)

    Celermajer David S


    Full Text Available Abstract Background Apical ballooning syndrome (or Takotsubo cardiomyopathy is a syndrome of transient left ventricular apical ballooning. Although first described in Japanese patients, it is now well reported in the Caucasian population. The syndrome mimicks an acute myocardial infarction but is characterised by the absence of obstructive coronary disease. We describe a serious and poorly understood complication of Takotsubo cardiomyopathy. Case Presentation We present the case of a 65 year-old lady referred to us from a rural hospital where she was treated with thrombolytic therapy for a presumed acute anterior myocardial infarction. Four hours after thrombolysis she developed acute pulmonary oedema and a new systolic murmur. It was presumed she had acute mitral regurgitation secondary to a ruptured papillary muscle, ischaemic dysfunction or an acute ventricular septal defect. Echocardiogram revealed severe mitral regurgitation, left ventricular apical ballooning, and systolic anterior motion of the mitral valve with significant left ventricular outflow tract gradient (60–70 mmHg. Coronary angiography revealed no obstructive coronary lesions. She had an intra-aortic balloon pump inserted with no improvement in her parlous haemodynamic state. We elected to replace her mitral valve to correct the outflow tract gradient and mitral regurgitation. Intra-operatively the mitral valve was mildly myxomatous but there were no structural abnormalities. She had a mechanical mitral valve replacement with a 29 mm St Jude valve. Post-operatively, her left ventricular outflow obstruction resolved and ventricular function returned to normal over the subsequent 10 days. She recovered well. Conclusion This case represents a serious and poorly understood association of Takotsubo cardiomyopathy with acute pulmonary oedema, severe mitral regurgitaton and systolic anterior motion of the mitral valve with significant left ventricular outflow tract obstruction. The

  7. A system for visualization and automatic placement of the endoclamp balloon catheter

    NARCIS (Netherlands)

    Furtado, H.; Stüdeli, T.; Sette, M.; Samset, E.; Gersak, B.


    The European research network "Augmented Reality in Surgery" (ARIS*ER) developed a system that supports minimally invasive cardiac surgery based on augmented reality (AR) technology. The system supports the surgical team during aortic endoclamping where a balloon catheter has to be positioned and ke

  8. Aortic valve bypass

    DEFF Research Database (Denmark)

    Lund, Jens T; Jensen, Maiken Brit; Arendrup, Henrik;


    In aortic valve bypass (AVB) a valve-containing conduit is connecting the apex of the left ventricle to the descending aorta. Candidates are patients with symptomatic aortic valve stenosis rejected for conventional aortic valve replacement (AVR) or transcatheter aortic valve implantation (TAVI...

  9. Successful rescue from cardiac arrest in a patient with postinfarction left ventricular blow-out rupture: "extra-pericardial aortic cannulation" for establishment total cardiopulmonary bypass. (United States)

    Ohira, Suguru; Yaku, Hitoshi; Nakajima, Shunsuke; Takahashi, Akihiko


    We report a quick and simple technique to establish cardiopulmonary bypass (CPB) in a left ventricular (LV) blow-out rupture. A 74-year-old woman with a diagnosis of acute myocardial infarction suddenly collapsed and lost consciousness. A venous-arterial extracorporeal membrane oxygenation (ECMO) device was inserted by femoral cannulation. Emergent median sternotomy was performed. The pericardium was not opened first, and the thymus was divided to expose the ascending aorta just above the pericardial reflection. After placing two purse-string sutures on the distal ascending aorta, a 7-mm aortic cannula (Terumo, Tokyo, Japan) was inserted. The pericardium was then incised. A large volume of blood was expelled from the pericardial space, and CPB was initiated with suction drainage. A two-stage venous drainage cannula was then inserted from the right atrial appendage without hemodynamic collapse. After cardiac arrest, closure of ruptured LV wall and concomitant coronary artery bypass grafting were performed. The patient was weaned from CPB with an intra-aortic balloon pump (IABP) and the previously inserted venous-arterial ECMO. Extra-pericardial aortic cannulation is an effective and reproducible method to prepare for CPB in emergent cases of LV rupture.

  10. Mars Solar Balloon Lander Project (United States)

    National Aeronautics and Space Administration — The Mars Solar Balloon Lander (MSBL) is a novel concept which utilizes the capability of solar-heated hot air balloons to perform soft landings of scientific...

  11. Venus Altitude Cycling Balloon Project (United States)

    National Aeronautics and Space Administration — The ISTAR Group ( IG) and team mate Thin Red Line Aerospace (TRLA) propose a Venus altitude cycling balloon (Venus ACB), an innovative superpressure balloon...

  12. On-Pump Beating Coronary Artery Bypass in High Risk Coronary Patients

    Directory of Open Access Journals (Sweden)

    Abbas Afrasiabirad


    Full Text Available Background: There are some conflicting results with Conventional Coronary Artery Bypass Grafts (CCABG with arrested heart in coronary high-risk patients. Moreover, performing off-pump CABG in these cases may be associated with serious complications. The objective of this study is to evaluate the efficacy of the on-pump beating CABG (OPBCABG in coronary high-risk patients in comparison with the conventional methods. Methods: In a prospective research study, 3000 off-pump CABG patients were considered during June 2003 to December 2011. Among these, 157 patients with one or more of the following risk factors were included for OPBCABG; severe left main stenosis, early post-acute myocardial infarction with ongoing chest pain, unstable angina, intractable ventricular arrhythmia, post complicated coronary intervention and severe left ventricular dysfunction. These patients were compared with 157 similar patients undergone CCABG with aortic cross clamp before 2003. Results: Preoperative patient characteristics revealed no significant differences between the two groups. The patients’ mean age and number of grafts were 57 years and 3 per patient respectively. Hospital mortality was 3.2% and 9% in OPBCABG and CCABG groups, respectively (P<0.001. Preoperative myocardial infarction, requirement of inotropic agents and intraaortic balloon pump, renal dysfunction and prolonged ventilation time were significantly higher in CCABG group. Conclusion: Our results suggest that OPBCABG is effective in coronary high-risk patients and significantly reduces mortality and the incidence of perioperative MI and other major complications.

  13. 冠状动脉支架植入术患者应用主动脉球囊反搏的护理查房%Coronary Stent Implantation in Patients With Aortic Balloon Pump in Nursing Rounds

    Institute of Scientific and Technical Information of China (English)

    练柳兰; 邓惠民; 谭慧文



  14. Desenvolvimento de um projeto para construção de bomba-balão para contrapulsação aórtica Development and construction of a balloon-pump for aortic counterpulsation


    Celso Luiz dos Reis; Paulo Roberto Barbosa Évora; José Carlos Franco Brasil; Paulo José de Freitas Ribeiro; Adonis Garcia Otaviano; Hércules Lisboa Bongiovani; Rúbio Bombonato; Marcus Antônio Ferez; Ricardo Nilsson Sgarbieri; Francisco Fernandes Moreira Neto; Almir Sales Pereira; Percival Gomes


    O presente trabalho tem por finalidade apresentar as etapas de um projeto para construção de uma bomba-balâo para contrapulsação aórtica. Desenvolveram-se três protótipos, sendo que os dois primeiros utilizavam ar comprimido e vácuo hospitalares para insuflação e deflação do cateter-balão. Esses dois protótipos apresentavam como diferenças fundamentais: o tipo de dispositivo que captava o sinal luminoso da onda R do ECG utilizado para a sincronização do bombeamento; o tipo de válvula solenóid...

  15. 主动脉球囊反搏术治疗急性心肌梗死并心源性休克的疗效观察%Aortic Balloon Pump Treatment of Acute Myocardial Infarction and Cardiogenic Shock Efficacy

    Institute of Scientific and Technical Information of China (English)

    邹琼辉; 新怡康; 马伟东


    Objective:To explore the application value of IABP combined with cardiogenic shock patients in the treatment of AMI.Method:Clinical data of patients with AMI complicated with cardiogenic shock in 25 cases with IABP in our hospital from 2011 January to 2012 December were treated in Department of Cardiology under the support of emergency PCI treatment.Patients after diagnosis,given all patients in the IABP placement in the cardiac catheterization laboratory,and coronary angiography,and interventional therapy.Result:All the patients after treatment,the clinical symptoms disappeared,blood pressure,heart rate,urine volume than before treatment was obviously improved,compared with preoperative,postoperative, results had significant difference(P<0.05),2 patients with postoperative complication,after symptomatic treatment improved,2 patients died,clinical efficiency was 92%.Conclusion:As far as possible application of IABP treatment should be conclusion patients with AMI complicated with cardiogenic shock.%  目的:探讨IABP术在AMI合并心源性休克患者救治中的应用价值。方法:选择笔者所在医院自2011年1月-2012年12月心内科收治的25例应用IABP支持下行急症PCI治疗的AMI合并心源性休克患者的临床资料。患者确诊后,给予全部患者于心导管室行IABP置入术,再行冠状动脉造影术,及介入治疗。结果:全部患者经治疗后,临床症状逐渐消失,血压、心率、尿量等均较治疗前得到明显改善,术前、术后对比,差异有统计学意义(P<0.05),2例患者术后合并并发症,经对症治疗后得到好转,2例患者死亡,临床有效率为92%。结论:AMI合并心源性休克患者应尽量应用IABP治疗。

  16. Impact of different aortic valve calcification patterns on the outcome of transcatheter aortic valve implantation: A finite element study. (United States)

    Sturla, Francesco; Ronzoni, Mattia; Vitali, Mattia; Dimasi, Annalisa; Vismara, Riccardo; Preston-Maher, Georgia; Burriesci, Gaetano; Votta, Emiliano; Redaelli, Alberto


    Transcatheter aortic valve implantation (TAVI) can treat symptomatic patients with calcific aortic stenosis. However, the severity and distribution of the calcification of valve leaflets can impair the TAVI efficacy. Here we tackle this issue from a biomechanical standpoint, by finite element simulation of a widely adopted balloon-expandable TAVI in three models representing the aortic root with different scenarios of calcific aortic stenosis. We developed a modeling approach realistically accounting for aortic root pressurization and complex anatomy, detailed calcification patterns, and for the actual stent deployment through balloon-expansion. Numerical results highlighted the dependency on the specific calcification pattern of the "dog-boning" of the stent. Also, local stent distortions were associated with leaflet calcifications, and led to localized gaps between the TAVI stent and the aortic tissues, with potential implications in terms of paravalvular leakage. High stresses were found on calcium deposits, which may be a risk factor for stroke; their magnitude and the extent of the affected regions substantially increased for the case of an "arc-shaped" calcification, running from commissure to commissure. Moreover, high stresses due to the interaction between the aortic wall and the leaflet calcifications were computed in the annular region, suggesting an increased risk for annular damage. Our analyses suggest a relation between the alteration of the stresses in the native anatomical components and prosthetic implant with the presence and distribution of relevant calcifications. This alteration is dependent on the patient-specific features of the calcific aortic stenosis and may be a relevant indicator of suboptimal TAVI results.

  17. Surgical versus percutaneous treatment of aortic coarctation: new standards in an era of transcatheter repair. (United States)

    Luijendijk, Paul; Bouma, Berto J; Groenink, Maarten; Boekholdt, Matthijs; Hazekamp, Mark G; Blom, Nico A; Koolbergen, Dave R; de Winter, Robbert J; Mulder, Barbara J M


    Aortic coarctation is a common congenital cardiovascular defect, which can be diagnosed over a wide range of ages and with varying degrees of severity. Surgery has proven to be an effective treatment for the management of native aortic coarctation, and remains the treatment of choice in neonates. Balloon angioplasty with or without stenting has evolved rapidly over the past decade. Balloon angioplasty is the treatment of choice in children with re-coarctation, and currently available immediate results in native coarctation are similar with regards to gradient reduction as compared with surgery. However, both treatment options carry the risk of restenosis and aortic wall complications, especially after balloon angioplasty without stenting in native coarctation. On the other hand, stent implantation has shown excellent short-term results in both children beyond infancy and in adults with native coarctation. In patients with recurrent coarctation who are at high surgical risk, balloon angioplasty and stent repair offer a less invasive and equally effective method. Stent repair is preferred over balloon angioplasty in adults and outgrown children with a recurrent coarctation, as the risk for re-coarctation and aneurysm formation seems to be lower. Data with regard to long-term outcome after percutaneous treatment strategies are scarce. This review summarizes the current insights in the efficacy and safety of both surgical and transcatheter treatment options for aortic coarctation.

  18. Early severe coronary artery disease and aortic coarctation in a child with familial hypercholesterolaemia. (United States)

    Labib, Dina; Soliman, Haytham; Said, Kareem; Sorour, Khaled


    An 11-year-old boy presented with easy fatigability, multiple xanthomas, and absent pedal pulsations. Laboratory workup showed severe hypercholesterolaemia and non-invasive imaging revealed 'normally functioning' bicuspid aortic valve and tight aortic coarctation. Coronary angiography showed severe right coronary artery (RCA) stenosis. Medical treatment resulted in significant improvement of dyslipidaemia. We successfully performed balloon dilation and stenting of his coarctation, as well as percutaneous coronary intervention for RCA lesion.

  19. Aortic Annular Enlargement during Aortic Valve Replacement

    Directory of Open Access Journals (Sweden)

    Selman Dumani


    Full Text Available In the surgery of aortic valve replacement is always attempted, as much as possible, to implant the larger prosthesis with the mains goals to enhance the potential benefits, to minimise transvalvular gradient, decrease left ventricular size and avoid the phenomenon of patient-prosthesis mismatch. Implantation of an ideal prosthesis often it is not possible, due to a small aortic annulus. A variety of aortic annulus enlargement techniques is reported to avoid patient-prosthesis mismatch. We present the case that has submitted four three times open heart surgery. We used Manouguian technique to enlarge aortic anulus with excellent results during the fourth time of surgery.

  20. The future of transcatheter aortic valve implantation. (United States)

    Hamm, Christian W; Arsalan, Mani; Mack, Michael J


    Since the introduction of transcatheter aortic valve implantation (TAVI) into clinical practice, the treatment of aortic stenosis has changed dramatically. In the past, medical therapy with or without balloon aortic valvuloplasty was the only option for inoperable patients. More recently, TAVI has become the treatment of choice for these patients and the preferred alternative for high-risk operable patients. Surgical aortic valve replacement (SAVR) currently remains the gold standard for patients at low or intermediate operative risk. As randomized trials have demonstrated comparable results between TAVI and SAVR in the high-risk population, there is now a clear trend towards performing TAVI even in intermediate-risk patients while awaiting the results of randomized trials in that population. Nevertheless, there are still questions regarding TAVI involving paravalvular leak (PVL), stroke, pacemaker requirements, and durability that remain to be more definitively answered before TAVI can routinely be performed in a broader, lower risk population. Improvements in patient selection, imaging, and second and third generation devices have decreased the incidence of PVLs and vascular complications that followed the earliest TAVI procedures, but the rates of perioperative stroke and permanent pacemaker implantation must still be addressed. Furthermore, the long-term durability of TAVI devices and a role for post-procedure antithrombotic management remain unanswered. Until these questions are more clearly answered, it is the Heart Team's task to determine the optimal treatment for each patient based on risk scores, frailty metrics, comorbidities, patient preference, and potential for improvement in quality of life.

  1. Aortic Balloon Occlusion is Effective in Controlling Pelvic Hemorrhage (United States)


    improvised explosive devices (IEDs) [6]. Frequently these patients have sustained bilateral high lower extremity amputations with pelvic disruption and...inal hemorrhage [16,17]. However, the technique was not recommended for practice because of the high incidence of hind limb paralysis in survived...injury patterns. Another limitation relates to the artificial nature of the induced coagulopathy. Specifically, the model of coagulop- athy in this

  2. The Inflammatory Sequelae of Aortic Balloon Occlusion in Hemorrhagic Shock (United States)


    prophylactically deliver an anti inflammatory perfusate such as a statin suspension [37]. 5. Conclusions The present study reaffirms that in severe...experimental model of ischemia reperfusion in the rat . J Pharmacol Sci 2006;102:413. j o u r n a l o f s u r g i c a l r e s e a r c h 1 9 1 ( 2 0 1 4 ) 4 2 3 4 3 1 431

  3. Aortic aneurysm repair - endovascular (United States)

    EVAR; Endovascular aneurysm repair - aorta; AAA repair - endovascular; Repair - aortic aneurysm - endovascular ... Endovascular aortic repair is done because your aneurysm is very large, growing quickly, or is leaking or bleeding. You may have ...

  4. Abdominal aortic aneurysm (United States)

    ... this page: // Abdominal aortic aneurysm To use the sharing features on this page, ... blood to the abdomen, pelvis, and legs. An abdominal aortic aneurysm occurs when an area of the aorta becomes ...

  5. Aortic growth rates in chronic aortic dissection

    Energy Technology Data Exchange (ETDEWEB)

    Kelly, A.M. [Department of Radiology, Division of Thoracic Radiology, University of Michigan Medical Center (United States)]. E-mail:; Quint, L.E. [Department of Radiology, Division of Thoracic Radiology, University of Michigan Medical Center (United States); Nan, B. [School of Public Health, University of Michigan, Ann Arbor, Michigan (United States); Zheng, J. [School of Public Health, University of Michigan, Ann Arbor, Michigan (United States); Cronin, P. [Department of Radiology, Division of Thoracic Radiology, University of Michigan Medical Center (United States); Deeb, G.M. [Division of Cardiac Surgery, University of Michigan Medical Center (United States); Williams, D.M. [Division of Vascular Interventional Imaging, University of Michigan Medical Center (United States)


    Aim: To determine and compare rates of descending aortic enlargement and complications in chronic aortic dissection with and without a proximal aortic graft. Methods and materials: Fifty-two patients with dissection involving the descending aorta and who had undergone at least two computed tomography (CT) examinations at our institution between November, 1993 and February, 2004 were identified, including 24 non-operated patients (four type A, 20 type B) and 28 operated patients (type A). CT examinations per patient ranged from two to 10, and follow-up ranged from 1-123 months (mean 49 months, median 38.5 months). On each CT image, the aortic short axis (SA), false lumen (FL), and true lumen (TL) diameters were measured at the longitudinal midpoint of the dissection and at the point of maximum aortic diameter. Complications were tabulated, including aortic rupture and aortic enlargement requiring surgery. Results: For non-operated patients, the midpoint and maximum point SA, TL, and FL diameters increased significantly over time. For operated patients, the midpoint and maximum point SA and FL diameters increased significantly over time. In both groups, aortic enlargement was predominantly due to FL expansion. Diameter increases in non-operated patients were significantly larger than those in operated patients. The rate of change in aortic diameter was constant, regardless of aortic size. Four non-operated and six operated patients developed aortic complications. Conclusions: In patients with a dissection involving the descending thoracic aorta, the FL increased in diameter over time, at a constant rate, and to a greater degree in non-operated patients (mostly type B) compared with operated patients (all type A)

  6. Space Weather Ballooning (United States)

    Phillips, Tony; Johnson, Sam; Koske-Phillips, Amelia; White, Michael; Yarborough, Amelia; Lamb, Aaron; Herbst, Anna; Molina, Ferris; Gilpin, Justin; Grah, Olivia; Perez, Ginger; Reid, Carson; Harvey, Joey; Schultz, Jamie


    We have developed a "Space Weather Buoy" for measuring upper atmospheric radiation from cosmic rays and solar storms. The Buoy, which is carried to the stratosphere by helium balloons, is relatively inexpensive and uses off-the-shelf technology accessible to small colleges and high schools. Using this device, we have measured two Forbush Decreases and a small surge in atmospheric radiation during the St. Patrick's Day geomagnetic storm of March 2015.

  7. Cleft formation in pumpkin balloons (United States)

    Baginski, Frank E.; Brakke, Kenneth A.; Schur, Willi W.

    NASA’s development of a large payload, high altitude, long duration balloon, the Ultra Long Duration Balloon, centers on a pumpkin shape super-pressure design. Under certain circumstances, it has been observed that a pumpkin balloon may be unable to pressurize into the desired cyclically symmetric equilibrium configuration, settling into a distorted, undesired state instead. Success of the pumpkin balloon for NASA requires a thorough understanding of the phenomenon of multiple stable equilibria and developing of means for the quantitative assessment of design measures that prevent the occurrence of undesired equilibrium. In this paper, we will use the concept of stability to classify cyclically symmetric equilibrium states at full inflation and pressurization. Our mathematical model for a strained equilibrium balloon, when applied to a shape that mimics the Phase IV-A balloon of Flight 517, predicts instability at float. Launched in Spring 2003, this pumpkin balloon failed to deploy properly. Observations on pumpkin shape type super-pressure balloons that date back to the 1980s suggest that within a narrowly defined design class of pumpkin shape super-pressure balloons where individual designs are fully described by the number of gores ng and by a single measure of the bulging gore shape, the designs tend to become more vulnerable with the growing number of gores and with the diminishing size of the bulge radius rB Weight efficiency considerations favor a small bulge radius, while robust deployment into the desired cyclically symmetrical configuration becomes more likely with an increased bulge radius. In an effort to quantify this dependency, we will explore the stability of a family of balloon shapes parametrized by (ng, rB) which includes a design that is very similar, but not identical, to the balloon of Flight 517. In addition, we carry out a number of simulations that demonstrate other aspects related to multiple equilibria of pumpkin balloons.

  8. Breakthrough in Mars balloon technology (United States)

    Kerzhanovich, V. V.; Cutts, J. A.; Cooper, H. W.; Hall, J. L.; McDonald, B. A.; Pauken, M. T.; White, C. V.; Yavrouian, A. H.; Castano, A.; Cathey, H. M.; Fairbrother, D. A.; Smith, I. S.; Shreves, C. M.; Lachenmeier, T.; Rainwater, E.; Smith, M.


    Two prototypes of Mars superpressure balloons were flight tested for aerial deployment and inflation in the Earth's stratosphere in June, 2002. One was an 11.3 m diameter by 6.8 m high pumpkin balloon constructed from polyethylene film and Zylon (PBO) tendons, the second was a 10 m diameter spherical balloon constructed from 12 μm thick Mylar film. Aerial deployment and inflation occurred under parachute descent at 34 km altitude, mimicing the dynamic pressure environment expected during an actual Mars balloon mission. Two on-board video cameras were used on each flight to provide real-time upward and downward views of the flight train. Atmospheric pressure and temperature were also recorded. Both prototypes successfully deployed from their storage container during parachute descent at approximately 40 m/s. The pumpkin balloon also successfully inflated with a 440 g charge of helium gas injected over a 1.5-min period. Since the helium inflation system was deliberately retained after inflation in this test, the pumpkin balloon continued to fall to the ocean where it was recovered for post-flight analysis. The less robust spherical balloon achieved only a partial (~70%) inflation before a structural failure occurred in the balloon film resulting in the loss of the vehicle. This structural failure was diagnosed to result from the vigorous oscillatory motion of the partially inflated balloon, possibly compounded by contact between the balloon film and an instrumentation box above it on the flight train. These two flights together represent significant progress in the development of Mars superpressure balloon technology and pave the way for future flight tests that will include post-deployment flight of the prototype balloons at a stable altitude.

  9. O uso do balão intra-aórtico no pré-operatório de cirurgia de revascularização miocárdica, associada à disfunção ventricular grave The use of preoperative intra-aortic balloon in myocardial revascularization surgery associated to severe ventricular dysfunction

    Directory of Open Access Journals (Sweden)

    Marcelo Kern


    Full Text Available OBJETIVO: Avaliar a efetividade do Balão Intra-Aórtico (BIAo profilático em cirurgia de revascularização miocárdica (CRM eletiva, para prevenir o infarto trans ou pós-operatório e para reduzir a mortalidade intra-hospitalar nos pacientes com baixa fração de ejeção ventricular esquerda. MÉTODOS: Em modelo de estudo de coorte, foram analisados 239 pacientes com fração de ejeção do ventrículo esquerdo inferior ou igual a 40%, submetidos à CRM eletiva com circulação extracorpórea (CEC, no período compreendido entre março de 1995 a fevereiro de 2001. RESULTADOS: Destes, 58 pacientes receberam BIAo pré-operatório e os demais foram operados sem assistência circulatória (grupo controle. Os dois grupos de pacientes tinham características semelhantes quanto a fatores associados aos desfechos em questão. Ocorreram 5 (8,6% óbitos no grupo com BIAo e 21 (11,6%, no grupo controle (diferença não-signifícativa. Ocorreram 2 (3,4% infartos no grupo com BIAo e 28 (15,5%, no grupo controle BIAo (p OBJECTIVE: To evaluate the effectiveness of prophylactic intra-aortic balloon (IAB in elective myocardial revascularization surgery (MRS, to prevent trans or post-operative infarction and reduce intra-hospital mortality in patients with low left ventricular ejection fraction. METHODS: Using a cohort study model, 239 patients with left ventricular ejection fraction <40%, submitted to elective MRS with extracorporeal circulation (ECC were evaluated from March 1995 to February 2001. RESULTS: Of these, 58 patients received preoperative IAB and the remainder underwent surgery without circulatory assistance (control group. The two groups of patients had similar characteristics regarding factors associated to the pertaining outcomes. There were five demises (8.6% in the group with IAB and 21 (11.6% in the control group (non-significant difference. There were 2 (3.4% infarctions in the IAB group and 28 (15.5% in the control group (p< 0

  10. Titan Balloon Convection Model Project (United States)

    National Aeronautics and Space Administration — This innovative research effort is directed at determining, quantitatively, the convective heat transfer coefficients applicable to a Montgolfiere balloon operating...

  11. Transcatheter therapy for aortic coarctation with severe systemic hypertension during pregnancy. (United States)

    Assaidi, Anass; Sbragia, Pascal; Fraisse, Alain


    Aortic coarctation is an unusual cause of hypertension during pregnancy and its management is not clarified. We report transcatheter balloon dilatation and stenting for native aortic coarctation in a 22-year-old pregnant woman with severe and uncontrolled systemic hypertension. Arterial blood pressure could be successfully controlled with medical treatment during the rest of the pregnancy and the patient underwent uneventful delivery. No adverse events or recoarctation was observed during 24 months clinical follow-up. In conclusion, native aortic coarctation can be successfully treated during pregnancy with transcatheter therapy. More experience is needed to confirm the safety and efficacy of such management.

  12. Endovascular treatment of acute type B dissection complicating aortic coarctation. (United States)

    Kassaian, Seyed Ebrahim; Abbasi, Kyomars; Mousavi, Mehdi; Sahebjam, Mohammad


    Surgical treatment poses a high risk to patients with concomitant aortic coarctation and dissection, and an interventional approach could be an alternative. We describe the case of a 52-year-old man with a long history of untreated hypertension and aortic coarctation who emergently presented at our institution with an acute Stanford type B dissection. The patient's elevated serum creatinine level, perfusion deficit in the right lower limb, and hypertension did not respond to medical therapy, and he did not consent to surgery. By endovascular means, we used a self-expandable stent-graft to cover the entry point of the dissection; then, we deployed a balloon-expandable bare-metal stent to correct residual stenosis. To our knowledge, this is the first report of the endovascular treatment of aortic coarctation complicated by type B dissection.

  13. Ruptured abdominal aortic aneurysm and aortoiliac vein fistula. (United States)

    Gyoten, Takayuki; Doi, Toshio; Yamashita, Akio; Fukahara, Kazuaki; Kotoh, Keiju; Yoshimura, Naoki


    A 67-year-old man was admitted with severe abdominal pain and back pain. Computed tomography showed an infrarenal abdominal aortic aneurysm (8.4 × 8.3 cm) and a large retroperitoneal hematoma. Immediately afterwards, the patient suffered circulatory collapse and was rushed to the operating theater. A fistula communicating with the left iliac vein was found. It was repaired with a Dacron patch while balloon-tipped catheters controlled the bleeding. The abdominal aortic aneurysm was replaced with a bifurcated graft. The postoperative course was uneventful. There have been few reports of successful repair of a ruptured abdominal aortic aneurysm associated with aortoiliac arteriovenous fistula.

  14. A Methane Balloon Inflation Chamber (United States)

    Czerwinski, Curtis J.; Cordes, Tanya J.; Franek, Joe


    The various equipments, procedure and hazards in constructing the device for inflating a methane balloon using a standard methane outlet in a laboratory are described. This device is fast, safe, inexpensive, and easy to use as compared to a hydrogen gas cylinder for inflating balloons.

  15. Nationwide Eclipse Ballooning Project (United States)

    Colman Des Jardins, Angela; Berk Knighton, W.; Larimer, Randal; Mayer-Gawlik, Shane; Fowler, Jennifer; Harmon, Christina; Koehler, Christopher; Guzik, Gregory; Flaten, James; Nolby, Caitlin; Granger, Douglas; Stewart, Michael


    The purpose of the Nationwide Eclipse Ballooning Project is to make the most of the 2017 rare eclipse event in four main areas: public engagement, workforce development, partnership development, and science. The Project is focused on two efforts, both student-led: online live video of the eclipse from the edge of space and the study of the atmospheric response to the eclipse. These efforts, however, involving more than 60 teams across the US, are challenging in many ways. Therefore, the Project is leveraging the NASA Space Grant and NOAA atmospheric science communities to make it a success. The first and primary topic of this poster is the NASA Space Grant supported online live video effort. College and high school students on 48 teams from 31 states will conduct high altitude balloon flights from 15-20 locations across the 8/21/2017 total eclipse path, sending live video and images from near space to a national website. Video and images of a total solar eclipse from near space are fascinating and rare. It’s never been done live and certainly not in a network of coverage across a continent. In addition to the live video to the web, these teams are engaged in several other science experiments as secondary payloads. We also briefly highlight the eclipse atmospheric science effort, where about a dozen teams will launch over one hundred radiosondes from across the 2017 path, recording an unprecedented atmospheric data sample. Collected data will include temperature, density, wind, humidity, and ozone measurements.

  16. Supravalvular aortic stenosis in adult with anomalies of aortic arch vessels and aortic regurgitation (United States)

    Valente, Acrisio Sales; Alencar, Polyanna; Santos, Alana Neiva; Lobo, Roberto Augusto de Mesquita; de Mesquita, Fernando Antônio; Guimarães, Aloyra Guedis


    The supravalvular aortic stenosis is a rare congenital heart defect being very uncommon in adults. We present a case of supravalvular aortic stenosis in adult associated with anomalies of the aortic arch vessels and aortic regurgitation, which was submitted to aortic valve replacement and arterioplasty of the ascending aorta with a good postoperative course. PMID:24598962

  17. Aortic Valvuloplasty as Bridging for TAVI in High-Risk Patients with Heyde’s Syndrome: A Case Report

    Directory of Open Access Journals (Sweden)

    Cosmo Godino


    Full Text Available There is a frequent association between aortic valve stenosis and gastrointestinal bleeding, also known as Heyde’s syndrome. In these patients, the aortic valve replacement should be recommended as “gold standard.” In high-surgical-risk patients, the Transcatheter Aortic Valve Implantation (TAVI is an alternative option. However, the risk of bleeding recurrence, related to double antiplatelet therapy started after TAVI, cannot be excluded especially in the first months. We present a case of a patient with a severe aortic valve stenosis and a history of previously documented angiodysplasia and recurrence of gastrointestinal bleeding initially treated only with balloon aortic valvuloplasty that excluded recurrence of bleeding during the subsequent six months of followup. Therefore, a definite transfemoral Edwards XT valve implantation was planned to be performed in case of recurrence of aortic stenosis.

  18. Correlation of Preoperative Renal Insufficiency With Mortality and Morbidity After Aortic Valve Replacement: A Propensity Score Matching Analysis (United States)

    Lin, Chun-Yu; Tsai, Feng-Chun; Chen, Yung-Chang; Lee, Hsiu-An; Chen, Shao-Wei; Liu, Kuo-Sheng; Lin, Pyng-Jing


    Abstract Preoperative end-stage renal disease carries a high mortality and morbidity risk after aortic valve replacement (AVR), but the effect of renal insufficiency remains to be clarified. Through propensity score analysis, we compared the preoperative demographics, perioperative profiles, and outcomes between patients with and without renal insufficiency. From August 2005 to November 2014, 770 adult patients underwent AVR in a single institution. Patients were classified according to their estimated glomerular infiltration rate (eGFR) as renal insufficiency (eGFR: 30–89 mL/min/1.73 m2) or normal (eGFR, ≥90 mL/min/1.73 m2). Propensity scoring was performed with a 1:1 ratio, resulting in a matched cohort of 88 patients per group. Demographics, comorbidities, and surgical procedures were well balanced between the 2 groups, except for diabetes mellitus and eGFR. Patients with renal insufficiency had higher in-hospital mortality (19.3% versus 3.4%, P 72 hour; 25% versus 9.1%, P = .008), intensive care unit stays (8.9 ± 9.9 versus 4.9 ± 7.5 days, P = .046), and hospital stays (35.3 ± 31.7 versus 24.1 ± 20.3 days, P = .008), compared with those with normal renal function. Multivariate analysis confirmed that preoperative renal insufficiency was an in-hospital mortality predictor (odds ratio, 2.33; 95% confidence interval, 1.343–4.043; P = .003), as were prolonged cardiopulmonary bypass time, intraaortic balloon pump support, and postoperative hemodialysis. The 1-year survival significantly differed between the 2 groups including (normal 87.5% versus renal insufficiency 67.9%, P < .001) or excluding in-hospital mortality (normal 90.7% versus renal insufficiency 82.1%, P = .05). Patients with preoperative renal insufficiency who underwent AVR had higher in-hospital mortality rates and increased morbidities, especially those associated with hemodynamic instabilities requiring intraaortic balloon pump support or

  19. Percutaneous balloon valvuloplasty in mitral stenosis

    Energy Technology Data Exchange (ETDEWEB)

    Park, Jae Hyung; Oh, Byung Hee; Park, Kyung Ju; Kim, Seung Hyup; Lee, Young Woo; Han, Man Chung [Seoul National University College of Medicine, Seoul (Korea, Republic of)


    Percutaneous balloon valvuloplasty(PBV) was successfully performed in 8 mitral stenosis patients for recent 3 months. Five patients have aortic insufficiencies also and two patients have mitral regurgitations below grade II/IV. All patients showed sinus rhythm on EKG, and had no mitral valvular calcification on echocardiography and fluoroscopy. PBV resulted in an increase in mitral valve area from 1.22{+-}0.22 to 2.57{+-}0.86 cm{sup 2}, a decrease in mean left atrial pressure from 23.4{+-}9.6 to 7.5{+-}3.4 mmHg and a decrease in mean mitral pressure gradient from 21.3{+-}9.4 to 6.8{+-}3.1 mmHg. There were no significant complications except 2 cases of newly appeared and mildly aggravated mitral regurgitation. We believe that PBV will become a treatment modality of choice replacing surgical commissurotomy or valve replacement in a group of mitral stenosis patients, because of its effectiveness and safety.

  20. US Air Force Balloon Observations (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Worksheets containing pilot balloon data computed from releases at Air Force stations in the western United States. Elevation and azimuth angles are used to compute...

  1. US Monthly Pilot Balloon Observations (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Monthly winds aloft summary forms summarizing Pilot Balloon observational data for the United States. Generally labeled as Form 1114, and then transitioning to Form...

  2. Superpressure Tow Balloon for Extending Durations and Modifying Trajectories of High Altitude Balloon Systems Project (United States)

    National Aeronautics and Space Administration — The proposed innovation involves the concept of using a Superpressure Tow Balloon (STB) with existing NASA high altitude balloon designs to form a tandem balloon...

  3. Off-Pump Repair of a Post Myocardial Infarction Ventricular Septal Defect

    Directory of Open Access Journals (Sweden)

    Feridoun Sabzi


    Full Text Available Refractory cardiogenic shock meant that traditional patch repairs requiring cardiopulmonary bypass would be poorly tolerated and external sandwich closure of post myocardial ventricular septal defect (VSD appears to be simple and effective after initial myocardial infarction (MI. The three cases presented with a VSD after of acute MI with or without thrombolysed with streptokinase during patient admission. The general condition of the three patients was poor with pulmonary edema, low cardiac output and renal failure. The heart was approached through a median sternotomy. Off-pump coronary artery bypass grafting of the coronary artery lesion was done first using octopus and beating heart surgery method and latero - lateral septal plication was performed using sandwich technique. Low cardiac output managed with intra-aortic balloon pump in these patients accompanied with inotropic drugs. Post-operative transesophageal echocardiography revealed that VSD was closed completely in one patient and in two patients small residual VSD remained. More experience is required to ascertain whether this technique will become an accepted alternative to patch repairs.

  4. Mycotic Saccular Abdominal Aortic Aneurysm in an Infant after Cardiac Catheterization: A Case Report. (United States)

    Benrashid, Ehsan; McCoy, Christopher C; Rice, Henry E; Shortell, Cynthia K; Cox, Mitchell W


    Abdominal aortic aneurysms (AAAs) are a rare entity in the pediatric population. Children with mycotic (infectious) AAA in particular are at risk of life-threatening rupture due to their rapid expansion coupled with aortic wall thinning and deterioration. Here, we present the case of a 10-month-old infant with prior 2-staged repair for hypoplastic left heart syndrome that was incidentally discovered to have a mycotic AAA on abdominal ultrasound (US) for evaluation of renovascular hypertension. Before the time of evaluation with US, the infant had developed methicillin-resistant Staphylococcus aureus bacteremia 3 days after cardiac catheterization with percutaneous thoracic aortic balloon angioplasty. She had normal aortic contours on contrasted computed tomography scan of the abdomen approximately 2 weeks before the aforementioned US evaluation. This infant subsequently underwent open aneurysmorrhaphy with cryopreserved vein patch angioplasty with resolution of her aneurysmal segment.

  5. Isoform-specific Regulation of Sodium pump α-subunit Gene Expression i n Aortic Smooth Muscle Cell of 1-kidney-1-clip Hypertensive Rats%“一肾一夹”高血压大鼠动脉平滑肌细胞钠泵α亚单位的基因表达

    Institute of Scientific and Technical Information of China (English)

    原卫清; 王颢; 吕卓人


    Objective To investigate the gene expression of sodium pump α-subunit in aortic smooth muscle of 1-kidney-1-clip (1k1c) hypertensive rats.  Methods 1k1c hypertensive rats were prepared by partially ligating the left renal artery and removing the right kidney. 4 weeks later, all the rats were killed and sodium pump α1- , α2-, and α3-subunit in aortic smooth muscles were detected with reverse transcription p ol ymerase chain reaction (RT-PCR) method and immunohistochemical assay at both mR NA and protein levels, respectively.  Resulsts Changes in the expression of sodi um pump α-subunit gene were found in aortic smooth muscles of 1k1c hypertensiv e rats: α1-su bunit increased at both mRNA protein levels, while α2- and α3-subunits r emained without changes.  Conclusions There were great changes in the gene expression of so dium pump α-subunit in aor tic smooth muscles of 1k1c hypertensive rats, which might be related to the development of hypertension in this hypertensive model.%目的 探讨“一肾一夹(1k1c)”高血压大鼠动脉平滑肌细胞钠泵α亚单位各异构体基 因表达的改变,为高血压发病机制的深入研究提供理论及实验依据。方法 分别应用分子生物学 RT-PCR及免疫组化技术,探讨1k1c高血压大鼠动脉平滑肌细胞钠泵α1、α2及α3亚单位mR NA及蛋白 水平基因表达的改变。结果 1k1c高血压大鼠动脉平滑肌细胞钠泵α亚单位基因表达发生改变: 无论在mRNA或蛋白水平,α1亚单位表达增强,而α2与α3亚单位表达无改变。结论 1k1c高血压大鼠动脉平滑肌细胞钠泵α亚单位基因表达发生改变,这种 改变可能参与了该模型的血压升高 机制。

  6. Sensor System for Super-Pressure Balloon Performance Modeling Project (United States)

    National Aeronautics and Space Administration — Long-duration balloon flights are an exciting new area of scientific ballooning, enabled by the development of large super-pressure balloons. As these balloons...

  7. Aortic Valve Disease (United States)

    ... that is safest for you based on your individual symptoms and circumstances. Recovery Recovery Most aortic valve ... is safe to do so. You should anticipate spending several days, but likely not more than a ...

  8. Bicuspid aortic valve (United States)

    ... aortic disease. In: Otto CM, Bonow RO, eds. Valvular Heart Disease: A Companion to Braunwald's Heart Disease . 4th ed. ... PA: Elsevier Saunders; 2014:chap 13. Carabello BA. Valvular heart disease. In: Goldman L, Schafer AI, eds. Goldman's Cecil ...

  9. Aortic Valve Regurgitation (United States)

    ... inside your heart that involves heart valves. Rheumatic fever. Rheumatic fever — a complication of strep throat and once a ... the United States — can damage the aortic valve. Rheumatic fever is still prevalent in developing countries but rare ...

  10. Aortic Valve Stenosis (United States)

    ... evaluation of aortic stenosis in adults. Accessed April 29, 2014. Mohty D, ... Valvular heart disease in elderly adults. Accessed May 2, 2014. Bonow RO, ...

  11. [Hemodynamic analysis of a centrifugal blood pump]. (United States)

    Wang, Yang; Yang, Ming; Xu, Zihao; Zhuang, Xiaoqi; Li, Qilei; Xu, Liang


    This paper built the mathematical model of a centrifugal blood pump, which was designed by ourselves, combined it with that of the human cardiovascular system and simulated the coupling system using Matlab. Then we set up the experiment platform, linked the blood pump to mock human cardiovascular system in case of three-stage heart failure, and measured aortic pressure and flow under different speed. The comparison between experiment results and simulation results not only indicates the coupling model is correct and the blood pump works well, but also shows that with the increase of blood pump speed, the pulsation of aortic pressure and flow will be reduced, this situation will affect the structure and function of blood vessels.

  12. Structure variations of pumpkin balloon (United States)

    Yajima, N.; Izutsu, N.; Honda, H.


    A lobed pumpkin balloon by 3-D gore design concept is recognized as a basic form for a super-pressure balloon. This paper deals with extensions of this design concept for other large pressurized membrane structures, such as a stratospheric airship and a balloon of which volume is controllable. The structural modifications are performed by means of additional ropes, belts or a strut. When the original pumpkin shape is modified by these systems, the superior characteristics of the 3-D gore design, incorporating large bulges with a small local radius and unidirectional film tension, should be maintained. Improved design methods which are adequate for the above subjects will be discussed in detail. Application for ground structures are also mentioned.

  13. Balloon Exoplanet Nulling Interferometer (BENI) (United States)

    Lyon, Richard G.; Clampin, Mark; Woodruff, Robert A.; Vasudevan, Gopal; Ford, Holland; Petro, Larry; Herman, Jay; Rinehart, Stephen; Carpenter, Kenneth; Marzouk, Joe


    We evaluate the feasibility of using a balloon-borne nulling interferometer to detect and characterize exosolar planets and debris disks. The existing instrument consists of a 3-telescope Fizeau imaging interferometer with 3 fast steering mirrors and 3 delay lines operating at 800 Hz for closed-loop control of wavefront errors and fine pointing. A compact visible nulling interferometer is under development which when coupled to the imaging interferometer would in-principle allow deep suppression of starlight. We have conducted atmospheric simulations of the environment above 100,000 feet and believe balloons are a feasible path forward towards detection and characterization of a limited set of exoplanets and their debris disks. Herein we will discuss the BENI instrument, the balloon environment and the feasibility of such as mission.

  14. Yellow Balloon in a Briar Patch. (United States)

    Cooper, Frank; Fitzmaurice, Robert W.


    As part of a meteorology unit, sixth grade science students launched helium balloons with attached return postcards. This article describes Weather Service monitoring of the balloons and postcard return results. (MA)

  15. Application of new balloon catheters in the treatment of congenital heart defects (United States)

    Fiszer, Roland; Szkutnik, Małgorzata; Smerdziński, Sebastian; Chodór, Beata; Białkowski, Jacek


    Introduction Balloon angioplasty (BAP) and aortic or pulmonary balloon valvuloplasty (BAV, BPV) are well-established treatment options in congenital heart defects. Recently, significant technological progress has been made and new catheters have been implemented in clinical practice. Aim To analyze the results of BAP, BAV and BPV with the new balloon catheter Valver and its second generation Valver II, which the company Balton (Poland) launched and developed. These catheters have not been clinically evaluated yet. Material and methods We performed 64 interventions with Valver I and Valver II. With Valver I the following procedures were performed: 17 BPV (including 9 in tetralogy of Fallot – TOF), 10 BAV and 27 BAP in coarctations of the aorta (CoA) – including 9 native and 18 after surgery. With Valver II ten interventions were done – 3 BPV, 2 pulmonary supravalvular BAP (after switch operations), 2 BAP of recoarctations and 3 other BAP. Age of the patients ranged from a few days to 40 years. Results All procedures were completed successfully, without rupture of any balloon catheters. The pressure gradient drop was statistically significant in all groups: BPV in isolated pulmonary valvular stenosis 28.1 mm Hg (mean), BPV in TOF 18.7 mm Hg, BAV 32.8 mm Hg, BAP in native CoA 15.4 mm Hg and in recoarctations 18.6 mm Hg. In 3 cases during rapid deflation of Valver I, wrinkles of the balloons made it impossible to insert the whole balloon into the vascular sheath (all were removed surgically from the groin). No such complication occured with Valver II. Conclusions Valver balloon catheters are an effective treatment modality in different valvular and vascular stenoses. PMID:27625686

  16. [Inflammatory abdominal aortic aneurysm]. (United States)

    Ziaja, K; Sedlak, L; Urbanek, T; Kostyra, J; Ludyga, T


    The reported incidence of inflammatory abdominal aortic aneurysm (IAAA) is from 2% to 14% of patients with abdominal aortic aneurysm and the etiology of this disease is still discussed--according to the literature several pathogenic theories have been proposed. From 1992 to 1997 32 patients with IAAA were operated on. The patients were mostly symptomatic--abdominal pain was present in 68.75% cases, back pain in 31.25%, fever in 12.5% and weight loss in 6.25% of the operated patients. In all the patients ultrasound examination was performed, in 4 patients CT and in 3 cases urography. All the patients were operated on and characteristic signs of inflammatory abdominal aortic aneurysm like: thickened aortic wall, perianeurysmal infiltration or retroperitoneal fibrosis with involvement of retroperitoneal structures were found. In all cases surgery was performed using transperitoneal approach; in three cases intraoperatively contiguous abdominal organs were injured, which was connected with their involvement into periaortic inflammation. In 4 cases clamping of the aorta was done at the level of the diaphragmatic hiatus. 3 patients (9.37%) died (one patient with ruptured abdominal aortic aneurysm). Authors present diagnostic procedures and the differences in the surgical tactic, emphasizing the necessity of the surgical therapy in patients with inflammatory abdominal aortic aneurysm.

  17. 穿透型胎盘植入行腹主动脉球囊置入的围术期管理1例%Perioperative management of abdominal aortic balloon occlusion in patients compli-cated with placenta percteta:a case report

    Institute of Scientific and Technical Information of China (English)

    曾鸿; 王妍; 王阳; 郭向阳


    SUMMARY When placenta previa complicated with placenta percreta, the exposure of operative field is difficult and the routine methods are difficult to effectively control the bleeding, even causing life-threatening results. A 31-year-old woman, who had been diagnosed with a complete type of placenta pre-via and placenta percreta with bladder invasion at 34 weeks gestation. Her ultrasound results showed a complete type of placenta previa and there was a loss of the decidual interface between the placenta and the myometrium on the lower part of the uterus, suggestive of placenta increta. For further evaluation of the placenta, pelvis magnetic resonance imaging was performed, which revealed findings suspicious of a placenta percreta. She underwent elective cecarean section at 36 weeks of gestation. Firstly, two ureteral stents were placed into the bilateral ureter through the cystoscope. After the infrarenal abdominal aorta catheter was inserted via the femoral artery ( 9 F sheath ) , subarachnoid anesthesia had been estab-lished. A healthy 2 510 g infant was delivered, with Apgar scores of 10 at 1 min and 10 at 5 min. Imme-diately after the baby was delivered, following which there was massive haemorrhage and general anaes-thesia was induced. The balloon catheter was immediately inflated until the wave of dorsal artery disap-peared. With the placenta retained within the uterus, a total hysterectomy was performed. The occluding time was 30 min. The intraoperative blood loss was 2 500 mL. The occluding balloon was deflated at the end of the operation. The patient had stable vital signs and normal laboratory findings during the recovery period and the hemoglobin was 116 g/L. She was discharged six days after delivery without intervention-related complications. This case illustrates that temporary occlusion of the infrarenal abdominal aorta using balloon might be a safe and effective treatment option for patients with placenta previa complicated with placenta percreta

  18. On-pump beating heart coronary surgery for high risk patients requiring emergency multiple coronary artery bypass grafting

    Directory of Open Access Journals (Sweden)

    von Segesser Ludwig K


    Full Text Available Abstract Background Cardiopulmonary bypass (CPB with aortic cross-clamping and cardioplegic arrest remains the method of choice for patients requiring standard myocardial revascularization. Therefore, very high-risk patients presenting with acute coronary syndrome, unstable angina, onset of cardiac decompensation and requiring emergency multiple myocardial revascularization, can have a poor outcome. The on-pump beating heart technique can reduce the mortality and the morbidity in such a selected group of patients and this report describes our clinical experience. Methods Out of 290 patients operated for CABG from January 2005 to January 2006, 25 (8.6% selected high-risk patients suffering from life threatening coronary syndrome (mean age 69 ± 7 years and requiring emergency multiple myocardial revascularization, underwent on-pump beating heart surgery. The mean pre-operative left ventricle ejection fraction (LVEF was 27 ± 8%. The majority of them (88% suffered of tri-vessel coronary disease and 6 (24% had a left main stump disease. Nine patients (35% were on severe cardiac failure and seven among them (28% received a pre-operative intra-aortic balloon pump. The pre-operative EuroScore rate was equal or above 8 in 18 patients (73%. Results All patients underwent on-pump-beating heart coronary revascularization. The mean number of graft/patient was 2.9 ± 0.6 and the internal mammary artery was used in 23 patients (92%. The mean CPB time was 84 ± 19 minutes. Two patients died during the recovery stay in the intensive care unit, and there were no postoperative myocardial infarctions between the survivors. Eight patients suffered of transitorily renal failure and 1 patient developed a sternal wound infection. The mean hospital stay was 12 ± 7 days. The follow-up was complete for all 23 patients survived at surgery and the mean follow-up time was 14 ± 5 months. One patient died during the follow-up for cardiac arrest and 2 patients required an

  19. Complications of balloon packing in epistaxis

    NARCIS (Netherlands)

    Vermeeren, Lenka; Derks, Wynia; Fokkens, Wytske; Menger, Dirk Jan


    Although balloon packing appears to be efficient to control epistaxis, severe local complications can occur. We describe four patients with local lesions after balloon packing. Prolonged balloon packing can cause damage to nasal mucosa, septum and alar skin (nasal mucosa, the cartilaginous skeleton

  20. Ballonnen in zee = balloons as marine litter

    NARCIS (Netherlands)

    Franeker, van J.A.


    Releasing balloons seems harmless. However, remains of balloons, especially valves and ribbons are becoming a common and persistent type of marine litter found on beaches. Following Dutch Queens day 2007, large numbers of Dutch balloons were found in Normandy, France. Animals may become entangled in

  1. Three-year-old child with middle aortic syndrome treated by endovascular stent implantation. (United States)

    Moszura, Tomasz; Goreczny, Sebastian; Dryzek, Pawel; Niwald, Marek


    Middle aortic syndrome (MAS) is an extremely rare anomaly and represents both a diagnostic and therapeutic challenge, particularly in young children. A case of a 3.5 year-old child with MAS and arterial hypertension is reported, where owing to the patient's young age and the length of the hypoplastic aortic segment, surgical correction with end-to-end anastomosis was not feasible. Instead of palliative bypass grafting between the thoracic and abdominal aorta, successful percutaneous balloon angioplasty and stenting of the lesion was performed with the assistance of three-dimensional rotational angiography.

  2. Aortic Wave Dynamics and Its Influence on Left Ventricular Workload (United States)

    Pahlevan, Niema; Gharib, Morteza


    Clinical and epidemiologic studies have shown that hypertension plays a key role in development of left ventricular (LV) hypertrophy and ultimately heart failure mostly due to increased LV workload. Therefore, it is crucial to diagnose and treat abnormal high LV workload at early stages. The pumping mechanism of the heart is pulsatile, thus it sends pressure and flow wave into the compliant aorta. The wave dynamics in the aorta is dominated by interplay of heart rate (HR), aortic rigidity, and location of reflection sites. We hypothesized that for a fixed cardiac output (CO) and peripheral resistance (PR), interplay of HR and aortic compliance can create conditions that minimize LV power requirement. We used a computational approach to test our hypothesis. Finite element method with direct coupling method of fluid-structure interaction (FSI) was used. Blood was assumed to be incompressible Newtonian fluid and aortic wall was considered elastic isotropic. Simulations were performed for various heart rates and aortic rigidities while inflow wave, CO, and PR were kept constant. For any aortic compliance, LV power requirement becomes minimal at a specific heart rate. The minimum shifts to higher heart rates as aortic rigidity increases.

  3. Experimental Study and Early Clinical Application Of a Sutureless Aortic Bioprosthesis

    Directory of Open Access Journals (Sweden)

    Walter J. Gomes


    Full Text Available ABSTRACT INTRODUCTION: The conventional aortic valve replacement is the treatment of choice for symptomatic severe aortic stenosis. Transcatheter technique is a viable alternative with promising results for inoperable patients. Sutureless bioprostheses have shown benefits in high-risk patients, such as reduction of aortic clamping and cardiopulmonary bypass, decreasing risks and adverse effects. OBJECTIVE: The objective of this study was to experimentally evaluate the implantation of a novel balloon-expandable aortic valve with sutureless bioprosthesis in sheep and report the early clinical application. METHODS: The bioprosthesis is made of a metal frame and bovine pericardium leaflets, encapsulated in a catheter. The animals underwent left thoracotomy and the cardiopulmonary bypass was established. The sutureless bioprosthesis was deployed to the aortic valve, with 1/3 of the structure on the left ventricular face. Cardiopulmonary bypass, aortic clamping and deployment times were recorded. Echocardiograms were performed before, during and after the surgery. The bioprosthesis was initially implanted in an 85 year-old patient with aortic stenosis and high risk for conventional surgery, EuroSCORE 40 and multiple comorbidities. RESULTS: The sutureless bioprosthesis was rapidly deployed (50-170 seconds; average=95 seconds. The aortic clamping time ranged from 6-10 minutes, average of 7 minutes; the mean cardiopulmonary bypass time was 71 minutes. Bioprostheses were properly positioned without perivalvar leak. In the first operated patient the aortic clamp time was 39 minutes and the patient had good postoperative course. CONCLUSION: The deployment of the sutureless bioprosthesis was safe and effective, thereby representing a new alternative to conventional surgery or transcatheter in moderate- to high-risk patients with severe aortic stenosis.

  4. Valvoplastia aórtica por cateter-balão em emergência materno-fetal na adolescência Valvuloplastia aórtica por catéter con balón en emergencia materno-fetal en la adolescencia Aortic valvuloplasty with balloon catheter in maternal-fetal emergency in adolescence

    Directory of Open Access Journals (Sweden)

    Walkiria Samuel Avila


    Full Text Available O aumento do débito cardíaco durante a gravidez é causa de insuficiência cardíaca em portadoras de estenose valvar aórtica grave. A valvoplastia aórtica percutânea tem sido associada a graves complicações e reestenose valvar em curto prazo. O presente caso mostrou que a valvoplastia aórtica percutânea permitiu o alcance do parto com sobrevida da mãe e do feto, e que a interrupção do tratamento no pós-parto resultou em morte materna no puerpério tardio.El aumento del gasto cardiaco durante el embarazo es la causa de insuficiencia cardiaca en portadoras de estenosis valvular aórtica severa. Se viene asociando la valvuloplastia aórtica percutánea a severas complicaciones y reestenosis valvular en corto plazo. El presente caso reveló que la valvuloplastia aórtica percutánea permitió el alcance del parto con sobrevida de la madre y del feto, y que la interrupción del tratamiento en el postparto resultó en muerte materna en el puerperio tardío.The increase of cardiac output during pregnancy is the cause of heart failure in women with severe aortic valvular stenosis. Percutaneous aortic valvuloplasty has been associated with severe complications and short-term valvar restenosis. This case showed that percutaneous aortic valvuloplasty allowed both mother and fetus to survive after childbirth, and that postpartum treatment interruption resulted in maternal death in late postpartum care.

  5. Pseudoperforation during kissing balloon angioplasty. (United States)

    Panetta, Carmelo J; Fasseas, Panayotis; Raveendran, Ganesh; Garratt, Kirk N


    We describe a case of apparent perforation during kissing balloon angioplasty of a bifurcation lesion. There was no evidence of perforation on follow-up angiography or via intravascular ultrasound. Possible etiologies include minimal perforation that immediately sealed postdeflation or forced contrast into the microvascular bed via a proximal side branch.

  6. Simulating clefts in pumpkin balloons (United States)

    Baginski, Frank; Brakke, Kenneth


    The geometry of a large axisymmetric balloon with positive differential pressure, such as a sphere, leads to very high film stresses. These stresses can be significantly reduced by using a tendon re-enforced lobed pumpkin-like shape. A number of schemes have been proposed to achieve a cyclically symmetric pumpkin shape, including the constant bulge angle (CBA) design, the constant bulge radius (CBR) design, CBA/CBR hybrids, and NASA’s recent constant stress (CS) design. Utilizing a hybrid CBA/CBR pumpkin design, Flight 555-NT in June 2006 formed an S-cleft and was unable to fully deploy. In order to better understand the S-cleft phenomenon, a series of inflation tests involving four 27-m diameter 200-gore pumpkin balloons were conducted in 2007. One of the test vehicles was a 1/3-scale mockup of the Flight 555-NT balloon. Using an inflation procedure intended to mimic ascent, the 1/3-scale mockup developed an S-cleft feature strikingly similar to the one observed in Flight 555-NT. Our analysis of the 1/3-scale mockup found it to be unstable. We compute asymmetric equilibrium configurations of this balloon, including shapes with an S-cleft feature.

  7. Stability of the pumpkin balloon (United States)

    Baginski, Frank

    A large axisymmetric balloon with positive differential pressure, e.g., a sphere, leads to high film stresses. These can be significantly reduced by using a lobed pumpkin-like shape re-enforced with tendons. A number of schemes have been proposed to achieve a cyclically symmetric pumpkin-shape at full inflation, including the constant bulge angle (CBA) design and the constant bulge radius (CBR) design. The authors and others have carried out stability studies of CBA and CBR designs and found instabilities under various conditions. While stability seems to be a good indicator of deployment problems for large balloons under normal ascent conditions, one cannot conclude that a stable design will deploy reliably. Nevertheless, stability analysis allows one to quantify certain deployment characteristics. Ongoing research by NASA's Balloon Program Office utilizes a new design approach developed by Rodger Farley, NASA/GSFC, that takes into account film and tendon strain. We refer to such a balloon as a constant stress (CS) pumpkin design. In June 2006, the Flight 555-NT balloon (based on a hybrid CBR/CBA design) developed an S-cleft and did not deploy. In order to understand the S-cleft phenomena and study a number of aspects related to the CS-design, a series of inflation tests were conducted at TCOM, Elizabeth City, NC in 2007. The test vehicles were 27 meter diameter pumpkins distinguished by their respective equatorial bulge angles (BA). For example, BA98 indicates an equatorial bulge angle of 98° . BA90, BA55, and BA00 are similarly defined. BA98 was essentially a one-third scale version of of the Flight 555 balloon (i.e., 12 micron film instead of 38.1 micron, mini-tendons, etc.). BA90 and BA55 were Farley CS-designs. BA00 was derived from the BA55 design so that a flat chord spanned adjacent tendons. In this paper, we will carry out stability studies of BA98, BA90, BA55, and BA00. We discuss the deployment problem of pumpkin balloons in light of 2007 inflation

  8. Screening for Abdominal Aortic Aneurysm (United States)

    Understanding Task Force Recommendations Screening for Abdominal Aortic Aneurysm The U.S. Preventive Services Task Force (Task Force) has issued a final recommendation statement on Screening for Abdominal Aortic Aneurysm. This final ...

  9. Abdominal aortic aneurysm repair - open (United States)

    ... this page: // Abdominal aortic aneurysm repair - open To use the sharing features on this page, please enable JavaScript. Open abdominal aortic aneurysm repair is surgery to fix a widened part ...

  10. Magnetic resonance imaging of coarctation of the aorta and postoperative interrupted aortic arch

    Energy Technology Data Exchange (ETDEWEB)

    Kakizawa, Hideyuki; Tanaka, Takashi; Takada, Osamu; Nakayama, Shingo; Ogata, Hiroshi; Zuguchi, Masayuki (Tohoku Univ., Sendai (Japan). School of Medicine)


    ECG-gated MRI was performed at 1.5 T on 9 patients with coarctation of the aorta and restensis of the aorta after previous aortoplasty for coarctation of the aorta or interrupted aortic arch. The age of the patients ranged from 7 days to 3.3 years. MRI was more useful in assessing the severity of stenosis than echocardiography. Four patients had balloon dilation angioplasty for restenosis of the aorta. MRI was also useful in deciding the appropriate balloon size for angioplasty, and follow up after treatment. However, MRI could not always visualize the whole lesion in one slice, especially when the course of the aortic arch was not on the same plane. (author).

  11. Direct transcatheter aortic valve implantation with self-expandable bioprosthesis: Feasibility and safety

    Energy Technology Data Exchange (ETDEWEB)

    Fiorina, Claudia, E-mail: [Cardiac Catheterization Laboratory, Cardiothoracic Department, Spedali Civili, Brescia (Italy); Maffeo, Diego; Curello, Salvatore [Cardiac Catheterization Laboratory, Cardiothoracic Department, Spedali Civili, Brescia (Italy); Lipartiti, Felicia [Division of Cardiology, Cardiothoracic Department, Spedali Civili, Brescia (Italy); Chizzola, Giuliano [Cardiac Catheterization Laboratory, Cardiothoracic Department, Spedali Civili, Brescia (Italy); D' Aloia, Antonio [Division of Cardiology, Cardiothoracic Department, Spedali Civili, Brescia (Italy); Adamo, Marianna [Cardiac Catheterization Laboratory, Cardiothoracic Department, Spedali Civili, Brescia (Italy); Mastropierro, Rosy [Division of Cardiothoracic Anestesiology, Cardiothoracic Department, Spedali Civili, Brescia (Italy); Gavazzi, Emanuele [Department of Radiology, University of Brescia, Spedali Civili, Brescia (Italy); Ciccarese, Camilla; Chiari, Ermanna [Division of Cardiology, Cardiothoracic Department, Spedali Civili, Brescia (Italy); Ettori, Federica [Cardiac Catheterization Laboratory, Cardiothoracic Department, Spedali Civili, Brescia (Italy)


    Background: Balloon valvuloplasty has been considered a mandatory step of the transcatheter aortic valve implantation (TAVI), although it is not without risk. The aim of this work was to evaluate the feasibility and safety of TAVI performed without pre-dilation (direct TAVI) of the stenosed aortic valve. Material and Methods: Between June 2012 and June 2013, 55 consecutive TAVI performed without pre-dilation at our institution using the self-expandable CoreValve prosthesis (Medtronic, Minneapolis, MN) were analyzed and compared with 45 pre-dilated TAVI performed the previous year. Inclusion criteria were a symptomatic and severe aortic stenosis. Exclusion criteria were defined as presence of pure aortic regurgitation, degenerated surgical bioprosthesis or bicuspid aortic valve and prior procedure of balloon aortic valvuloplasty performed as a bridge to TAVI. Results: High-burden calcification in the device landing zone, assessed by CT scan, was found in most of the patients. The valve size implanted was similar in both groups. Device success was higher in direct TAVI (85% vs. 64%, p = 0.014), mostly driven by a significant lower incidence of paravalvular leak (PVL ≥2; 9% vs. 33%, p = 0.02). Safety combined end point at 30 days was similar in both groups. Conclusion: Compared to TAVI with pre-dilation, direct TAVI is feasible regardless of the presence of bulky calcified aortic valve and the valve size implanted. Device success was higher in direct TAVI, mostly driven by a lower incidence of paravalvular leak. Safety at 30 days was similar in two groups.

  12. Centrifugal pumps

    CERN Document Server

    Anderson, HH


    Centrifugal Pumps describes the whole range of the centrifugal pump (mixed flow and axial flow pumps are dealt with more briefly), with emphasis on the development of the boiler feed pump. Organized into 46 chapters, this book discusses the general hydrodynamic principles, performance, dimensions, type number, flow, and efficiency of centrifugal pumps. This text also explains the pumps performance; entry conditions and cavitation; speed and dimensions for a given duty; and losses. Some chapters further describe centrifugal pump mechanical design, installation, monitoring, and maintenance. The

  13. Pumping life

    DEFF Research Database (Denmark)

    Sitsel, Oleg; Dach, Ingrid; Hoffmann, Robert Daniel


    of membrane proteins: P-type ATPase pumps. This article takes the reader on a tour from Aarhus to Copenhagen, from bacteria to plants and humans, and from ions over protein structures to diseases caused by malfunctioning pump proteins. The magazine Nature once titled work published from PUMPKIN ‘Pumping ions......’. Here we illustrate that the pumping of ions means nothing less than the pumping of life....

  14. Aortic valve replacement

    DEFF Research Database (Denmark)

    Kapetanakis, Emmanouil I; Athanasiou, Thanos; Mestres, Carlos A;


    mortality were collected. Group analysis by patient geographic distribution and by annular diameter of the prosthesis utilized was conducted. Patients with a manufacturer's labeled prosthesis size > or = 21 mm were assigned to the 'large' aortic size subset, while those with a prosthesis size ... assigned to the 'small' aortic size subset. Effective orifice area indices were calculated for all patients to assess the geographic distribution of patient-prosthesis mismatch. Univariable and multivariable logistic regression analyses adjusting for possible confounding variables were performed. RESULTS...... differences in the distribution of either gender or BSA. In the multivariable model, south European patients were seven times more likely to receive a smaller-sized aortic valve (OR = 6.5, 95% CI = 4.82-8.83, p

  15. Robotic aortic surgery. (United States)

    Duran, Cassidy; Kashef, Elika; El-Sayed, Hosam F; Bismuth, Jean


    Surgical robotics was first utilized to facilitate neurosurgical biopsies in 1985, and it has since found application in orthopedics, urology, gynecology, and cardiothoracic, general, and vascular surgery. Surgical assistance systems provide intelligent, versatile tools that augment the physician's ability to treat patients by eliminating hand tremor and enabling dexterous operation inside the patient's body. Surgical robotics systems have enabled surgeons to treat otherwise untreatable conditions while also reducing morbidity and error rates, shortening operative times, reducing radiation exposure, and improving overall workflow. These capabilities have begun to be realized in two important realms of aortic vascular surgery, namely, flexible robotics for exclusion of complex aortic aneurysms using branched endografts, and robot-assisted laparoscopic aortic surgery for occlusive and aneurysmal disease.

  16. Scientific ballooning in India: recent developments (United States)

    Joshi, M. N.; Damle, S. V.

    The National Scientific Balloon Facility (NBF) of the Tata Institute of Fundamental Research (TIFR) has been conducting regular balloon flights for various experiments in the areas of Space Astronomy and Atmospheric Sciences. A continuous improvement in all aspects of Scientific Ballooning through a sustained R and D programme ensures uptodate services and a better handle on the design specifications for the balloon. Recent developments in balloon grade films, continuous improvements in design specifications, balloon manufacturing methods, flight operational procedures and improved balloon flight capabilities have resulted in a greatly improved flight performance in the last five years. A launch capability upgradation programme in terms of new launch spool and new launch vehicle has been initiated to be able to safely launch balloons with gross lifts upto 3500 kg, balloon volumes upto 450,000 m^3 and payloads upto 1400 kg. A series of steps have been initiated to improve long duration flight capabilities. In this paper, we present details on some of these aspects of Scientific Ballooning in India.

  17. Viscoelastic behaviour of pumpkin balloons (United States)

    Gerngross, T.; Xu, Y.; Pellegrino, S.


    The lobes of the NASA ULDB pumpkin-shaped super-pressure balloons are made of a thin polymeric film that shows considerable time-dependent behaviour. A nonlinear viscoelastic model based on experimental measurements has been recently established for this film. This paper presents a simulation of the viscoelastic behaviour of ULDB balloons with the finite element software ABAQUS. First, the standard viscoelastic modelling capabilities available in ABAQUS are examined, but are found of limited accuracy even for the case of simple uniaxial creep tests on ULDB films. Then, a nonlinear viscoelastic constitutive model is implemented by means of a user-defined subroutine. This approach is verified by means of biaxial creep experiments on pressurized cylinders and is found to be accurate provided that the film anisotropy is also included in the model. A preliminary set of predictions for a single lobe of a ULDB is presented at the end of the paper. It indicates that time-dependent effects in a balloon structure can lead to significant stress redistribution and large increases in the transverse strains in the lobes.

  18. Simulation study and function analysis of the dynamic aortic valve

    Institute of Scientific and Technical Information of China (English)

    XIA Dongdong; BAI Jing


    The dynamic aortic valve (DAV) is a new left ventricular assist device, a micro-axial blood pump implemented at the position of the aortic valve, pumping blood from the left ventricle into the aortic artery. The present dynamic aortic valve operates at 7 different rotation speeds, ranging from 3000 r/min (speed 1) to 9000 r/min (speed 7). Because in vivo experiments need a lot of live animals and take a long period of time, modeling and simulation have been widely used to simulate and analyze hydra-dynamic property of the DAV and its assisting effects. With the measurements from the mock circulatory loop, a mathematic model of the DAV is established and embedded into the previously developed canine circulatory system. Using this model, the effect of the DAV on the failing heart at each rotation speed level is investigated. The vital cardiac variables are computed and compared with in vivo experimental results, which are in good agreement with an acceptable difference mostly 15 %. The establishment of the DAV model and its simulation are useful for further improvement of the DAV device.


    Directory of Open Access Journals (Sweden)

    Beenish A. Majeed


    Full Text Available The immune system is suggested to be essential in vascular remodeling and stiffening. To study the dependence upon lymphocytes in vascular stiffening, we compared an angiotensin II-model of vascular stiffening in normal C57BL/6J mice with lymphocyte-deficient RAG 1-/- mice and additionally characterized the component of vascular stiffness due to vasoconstriction versus vascular remodeling. Chronic angiotensin II increased aortic pulse wave velocity, effective wall stiffness, and effective Young’s modulus in C57BL/6J mice by 3-fold but caused no change in the RAG 1-/- mice. These functional measurements were supported by aortic morphometric analysis. Adoptive transfer of CD4+ T helper lymphocytes restored the angiotensin II-mediated aortic stiffening in the RAG 1-/- mice. In order to account for the hydraulic versus material effects of angiotensin II on pulse wave velocity, subcutaneous osmotic pumps were removed after 21 days of angiotensin II-infusion in the WT mice to achieve normotensive values. The pulse wave velocity decreased from 3- to 2-fold above baseline values up to 7 days following pump removal. This study supports the pivotal role of the CD4+ T-lymphocytes in angiotensin II-mediated vascular stiffening and that angiotensin II-mediated aortic stiffening is due to the additive effect of active vascular smooth muscle vasoconstriction and vascular remodeling.

  20. Unoperated aortic aneurysm

    DEFF Research Database (Denmark)

    Perko, M J; Nørgaard, M; Herzog, T M;


    From 1984 to 1993, 1,053 patients were admitted with aortic aneurysm (AA) and 170 (15%) were not operated on. The most frequent reason for nonoperative management was presumed technical inoperability. Survivals for patients with thoracic, thoracoabdominal, and abdominal AA were comparable...... hypertension were predictive of mortality, whereas...

  1. Magnetocaloric pump (United States)

    Brown, G. V.


    Very cold liquids and gases such as helium, neon, and nitrogen can be pumped by using magnetocaloric effect. Adiabatic magnetization and demagnetization are used to alternately heat and cool slug of pumped fluid contained in closed chamber.

  2. Lifting options for stratospheric aerosol geoengineering: advantages of tethered balloon systems. (United States)

    Davidson, Peter; Burgoyne, Chris; Hunt, Hugh; Causier, Matt


    The Royal Society report 'Geoengineering the Climate' identified solar radiation management using albedo-enhancing aerosols injected into the stratosphere as the most affordable and effective option for geoengineering, but did not consider in any detail the options for delivery. This paper provides outline engineering analyses of the options, both for batch-delivery processes, following up on previous work for artillery shells, missiles, aircraft and free-flying balloons, as well as a more lengthy analysis of continuous-delivery systems that require a pipe connected to the ground and supported at a height of 20 km, either by a tower or by a tethered balloon. Towers are shown not to be practical, but a tethered balloon delivery system, with high-pressure pumping, appears to have much lower operating and capital costs than all other delivery options. Instead of transporting sulphuric acid mist precursors, such a system could also be used to transport slurries of high refractive index particles such as coated titanium dioxide. The use of such particles would allow useful experiments on opacity, coagulation and atmospheric chemistry at modest rates so as not to perturb regional or global climatic conditions, thus reducing scale-up risks. Criteria for particle choice are discussed, including the need to minimize or prevent ozone destruction. The paper estimates the time scales and relatively modest costs required if a tethered balloon system were to be introduced in a measured way with testing and development work proceeding over three decades, rather than in an emergency. The manufacture of a tether capable of sustaining the high tensions and internal pressures needed, as well as strong winds, is a significant challenge, as is the development of the necessary pumping and dispersion technologies. The greatest challenge may be the manufacture and launch of very large balloons, but means have been identified to significantly reduce the size of such balloons or aerostats.

  3. Hyperspectral Polarimeter for Monitoring Balloon Strain Project (United States)

    National Aeronautics and Space Administration — NASA's latest generation of superpressure, ultra long duration balloons (ULDB) extend the flight time for stratospheric experiments to levels previously unattainable...

  4. Post-stenotic aortic dilatation

    Directory of Open Access Journals (Sweden)

    Jahangiri Marjan


    Full Text Available Abstract Aortic stenosis is the most common valvular heart disease affecting up to 4% of the elderly population. It can be associated with dilatation of the ascending aorta and subsequent dissection. Post-stenotic dilatation is seen in patients with AS and/or aortic regurgitation, patients with a haemodynamically normal bicuspid aortic valve and following aortic valve replacement. Controversy exists as to whether to replace the aortic root and ascending aorta at the time of aortic valve replacement, an operation that potentially carries a higher morbidity and mortality. The aetiology of post-stenotic aortic dilatation remains controversial. It may be due to haemodynamic factors caused by a stenotic valve, involving high velocity and turbulent flow downstream of the stenosis, or due to intrinsic pathology of the aortic wall. This may involve an abnormality in the process of extracellular matrix remodelling in the aortic wall including inadequate synthesis, degradation and transport of extracellular matrix proteins. This article reviews the aetiology, pathology and management of patients with post-stenotic aortic dilatation.

  5. Scientific Ballooning Activities and Recent Developments in Technology and Instrumentation of the TIFR Balloon Facility, Hyderabad (United States)

    Buduru, Suneel Kumar


    The Balloon Facility of Tata Institute of Fundamental Research (TIFR-BF) is a unique center of expertise working throughout the year to design, fabricate and launch scientific balloons mainly for space astronomy, atmospheric science and engineering experiments. Recently TIFR-BF extended its support to new user scientists for conducting balloon launches for biological and middle atmospheric sciences. For the first time two balloon launches conducted for sending live lab rats to upper stratosphere and provided launch support for different balloon campaigns such as Tropical Tropopause Dynamics (TTD) to study water vapour content in upper tropospheric and lower stratospheric regions over Hyderabad and the other balloon campaign to study the Asian Tropopause Aerosol Layer (BATAL) during the Indian summer monsoon season. BATAL is the first campaign to conduct balloon launches during active (South-West) monsoon season using zero pressure balloons of different volumes. TIFR-BF also provided zero pressure and sounding balloon support to various research institutes and organizations in India and for several international space projects. In this paper, we present details on our increased capability of balloon fabrication for carrying heavier payloads, development of high strength balloon load tapes and recent developments of flight control and safety systems. A summary of the various flights conducted in two years will be presented along with the future ballooning plans.

  6. Heat pumps

    CERN Document Server

    Macmichael, DBA


    A fully revised and extended account of the design, manufacture and use of heat pumps in both industrial and domestic applications. Topics covered include a detailed description of the various heat pump cycles, the components of a heat pump system - drive, compressor, heat exchangers etc., and the more practical considerations to be taken into account in their selection.

  7. Heat pumps

    CERN Document Server

    Brodowicz, Kazimierz; Wyszynski, M L; Wyszynski


    Heat pumps and related technology are in widespread use in industrial processes and installations. This book presents a unified, comprehensive and systematic treatment of the design and operation of both compression and sorption heat pumps. Heat pump thermodynamics, the choice of working fluid and the characteristics of low temperature heat sources and their application to heat pumps are covered in detail.Economic aspects are discussed and the extensive use of the exergy concept in evaluating performance of heat pumps is a unique feature of the book. The thermodynamic and chemical properties o

  8. Tobacco smoking and aortic aneurysm

    DEFF Research Database (Denmark)

    Sode, Birgitte F; Nordestgaard, Børge G; Grønbæk, Morten


    General Population Study, respectively. According to the magnitude of the hazard ratios, tobacco consumption was the most important risk factor for hospitalization and death from aortic aneurysm, followed by male sex and hypertension in both cohorts. The population attributable risk of aortic aneurysm...... outcomes due to tobacco consumption was 64% and 47% in the Copenhagen City Heart Study and Copenhagen General Population Study, respectively, and ranked highest among population attributable risks of aortic aneurysm in both cohorts. The absolute 10-year risk for hospitalization or death from aortic......BACKGROUND: We determined the predictive power of tobacco smoking on aortic aneurysm as opposed to other risk factors in the general population. METHODS: We recorded tobacco smoking and other risk factors at baseline, and assessed hospitalization and death from aortic aneurysm in 15,072 individuals...

  9. Intragastric balloon and multidisciplinary team

    Directory of Open Access Journals (Sweden)

    R. A. Mazure

    Full Text Available Background: The intragastric balloon is widely used for weight reduction in obese patients, but results are variable. We describe our results enhancing the importance of a Multidisciplinary Team (MT taking part in the treatment. Methods: A retrospective review was done concerning a total of 119 balloons , placed in 116 patients, under endoscopic control and conscious sedation, from May 2001 until August 2006. 49 patients were prepared and recommended to be followed by a MT in a physical unit, at least every 15 days during 6 months. 67 were indicated and followed by other colleagues, without MT. Removal was performed 6 months later. Results: Concerning our 49 patients, mean age was 38, 1 years, 31 female and 18 males, with BMI ranged between 32 and 63, average of 42. The average decrease of weight excess was 31, 85% (-4, 45-80, 4%, and the BMI diminished 5,3 points (from 13,6 to gain of 0,9. The treatment failed in 34,6 % of our patients -including 4 patients lost of follow-up (8, 16%-, compared with 53, 8% of patients without structured MT for selection and follow-up. Physical exercise enhanced markedly the results with 45, 8% of excess of weight loss in women and 39, 7% in males, compared with 14, 6 and 15, 6% in patients who didn't follow the program. The weight loss was mostly fat mass, 89,9% in men and 75,6% in women.- The results maintenance was obtained in 40% of patients one year later. There were no major complications; one balloon had to be removed at 3 weeks because of intolerance, another at 5 months because of gastroesophageal reflux. Conclusions: BIB is an effective help to achieve a short term weight loss in obese patients; nevertheless, good and long lasting results will depend on the modification of life style obtained by a multidisciplinary approach.

  10. Ruptured abdominal aortic aneurysm. (United States)

    Sachs, T; Schermerhorn, M


    Ruptured abdominal aortic aneurysm (AAA) continues to be one of the most lethal vascular pathologies we encounter. Its management demands prompt and efficient evaluation and repair. Open repair has traditionally been the mainstay of treatment. However, the introduction of endovascular techniques has altered the treatment algorithm for ruptured AAA in most major medical centers. We present recent literature and techniques for ruptured AAA and its surgical management.

  11. Infrarenal Aortic Occlusion (United States)

    Traverso, L. W.; Baker, J. D.; Dainko, E. A.; Machleder, H. I.


    Twenty-eight patients with total occlusion of the infrarenal aorta have been seen at the UCLA Hospitals in the past 11 years. Claudication was the presenting complaint in all but one patient, with one-third having ischemic rest pain. The average age of these patients was 54 years, and their histories revealed a surprising absence of myocardial infarction, stroke, or diabetes, although 40% had essential hypertension. Heavy tobacco use, however, was characteristic of the entire group. Arteriography proved valuable in identifying and characterizing the vascular abnormalities, but posed problems in technique and interpretation. Significant distal arterial disease was detected radiographically in only 21% of these patients. Operative correction of the aortic occlusion was performed on 26 patients, 18 by aortic bypass grafts and eight by aorto-iliac endarterectomy, with one early postoperative death. Although the thrombus extended to the renal artery origins in 77% of the cases, a well-designed technical approach did not require renal artery occlusion. Using serial creatinine determinations, one case of renal insufficiency was detected which was associated with prolonged postoperative hypotension. Although the extent of distal disease was more severe in those who underwent bypass, symptoms of claudication returned earlier and were more prominent in the endarterectomy group. This recurrence of systems was not favorably altered by sympathectomy performed concomitantly with the initial procedure. Even though this condition seems to pose difficult technical obstacles and has a poor prognosis, infrarenal aortic occlusion can be successfully treated by aortic bypass, with favorable long-term results, if particular attention is paid to elements of the preoperative evaluation and the intraoperative technical requirements peculiar to this relatively uncommon disease entity. ImagesFig. 1.Fig. 2.Fig. 3. PMID:646479

  12. CT of thoracic aortic aneurysms. (United States)

    Posniak, H V; Olson, M C; Demos, T C; Benjoya, R A; Marsan, R E


    Aneurysms of the thoracic aorta are most often the result of arteriosclerotic disease. Other causes include degeneration of the medial layer of the aortic wall, either idiopathically or due to genetic disorders such as Marfan syndrome; aortic dissection; trauma; syphilis and other bacterial infection; noninfective aortitis; and congenital anomaly. We review normal anatomy of the aorta and discuss our technique and interpretation of computed tomography (CT) in the evaluation of the thoracic aorta. We illustrate the CT appearance of different types of aortic aneurysms as well as discuss the use of CT for assessing complications of aneurysms, for postoperative follow-up, and in the differentiation of aortic aneurysm from a paraaortic mass.

  13. Micromanaging Abdominal Aortic Aneurysms

    Directory of Open Access Journals (Sweden)

    Lars Maegdefessel


    Full Text Available The contribution of abdominal aortic aneurysm (AAA disease to human morbidity and mortality has increased in the aging, industrialized world. In response, extraordinary efforts have been launched to determine the molecular and pathophysiological characteristics of the diseased aorta. This work aims to develop novel diagnostic and therapeutic strategies to limit AAA expansion and, ultimately, rupture. Contributions from multiple research groups have uncovered a complex transcriptional and post-transcriptional regulatory milieu, which is believed to be essential for maintaining aortic vascular homeostasis. Recently, novel small noncoding RNAs, called microRNAs, have been identified as important transcriptional and post-transcriptional inhibitors of gene expression. MicroRNAs are thought to “fine tune” the translational output of their target messenger RNAs (mRNAs by promoting mRNA degradation or inhibiting translation. With the discovery that microRNAs act as powerful regulators in the context of a wide variety of diseases, it is only logical that microRNAs be thoroughly explored as potential therapeutic entities. This current review summarizes interesting findings regarding the intriguing roles and benefits of microRNA expression modulation during AAA initiation and propagation. These studies utilize disease-relevant murine models, as well as human tissue from patients undergoing surgical aortic aneurysm repair. Furthermore, we critically examine future therapeutic strategies with regard to their clinical and translational feasibility.

  14. Paraplegia following intraaortic balloon circulatory assistance

    Directory of Open Access Journals (Sweden)

    Benício Anderson


    Full Text Available Intraaortic balloon counterpulsation is frequently used in patients experiencing severe ventricular dysfunction following maximal drug therapy. However, even with the improvement of percutaneous insertion techniques, the procedure has always been followed by vascular, infectious, and neurological complications. This article describes a case of paraplegia due to intraaortic balloon counterpulsation in the postoperative period of cardiac surgery.

  15. Transcatheter Aortic Valve Replacement in Bicuspid Aortic Valve Disease

    DEFF Research Database (Denmark)

    Mylotte, Darren; Lefevre, Thierry; Søndergaard, Lars


    BACKGROUND: Limited information exists describing the results of transcatheter aortic valve (TAV) replacement in patients with bicuspid aortic valve (BAV) disease (TAV-in-BAV). OBJECTIVES: This study sought to evaluate clinical outcomes of a large cohort of patients undergoing TAV-in-BAV. METHODS...

  16. Development of a miniature intraventricular axial flow blood pump. (United States)

    Yamazaki, K; Umezu, M; Koyanagi, H; Outa, E; Ogino, S; Otake, Y; Shiozaki, H; Fujimoto, T; Tagusari, O; Kitamura, M


    A new intraventricular axial flow blood pump has been designed and developed as a totally implantable left ventricular assist device (LVAD). This pump consists of an impeller combined with a guide-vane, a tube housing, and a DC motor. The pump is introduced into the LV cavity through the LV apex, and the outlet cannula is passed antegrade across the aortic valve. Blood is withdrawn from the LV through the inlet ports at the pump base, and discharged to the ascending aorta. Our newly developed axial flow pump system has the following advantages: 1) it is a simple and compact system, 2) minimal blood stasis both in the device and the LV cavity, 3) minimal blood contacting surface of the pump, 4) easy accessibility with a less invasive surgical procedure, and 5) low cost. A pump flow > 5 L/min was obtained against 100 mmHg differential pressure in the mock circulatory system. The pump could produce a passive pulsatile flow effect with a beating heart more efficiently than other non-pulsatile pumps because of minimal pressure drop and inertia along the bypass tract. Anatomic fit studies using dissected hearts of dilated cardiomyopathy (DCM) cadavers showed that this pump could smoothly pass through the aortic valve without any interference with mitral valve function. Recently, a dynamic pressure groove bearing and a miniature lip seal have been developed. The dynamic pressure groove bearing has a simple structure and acts as a pressure resistant sealing mechanism.(ABSTRACT TRUNCATED AT 250 WORDS)

  17. Radiofrequency balloon angioplasty. Rationale and proof of principle

    Energy Technology Data Exchange (ETDEWEB)

    Becker, G.J.; Lee, B.I.; Waller, B.F.; Barry, K.J.; Kaplan, J.; Connolly, R.; Dreesen, R.G.; Nardella, P.


    Post-angioplasty restenosis (PARS) in atherosclerotic lesions of medium and small arteries occurs in about one-third of cases in the first year following percutaneous transluminal angioplasty (PTA) (early PARS). PARS includes acute spasm, dissection with reclosure, elastic recoil, fibrocellular proliferative response, and progressive atheromatous disease. Fibrocellular proliferation (possibly initiated by platelet derived growth factor) is felt to be culpable in many cases of early PARS (months). Pharmacologic regimens, stents, and thermal welding of the intimal-medial cracks of PTA are among the interventions being developed to deal with PARS. Radiofrequency (RF) current as a source of thermal energy may be useful in combination with balloon angioplasty to reduce PARS. Ideally, this combination would (1) weld intimal-medial cracks of PTA; (2) mold plaque and normal vessel to increase lumen diameters without creating intimal-medial cracks; and (3) destroy medial smooth muscle cells and multipotential cells (cellular substrate of PARS). Canine in vivo studies have established the feasibility of RF-mediated vascular tissue welding. Human aortic specimens (N = 28) were manually dissected into intima-media and media-adventitia layers. Bipolar RF energy (650 KHz, total 300 J) and mechanical pressure (1 atm) (experimental group, N = 24) or mechanical pressure alone (control group, N = 4) were applied to the reapposed specimen layers in a special chamber. The chamber was modified with a bipolar electrode designed to reproduce that planned for an RF balloon angioplasty catheter. Welding was demonstrated in normal and atherosclerotic treated specimens (23/24 or 96%) but not controls (0/4).

  18. Centrifugal pumps

    CERN Document Server

    Gülich, Johann Friedrich


    This book gives an unparalleled, up-to-date, in-depth treatment of all kinds of flow phenomena encountered in centrifugal pumps including the complex interactions of fluid flow with vibrations and wear of materials. The scope includes all aspects of hydraulic design, 3D-flow phenomena and partload operation, cavitation, numerical flow calculations, hydraulic forces, pressure pulsations, noise, pump vibrations (notably bearing housing vibration diagnostics and remedies), pipe vibrations, pump characteristics and pump operation, design of intake structures, the effects of highly viscous flows, pumping of gas-liquid mixtures, hydraulic transport of solids, fatigue damage to impellers or diffusers, material selection under the aspects of fatigue, corrosion, erosion-corrosion or hydro-abrasive wear, pump selection, and hydraulic quality criteria. As a novelty, the 3rd ed. brings a fully analytical design method for radial impellers, which eliminates the arbitrary choices inherent to former design procedures. The d...

  19. Aortic root geometry in aortic stenosis patients (a SEAS substudy)

    DEFF Research Database (Denmark)

    Bahlmann, Edda; Nienaber, Christoph A; Cramariuc, Dana


    AIMS: To report aortic root geometry by echocardiography in a large population of healthy, asymptomatic aortic stenosis (AS) patients in relation to current vendor-specified requirements for transcatheter aortic valve implantation (TAVI). METHODS AND RESULTS: Baseline data in 1481 patients...... with asymptomatic AS (mean age 67 years, 39% women) in the Simvastatin Ezetimibe in AS study were used. The inner aortic diameter was measured at four levels: annulus, sinus of Valsalva, sinotubular junction and supracoronary, and sinus height as the annulo-junctional distance. Analyses were based on vendor......-specified requirements for the aortic root geometry for current available prostheses, CoreValve and Edwards-Sapien. The ratio of sinus of Valsalva height to sinus width was 1:2. In multivariate linear regression analysis, larger sinus of Valsalva height was associated with older age, larger sinus of Valsalva diameter...

  20. Endoscopic vein harvest in elective off-pump coronary artery bypass grafting

    Institute of Scientific and Technical Information of China (English)

    Nai-kuan CHOU; Meng-lin LEE; Shoei-shen WANG


    While traditional open vein harvest was related to postoperative wound complications, endoscopic vein harvest was developed to minimize the morbidity in the greater saphenous vein harvest procedure. In this study, these two procedures were compared for postoperative wound healing and long-term graft patency. We reviewed all consecutive patients undergoing elective off-pump coronary artery bypass grafting from January 2004 to December 2005 and collected data regarding wound complications and coronary events. Wound complications included dehiscence, excessive discharge, edema, altered sensation, cellulitis, hema-toma, pain scale, and superlicial and deep wound infection. Coronary events were defined as diagnosis of myocardial infarction during the first year's follow-up. A total of 392 patients were included in our series, among whom 44 were excluded from the study due to emergent operation, preoperative intra-aortic balloon pump support, or the greater saphenous vein varicose characteristic, 78 belonged to open vein harvest group, and 270 to endoscopic vein harvest group. Wound complications were significantly less in the endoscopic group (5.2%) compared to the open group (19.2%) (P=0.0002). There was no significant difference on preopera-tive risk factors, total operative time, or hospitalization days. During one-year follow-up, both the early and late graft patency rates were similar between the two groups. Endoscopic vein harvest is safe and effective, which carries less risk for wound complica-tions and is associated with better satisfaction and cosmetic result than the traditional greater saphenous vein harvest procedure. The endoscopic vein harvest also demonstrates a great long-term patency.

  1. Transcatheter Aortic Valve Replacement in a Patient With a Previous Bioprosthetic Mitral Valve Replacement: Report of a Delayed Fatal Interaction. (United States)

    Poulin, Frédéric; Lamarche, Yoan; Le, Van Hoai Viet; Doucet, Michel; Roméo, Philippe; Généreux, Philippe


    We report on a man with bioprosthetic mitral valve perforation who presented late after transcatheter aortic valve replacement with a balloon-expandable transcatheter heart valve (THV). The protrusion of the commissural strut of the bioprosthetic mitral valve coupled with the low implanted THV resulted in repetitive trauma leading to rupture of a mitral leaflet. Potential preventive strategies are discussed. This case illustrates the importance of preprocedural imaging screening and cautious THV deployment in patients with a bioprosthetic mitral valve.

  2. Evaluation of aortic cannula jet lesions in a porcine cardiopulmonary bypass (CPB) model. (United States)

    Schnürer, C; Hager, M; Györi, G; Velik-Salchner, C; Moser, P L; Laufer, G; Lorenz, I H; Kolbitsch, C


    In cardiosurgery patients atherosclerotic debris displaced from the cannulation site but also from the opposite aortic wall by the "sandblast-like" effect of the high-pressure jet emanating from the cannula is a potential source of intraoperative arterial embolization and consequently postoperative neurologic dysfunction. The present study examined the extent to which shear stress exerted on the intact aortic intima by an aortic cannula jet stream can cause endothelial lesions that promote thrombogenesis and consequently thrombembolism. A single-stream, straight-tip aortic cannula was used in a porcine cardiopulmonary bypass (CPB) model. Following a 120-minute CPB pump run, a 60-minute stabilization period was allowed before sacrificing the pigs (N.=40) for histological evaluation of the ascending aorta and the brain. Opposite the cannulation site endothelial lesions (diameter: 3.81±1.3 mm; depth: 0.017±0.003 mm) were present in 22.5% (9/40) of aortic specimens. Cerebral thrombembolic lesions were not found. The present study showed that single-stream, straight-tip aortic cannulas caused jet lesions of the formerly intact aortic endothelium opposite the cannulation site in 22.5% of cases in a porcine CPB model.

  3. Effect of transcatheter aortic valve implantation on intraoperative left ventricular end-diastolic pressure. (United States)

    Toyota, Kosaku; Ota, Takashi; Nagamine, Katsutoshi; Koide, Yasuhiro; Nomura, Takeshi; Yamanaka, Futoshi; Shishido, Koki; Tanaka, Masashi; Saito, Shigeru


    Transcatheter aortic valve implantation (TAVI) for patients with aortic stenosis is a less invasive alternative to surgical aortic valve replacement. Despite this, careful anesthetic management, especially strict control of blood pressure and fluid management, is necessary. During TAVI, normalization of left ventricular afterload due to aortic balloon valvuloplasty and prosthetic valve deployment is expected to result in rapid improvement of systolic function and consequent improvement in diastolic function. However, the early effect of TAVI on left ventricular diastolic function is less clear. We hypothesized that TAVI induces a rapid decrease in left ventricular end-diastolic pressure (LVEDP) after valve deployment. This retrospective observational study included 71 patients who had undergone TAVI using the transfemoral approach with a balloon-expandable valve under general anesthesia. Intraoperative LVEDP was measured using an intracardiac catheter. The severity of residual aortic regurgitation (AR) was assessed using the Sellers criteria. The mean (SD) LVEDP was 17.8 (5.3) mmHg just before TAVI and increased significantly to 27.3 (8.2) mmHg immediately after prosthetic valve deployment (p < 0.0001). The change in LVEDP was 8.7 (8.6) mmHg in patients with low residual AR (Sellers ≤1) and 11.0 (7.1) mmHg in those with high residual AR (Sellers ≥2); however, this difference was not significant. No correlation was found between the LVEDP change and intraoperative fluid balance. In conclusion, LVEDP increased significantly in the early period after valve deployment during TAVI, regardless of residual AR severity. It was suggested that the tolerability of fluid load could be reduced at that time.

  4. Airborne Internet Providing Tethered Balloon System

    Directory of Open Access Journals (Sweden)

    Suvriti Dhawan1


    Full Text Available In this paper we shall introduce a new system for providing wireless network communication over a specified area using ’lighter than air’ balloons. This technology will replace the existing fiber optic network system. This will be done by using a tethered balloon along with the payload (containing a receiver, a transmitter and a radio communication device.This payload will be suspended from the ground at an altitude (depending on the area of coverage required. Users under this area will be able to access this system directly for internet connectivity. This system can be used over large areas like universities, companies and societies to provide internet facility to their users through Wi-Fi or over an area where the user is specified (commercial purposes. Currently Google is working on similar idea called the ’Google Loon’ in which they use high altitude balloons which float at an altitude twice as high as air planes and the weather. They recently tested this system over New-Zealand by providing internet to their pilot testers on ground. Their balloons not being stationary, move with directional winds and have to be replaced one after the other to maintain consistency. This can be a huge problem over the areas where upper atmospheric winds are not in favorable direction. We can resolve this problem by using our stationary tethered balloon system which can communicate with the loon balloons to provide internet facility over a desired area. Moreover when our balloon will communicate with the loon balloon it will increase the coverage area as the loon balloon has to communicate to a point which is above the ground. Our system will not only replace the existing fiber optic system but it will also be selfsustaining i.e. It will generate its own power using solar panels.

  5. Abdominal aortic aneurysm surgery

    DEFF Research Database (Denmark)

    Gefke, K; Schroeder, T V; Thisted, B


    The goal of this study was to identify patients who need longer care in the ICU (more than 48 hours) following abdominal aortic aneurysm (AAA) surgery and to evaluate the influence of perioperative complications on short- and long-term survival and quality of life. AAA surgery was performed in 553......, 78% stated that their quality of life had improved or was unchanged after surgery and had resumed working. These data justify a therapeutically aggressive approach, including ICU therapy following AAA surgery, despite failure of one or more organ systems....

  6. Transcatheter aortic valve implantation vs. surgical aortic valve replacement for treatment of severe aortic stenosis

    DEFF Research Database (Denmark)

    Siontis, George C M; Praz, Fabien; Pilgrim, Thomas


    AIMS: In view of the currently available evidence from randomized trials, we aimed to compare the collective safety and efficacy of transcatheter aortic valve implantation (TAVI) vs. surgical aortic valve replacement (SAVR) across the spectrum of risk and in important subgroups. METHODS AND RESULTS...

  7. Stratospheric electric field measurements with transmediterranean balloons (United States)

    de La Morena, B. A.; Alberca, L. F.; Curto, J. J.; Holzworth, R. H.


    The horizontal component of the stratospheric electric field was measured using a balloon in the ODISEA Campaign of Transmediterranean Balloon Program. The balloon flew between Trapani (Sicily) and El Arenosillo (Huelva, Spain) along the 39 deg N parallel at a height between 34 and 24 km. The high values found for the field on fair-weather and its quasi-turbulent variation, both in amplitude and direction, are difficult to explain with the classical electric field source. A new source, first described by Holzworth (1989), is considered as possibly causing them.

  8. A balloon-borne integrating nephelometer

    Energy Technology Data Exchange (ETDEWEB)

    Brown, G.S.; Apple, M.L. (Sandia National Labs., Albuquerque, NM (USA)); Weiss, R.E. (Radiance Research, Seattle, WA (USA))


    A balloon-borne integrating nephelometer has been successfully developed and flown by Sandia National Laboratories and Radiance Research. This report details instrument design, calibration and data conversion procedure. Free and tethered balloon transport and telemetry systems are described. Data taken during March 1989 South-Central New Mexico free flight ascents are presented as vertical profiles of atmospheric particle scattering coefficient, temperature and balloon heading. Data taken during December 1989 Albuquerque, New Mexico tethered flights are also presented as vertical profiles. Data analysis shows superior instrument performance. 5 refs., 22 figs.

  9. Looners: Inside the world of balloon fetishism


    McIntyre, Karen E


    In the spring of 1997, Shaun had just broken up with a boyfriend, and his roommate had moved out. Living alone for the first time and relieved of the fear that someone might walk in the door, he was finally able to indulge his fantasy. The young man sat on his couch and started blowing up balloons. Shaun had loved playing with balloons since he was a child. When he hit puberty, he felt his first orgasm rubbing against a balloon. It was then that his relationship with the object took ...

  10. [Aortic valve replacement for the small aortic annulus]. (United States)

    Oshima, H; Usui, A; Akita, T; Ueda, Y


    Aortic valve surgery for the small aortic annulus is still challenging for surgeons. Recently, the new types of high performance prosthesis have been developed and the chance of an aortic root enlargement (ARE) is decreasing. In this study, we propose the ideal strategy of the aortic surgery for the small aortic annulus. We analyzed the clinical records of 158 patients who underwent aortic valve replacement from August 1999 to October 2005 in our institution. The small aortic annulus was observed in 38 patients (24%). Fourteen patients of this group underwent ARE. Patient-prosthesis mismatch (PPM) was less frequently observed in patients with ARE compared to those without ARE. The additional time required for ARE was not considerable, and neither ischemic time nor cardiopulmonary bypass time was significantly prolonged by ARE. In conclusion, we have to select a prosthesis with sufficient orifice area to avoid PPM, otherwise we should choose an option of ARE. For this consideration, we definitely need the chart that demonstrates the relationship between the nominal size of various types of prostheses and the size of a patient's annulus that those prostheses actually fit.

  11. Valve-sparing aortic root replacement and aortic valve repair in a patient with acromegaly and aortic root dilatation

    Directory of Open Access Journals (Sweden)

    Karel Van Praet


    Full Text Available Aortic regurgitation and dilatation of the aortic root and ascending aorta are severe complications of acromegaly. The current trend for management of an aortic root aneurysm is valve-sparing root replacement as well as restoring the diameter of the aortic sinotubular junction (STJ and annulus. Our case report supports the recommendation that in patients with acromegaly, severe aortic root involvement may indicate the need for surgery.

  12. Ferroelectric Pump (United States)

    Jalink, Antony, Jr. (Inventor); Hellbaum, Richard F. (Inventor); Rohrbach, Wayne W. (Inventor)


    A ferroelectric pump has one or more variable volume pumping chambers internal to a housing. Each chamber has at least one wall comprising a dome shaped internally prestressed ferroelectric actuator having a curvature and a dome height that varies with an electric voltage applied between an inside and outside surface of the actuator. A pumped medium flows into and out of each pumping chamber in response to displacement of the ferroelectric actuator. The ferroelectric actuator is mounted within each wall and isolates each ferroelectric actuator from the pumped medium, supplies a path for voltage to be applied to each ferroelectric actuator, and provides for positive containment of each ferroelectric actuator while allowing displacement of the entirety of each ferroelectric actuator in response to the applied voltage.

  13. Aortic biomechanics in hypertrophic cardiomyopathy (United States)

    Badran, Hala Mahfouz; Soltan, Ghada; Faheem, Nagla; Elnoamany, Mohamed Fahmy; Tawfik, Mohamed; Yacoub, Magdi


    Background: Ventricular-vascular coupling is an important phenomenon in many cardiovascular diseases. The association between aortic mechanical dysfunction and left ventricular (LV) dysfunction is well characterized in many disease entities, but no data are available on how these changes are related in hypertrophic cardiomyopathy (HCM). Aim of the work: This study examined whether HCM alone is associated with an impaired aortic mechanical function in patients without cardiovascular risk factors and the relation of these changes, if any, to LV deformation and cardiac phenotype. Methods: 141 patients with HCM were recruited and compared to 66 age- and sex-matched healthy subjects as control group. Pulse pressure, aortic strain, stiffness and distensibility were calculated from the aortic diameters measured by M-mode echocardiography and blood pressure obtained by sphygmomanometer. Aortic wall systolic and diastolic velocities were measured using pulsed wave Doppler tissue imaging (DTI). Cardiac assessment included geometric parameters and myocardial deformation (strain and strain rate) and mechanical dyssynchrony. Results: The pulsatile change in the aortic diameter, distensibility and aortic wall systolic velocity (AWS') were significantly decreased and aortic stiffness index was increased in HCM compared to control (P < .001) In HCM AWS' was inversely correlated to age(r = − .32, P < .0001), MWT (r = − .22, P < .008), LVMI (r = − .20, P < .02), E/Ea (r = − .16, P < .03) LVOT gradient (r = − 19, P < .02) and severity of mitral regurg (r = − .18, P < .03) but not to the concealed LV deformation abnormalities or mechanical dyssynchrony. On multivariate analysis, the key determinant of aortic stiffness was LV mass index and LVOT obstruction while the role LV dysfunction in aortic stiffness is not evident in this population. Conclusion: HCM is associated with abnormal aortic mechanical properties. The severity of cardiac

  14. Reinforced aortic root reconstruction for acute type A aortic dissection involving the aortic root

    Directory of Open Access Journals (Sweden)

    Han Qing-qi


    Full Text Available OBJECTIVE: There are debates regarding the optimal approach for AAAD involving the aortic root. We described a modified reinforced aortic root reconstruction approach for treating AAAD involving the aortic root. METHODS: A total of 161 patients with AAAD involving the aortic root were treated by our modified reinforced aortic root reconstruction approach from January 1998 to December 2008. Key features of our modified approach were placement of an autologous pericardial patch in the false lumen, lining of the sinotubular junction lumen with a polyester vascular ring, and wrapping of the vessel with Teflon strips. Outcome measures included post-operative mortality, survival, complications, and level of aortic regurgitation. RESULTS: A total of 161 patients were included in the study (mean age: 43.3 1 15.5 years. The mean duration of follow-up was 5.1 1 2.96 years (2-12 years. A total of 10 (6.2% and 11 (6.8% patients died during hospitalization and during follow-up, respectively. Thirty-one (19.3% patients experienced postoperative complications. The 1-, 3-, 5-, and 10-year survival rates were 99.3%, 98%, 93.8%, and 75.5%, respectively. There were no instances of recurrent aortic dissection, aortic aneurysm, or pseudoaneurysm during the entire study period. The severity of aortic regurgitation dramatically decreased immediately after surgery (from 28.6% to 0% grade 3-4 and thereafter slightly increased (from 0% to 7.2% at 5 years and 9.1% at 10 years. CONCLUSION: This modified reinforced aortic root reconstruction was feasible, safe and durable/effective, as indicated by its low mortality, low postoperative complications and high survival rate.

  15. CT-angiography-based evaluation of the aortic annulus for prosthesis sizing in transcatheter aortic valve implantation (TAVI-predictive value and optimal thresholds for major anatomic parameters.

    Directory of Open Access Journals (Sweden)

    Florian Schwarz

    Full Text Available BACKGROUND/OBJECTIVES: To evaluate the predictive value of CT-derived measurements of the aortic annulus for prosthesis sizing in transcatheter aortic valve implantation (TAVI and to calculate optimal cutoff values for the selection of various prosthesis sizes. METHODS: The local IRB waived approval for this single-center retrospective analysis. Of 441 consecutive TAVI-patients, 90 were excluded (death within 30 days: 13; more than mild aortic regurgitation: 10; other reasons: 67. In the remaining 351 patients, the CoreValve (Medtronic and the Edwards Sapien XT valve (Edwards Lifesciences were implanted in 235 and 116 patients. Optimal prosthesis size was determined during TAVI by inflation of a balloon catheter at the aortic annulus. All patients had undergone CT-angiography of the heart or body trunk prior to TAVI. Using these datasets, the diameter of the long and short axis as well as the circumference and the area of the aortic annulus were measured. Multi-Class Receiver-Operator-Curve analyses were used to determine the predictive value of all variables and to define optimal cutoff-values. RESULTS: Differences between patients who underwent implantation of the small, medium or large prosthesis were significant for all except the large vs. medium CoreValve (all p's<0.05. Furthermore, mean diameter, annulus area and circumference had equally high predictive value for prosthesis size for both manufacturers (multi-class AUC's: 0.80, 0.88, 0.91, 0.88, 0.88, 0.89. Using the calculated optimal cutoff-values, prosthesis size is predicted correctly in 85% of cases. CONCLUSION: CT-based aortic root measurements permit excellent prediction of the prosthesis size considered optimal during TAVI.

  16. Shielded Mars Balloon Launcher (SMBL) Project (United States)

    National Aeronautics and Space Administration — Aurora Flight Sciences, along with its partner Vertigo Industries, proposes a novel approach to deployment of balloon-based payloads into the Martian atmosphere....

  17. Attitude determination for balloon-borne experiments

    CERN Document Server

    Gandilo, N N; Amiri, M; Angile, F E; Benton, S J; Bock, J J; Bond, J R; Bryan, S A; Chiang, H C; Contaldi, C R; Crill, B P; Devlin, M J; Dober, B; Dore, O P; Farhang, M; Filippini, J P; Fissel, L M; Fraisse, A A; Fukui, Y; Galitzki, N; Gambrel, A E; Golwala, S; Gudmundsson, J E; Halpern, M; Hasselfield, M; Hilton, G C; Holmes, W A; Hristov, V V; Irwin, K D; Jones, W C; Kermish, Z D; Klein, J; Korotkov, A L; Kuo, C L; MacTavish, C J; Mason, P V; Matthews, T G; Megerian, K G; Moncelsi, L; Morford, T A; Mroczkowski, T K; Nagy, J M; Netterfield, C B; Novak, G; Nutter, D; O'Brient, R; Pascale, E; Poidevin, F; Rahlin, A S; Reintsema, C D; Ruhl, J E; Runyan, M C; Savini, G; Scott, D; Shariff, J A; Soler, J D; Thomas, N E; Trangsrud, A; Truch, M D; Tucker, C E; Tucker, G S; Tucker, R S; Turner, A D; Ward-Thompson, D; Weber, A C; Wiebe, D V; Young, E Y


    An attitude determination system for balloon-borne experiments is presented. The system provides pointing information in azimuth and elevation for instruments flying on stratospheric balloons over Antarctica. In-flight attitude is given by the real-time combination of readings from star cameras, a magnetometer, sun sensors, GPS, gyroscopes, tilt sensors and an elevation encoder. Post-flight attitude reconstruction is determined from star camera solutions, interpolated by the gyroscopes using an extended Kalman Filter. The multi-sensor system was employed by the Balloon-borne Large Aperture Submillimeter Telescope for Polarimetry (BLASTPol), an experiment that measures polarized thermal emission from interstellar dust clouds. A similar system was designed for the upcoming flight of SPIDER, a Cosmic Microwave Background polarization experiment. The pointing requirements for these experiments are discussed, as well as the challenges in designing attitude reconstruction systems for high altitude balloon flights. ...

  18. Retrieving Balloon Data in Flight Project (United States)

    National Aeronautics and Space Administration —   NASA has plans to fly stratospheric ULDBs for missions of 100 days or more in the next few years. As these balloons circumnavigate the globe multiple times,...

  19. Deployment Instabilities of Lobed-Pumpkin Balloon (United States)

    Nakashino, Kyoichi

    A lobed-pumpkin balloon, currently being developed in ISAS/JAXA as well as in NASA, is a promising vehicle for long duration scientific observations in the stratosphere. Recent ground and flight experiments, however, have revealed that the balloon has deployment instabilities under certain conditions. In order to overcome the instability problems, a next generation SPB called 'tawara' type balloon has been proposed, in which an additional cylindrical part is appended to the standard lobed-pumpkin balloon. The present study investigates the deployment stability of tawara type SPB in comparison to that of standard lobed-pumpkin SPB through eigenvalue analysis on the basis of finite element methods. Our numerical results show that tawara type SPB enjoys excellent deployment performance over the standard lobed-pumpkin SPBs.

  20. Magnetometer for Balloons and UAVs Project (United States)

    National Aeronautics and Space Administration — This Phase I SBIR project will investigate a new, low-cost approach to atomic magnetometry that is suited for operation from UAVs and research balloons. Atomic...

  1. Power Systems Design for Long Duration Ballooning (United States)

    Stilwell, Bryan; Chuzel, Alain


    The Columbia Scientific Balloon Facility has been designing and building high-altitude balloon power systems for over 26 years. With that experience, we have found certain types of PV panels, batteries, and charge controllers that are reliable in stratospheric environments. The ultimate goal is to ensure that power systems will provide power reliably throughout the duration of an LDB flight. The purpose of this presentation is to provide some general guidelines and best practices for power system design.

  2. Anaesthetic management for balloon dilation of cor triatriatum dexter in a dog. (United States)

    De Monte, Valentina; Staffieri, Francesco; Caivano, Domenico; Bufalari, Antonello


    A three-month-old female Rottweiler puppy was referred for intravascular correction of a previously identified cor triatriatum dexter. Echocardiography confirmed the presence of a hyperechoic membrane that divided the right atrium into a cranial and caudal chamber. A foramen in this membrane allowed the blood to flow from the caudal to the cranial chamber. Balloon dilation of the defect under transthoracic echocardiographic guidance was scheduled for the following day. The dog was premedicated with 0.5 μg/kg sufentanil and 0.2 mg/kg midazolam administered intravenously. General anaesthesia was induced with 2 mg/kg propofol and maintained with inhaled isoflurane in oxygen; at the same time, a constant rate infusion of 0.5 μg/kg/h sufentanil was administered by means of an infusion pump. Uneventful ventricular and supraventricular tachyarrhythmias developed during the placement of catheters and balloon dilation. At the end of procedure, when the guide wire and balloon catheter were removed, normal sinus rhythm was observed. To the authors' knowledge, no previous reports have described the anaesthetic management of a balloon dilation procedure for cor triatriatum dexter in dogs.

  3. Penis Pump (United States)

    ... claim that they can be used to increase penis size, but there's no evidence that they work for ... circumstances, using a penis pump might help your penis maintain its natural size and shape after prostate surgery or if you ...


    Institute of Scientific and Technical Information of China (English)


    Objective.The present study investigated the role of endogenous carbon monoxide(CO)in the pathogenesis of neointimal formation induced by balloon injury in rat.Method.Endothelial denudation of the left common carotid artery of rat was carried out by three passages of a Fogarty 2F balloon catheter.DNA,collagen and elastin contents of each intima-media were estimated;and heme oxygenase(HO)activity and CO production in vascular smooth muscle cell(VSMC)were measured after administration of HO inhibitor.Result.Our data showed that neointima occurred in the rat on day 7 and day 21 after balloon injury,and at the same time HO activity and CO production in VSMC were markedly increased.Administration of HO inhibitor,zinc deuteroporphyrin 2,4-bisglycol(ZnDPBG),could effectively inhibit HO activity and CO production,significantly enhance neointimal formation(aortic intima/media ratio were 21.4±1.8% vs 17.6±2.0%,P<0.05 on day 7;and 30.5±2.4% vs 23.0±2.2%,P<0.01 on day 21,respectively,compared with balloon alone group).Conclusion.We concluded that 1)inhibition of CO production may enhance neointimal formation induced by endothelial denudation,implying endogenous CO play an protective role in response to vascular injury,and 2)induction of HO activity may be applied clinically for preventing restenosis after angioplasty.

  5. Abdominal aortic aneurysms

    DEFF Research Database (Denmark)

    Lindholt, Jes Sanddal


    Although the number of elective operations for abdominal aortic aneurysms (AAA) is increasing, the sex- and age-standardised mortality rate of AAAs continues to rise, especially among men aged 65 years or more. The lethality of ruptured AAA continues to be 80-95%, compared with 5-7% by elective....... The acceptance rate was 77%, and 95% accept control scans. Furthermore, persons at the highest risk of having an AAA attend screening more frequently. We found that 97% of the interval cases developed from aortas that initially measured 2.5-2.9 cm - i.e. approx. only 5% attenders need re-screening at 5-year...... methods for measuring the degree of wall calcification must be developed and validated....

  6. Imaging Sunlit Aurora from Balloon (United States)

    Lummerzheim, D.; Zhou, X.


    Since 1892 when aurora was first imaged by Martin Brendel, useful auroral images have been obtained only when the aurora is in darkness. While UV imagers onboard satellite provide global auroral dynamics, the sunlit aurora in the UV band is overwhelmed by the UV airglow that has the same wavelengths with the UV auroral emissions. The visible band imaging is feasible only when the aurora is in darkness to avoid the sunlight contamination. However, sunlit aurora (such as dayside aurora) is closely related to the solar wind - magnetosphere - ionosphere coupling. In addition, limited land area has badly restricted the capability of imaging dayside aurora from the northern hemisphere and nightside aurora from the southern hemisphere. We have confirmed that sunlit aurora can be imaged using a near-infrared (NIR) camera on board the balloon platform flying in Antarctica or Arctic. This method provides a unique capability for dayside and conjugate auroral investigations. Scientific questions that can be addressed by such observations include how does the dayside aurora respond to solar wind transient variations? Are auroras hemispherically symmetric? Are auroral forms and their variations under sunlight the same as those in darkness? etc. The new method is also cost effective comparing to space-borne imagers, and offers capabilities not obtainable from space and the ground. With the accomplishment of identifying auroral dynamics in sunlight and darkness, in the south and north simultaneously, our knowledge and understanding of auroral phenomenon and its causes will be expanded.


    NARCIS (Netherlands)



    Two patients with a quadricuspid aortic valve are described, one of them with concomitant juxtaposed coronary orifices facing the right hand facing sinus. The etiology and incidence of this congenital anomaly will be discussed.

  8. Transcatheter Aortic Heart Valve Thrombosis

    DEFF Research Database (Denmark)

    Hansson, Nicolaj C; Grove, Erik L; Andersen, Henning R;


    BACKGROUND: There is increasing focus on transcatheter heart valve (THV) thrombosis. However, there are limited data on incidence, clinical implications and predisposing factors of THV thrombosis following transcatheter aortic valve replacement (TAVR). OBJECTIVES: We assessed the incidence...

  9. Adult thoracic and abdominal aortic

    Directory of Open Access Journals (Sweden)

    Randa O. Kaddah


    Conclusion: Aortic COA could be found in any segment of the aorta. Proper identification of the anatomical details and pressure gradient studies are important factors affecting the plan of management.

  10. Minimally invasive aortic valve replacement

    DEFF Research Database (Denmark)

    Foghsgaard, Signe; Schmidt, Thomas Andersen; Kjaergard, Henrik K


    In this descriptive prospective study, we evaluate the outcomes of surgery in 98 patients who were scheduled to undergo minimally invasive aortic valve replacement. These patients were compared with a group of 50 patients who underwent scheduled aortic valve replacement through a full sternotomy....... The 30-day mortality rate for the 98 patients was zero, although 14 of the 98 mini-sternotomies had to be converted to complete sternotomies intraoperatively due to technical problems. Such conversion doubled the operative time over that of the planned full sternotomies. In the group of patients whose...... is an excellent operation in selected patients, but its true advantages over conventional aortic valve replacement (other than a smaller scar) await evaluation by means of randomized clinical trial. The "extended mini-aortic valve replacement" operation, on the other hand, is a risky procedure that should...

  11. [New aspects in aortic valve disease]. (United States)

    Tornos, P


    Renewed interest for aortic valve disease has evolved in recent years. Aortic valve replacement has become the second most frequent cause of cardiac surgery, following coronary bypass surgery. In addition, the etiologic and physiopathologic knowledge of this disorder has improved. In the present paper we analyze three aspects of the disease which are, at present, the subject of study and controversy: first, we discuss the possible relationship between degenerative aortic stenosis and atherosclerosis; second, the involvement of the aortic root in cases of bicuspid aortic valve; and third, the surgical indications in asymptomatic patients with either aortic stenosis or regurgitation.

  12. Clinical experience with the Sarns centrifugal pump. (United States)

    Curtis, J J; Walls, J T; Demmy, T L; Boley, T M; Schmaltz, R A; Goss, C F; Wagner-Mann, C C


    Since October 1986, we have had experience with 96 Sarns centrifugal pumps in 72 patients (pts). Heparinless left atrial to femoral artery or aorta bypass was used in 14 pts undergoing surgery on the thoracic aorta with 13 survivors (93%). No paraplegia or device-related complications were observed. In 57 patients, the Sarns centrifugal pump was used as a univentricular (27 pts) or biventricular (30 pts) cardiac assist device for postcardiotomy cardiogenic shock. In these patients, cardiac assist duration ranged from 2 to 434 h with a hospital survival rate of 29% in those requiring left ventricular assist and 13% in those requiring biventricular assist. Although complications were ubiquitous in this mortally ill patient population, in 5,235 pump-hours, no pump thrombosis was observed. Hospital survivors followed for 4 months to 6 years have enjoyed an improved functional class. We conclude that the Sarns centrifugal pump is an effective cardiac assist device when used to salvage patients otherwise unweanable from cardiopulmonary bypass. Partial left ventricular bypass using a centrifugal pump has become our procedure of choice for unloading the left ventricle and for maintenance of distal aortic perfusion pressure when performing surgery on the thoracic aorta. This clinical experience with the Sarns centrifugal pump appears to be similar to that reported with other centrifugal assist devices.

  13. The murine angiotensin II-induced abdominal aortic aneurysm model: rupture risk and inflammatory progression patterns

    Directory of Open Access Journals (Sweden)

    Richard Y Cao


    Full Text Available An abdominal aortic aneurysm (AAA is an enlargement of the greatest artery in the body defined as an increase in diameter of 1.5-fold. AAAs are common in the elderly population and thousands die each year from their complications. The most commonly used mouse model to study the pathogenesis of AAA is the angiotensin II (Ang II infusion method delivered via osmotic mini-pump for 28 days. Here, we studied the site-specificity and onset of aortic rupture, characterized three-dimensional (3D images and flow patterns in developing AAAs by ultrasound imaging, and examined macrophage infiltration in the Ang II model using 65 apolipoprotein E deficient mice. Aortic rupture occurred in 16 mice (25 % and was nearly as prevalent at the aortic arch (44 % as it was in the suprarenal region (56 % and was most common within the first seven days after Ang II infusion (12 of 16; 75 %. Longitudinal ultrasound screening was found to correlate nicely with histological analysis and AAA volume renderings showed a significant relationship with AAA severity index. Aortic dissection preceded altered flow patterns and macrophage infiltration was a prominent characteristic of developing AAAs. Targeting the inflammatory component of AAA disease with novel therapeutics will hopefully lead to new strategies to attenuate aneurysm growth and aortic rupture.

  14. Extra-anatomical bypass: a surgical option for recurrent aortic coarctation. (United States)

    Malaj, Alban; Martinelli, Ombretta; Irace, Francesco Giosue'; Jabbour, Jihad; Gossetti, Bruno; Mazzesi, Giuseppe


    Background. Balloon aortoplasty with or without stenting is a less invasive alternative to open surgery for the management of recurrent isthmic coarctation. However, in patients with previous small size tube graft, an open surgical correction is mandatory and, in most cases, an anatomical aortic reconstruction is carried out. Methods. We present the case of a 48-year-old woman with recurrent aortic coarctation and systemic hypertension with systolic value around 190-200 mmHg and preoperative systolic pressure gradient 70 mmHg, submitted to an extra-anatomical bypass. Through a median sternotomy, an extra-anatomical bypass from ascending to descending aorta was performed. Results. No intra- or postoperative complications were observed. The postoperative pressure gradient was 10 mmHg and the systolic pressure ranged from 130 to 140 mmHg. Conclusion. The extra-anatomical bypass can be considered an effective and safe alternative to the anatomical aortic reconstruction in the cases with recurrent aortic coarctation unfit for endovascular treatment.

  15. Extra-Anatomical Bypass: A Surgical Option for Recurrent Aortic Coarctation

    Directory of Open Access Journals (Sweden)

    Alban Malaj


    Full Text Available Background. Balloon aortoplasty with or without stenting is a less invasive alternative to open surgery for the management of recurrent isthmic coarctation. However, in patients with previous small size tube graft, an open surgical correction is mandatory and, in most cases, an anatomical aortic reconstruction is carried out. Methods. We present the case of a 48-year-old woman with recurrent aortic coarctation and systemic hypertension with systolic value around 190–200 mmHg and preoperative systolic pressure gradient 70 mmHg, submitted to an extra-anatomical bypass. Through a median sternotomy, an extra-anatomical bypass from ascending to descending aorta was performed. Results. No intra- or postoperative complications were observed. The postoperative pressure gradient was 10 mmHg and the systolic pressure ranged from 130 to 140 mmHg. Conclusion. The extra-anatomical bypass can be considered an effective and safe alternative to the anatomical aortic reconstruction in the cases with recurrent aortic coarctation unfit for endovascular treatment.

  16. Feasibility of transapical aortic valve replacement through a left ventricular apical diverticulum

    Directory of Open Access Journals (Sweden)

    Ferrari Enrico


    Full Text Available Abstract Transapical aortic valve replacement is an established technique performed in high-risk patients with symptomatic aortic valve stenosis and vascular disease contraindicating trans-vascular and trans-aortic procedures. The presence of a left ventricular apical diverticulum is a rare event and the treatment depends on dimensions and estimated risk of embolisation, rupture, or onset of ventricular arrhythmias. The diagnosis is based on standard cardiac imaging and symptoms are very rare. In this case report we illustrate our experience with a 81 years old female patient suffering from symptomatic aortic valve stenosis, respiratory disease, chronic renal failure and severe peripheral vascular disease (logistic euroscore: 42%, who successfully underwent a transapical 23 mm balloon-expandable stent-valve implantation through an apical diverticulum of the left ventricle. Intra-luminal thrombi were absent and during the same procedure were able to treat the valve disease and to successfully exclude the apical diverticulum without complications and through a mini thoracotomy. To the best of our knowledge, this is the first time that a transapical procedure is successfully performed through an apical diverticulum.

  17. Endovascular Treatment of Infrarenal Abdominal Aortic Lesions With or Without Common Iliac Artery Involvement

    Energy Technology Data Exchange (ETDEWEB)

    Oender, Hakan, E-mail: [Dicle University Medical Faculty, Department of Radiology (Turkey); Oguzkurt, Levent [Baskent University Medical Faculty, Department of Radiology (Turkey); Guer, Serkan [Sifa University Medical Faculty, Department of Radiology (Turkey); Tekbas, Gueven [Dicle University Medical Faculty, Department of Radiology (Turkey); Guerel, Kamil [Abant Izzet Baysal University Medical Faculty, Department of Radiology (Turkey); Coskun, Isa [Baskent University Medical Faculty, Department of Cardiovascular Surgery (Turkey); Oezkan, Ugur [Baskent University Medical Faculty, Department of Radiology (Turkey)


    To evaluate the results of stent placement for obstructive atherosclerotic aortic disease with or without involvement of the common iliac artery. Forty patients had self-expanding stents primarily or after balloon dilatation in the abdominal aorta between January 2005 and May 2011. All patients had trouble walking. Follow-up examinations were performed with clinical visits; these included color Doppler ultrasonography and computed tomographic angiography. Technical, clinical, and hemodynamic success was achieved in all patients. None of the patients underwent reintervention during the follow-up period, which ranged from 3 months to 6 years (median 24 months). Nine complications occurred in six patients. Of the nine complications, four were distal thromboembolisms, which were successfully treated with catheter-directed thrombolysis or anticoagulation therapy. Endovascular treatment of the obstructive aortic disease using self-expanding stents was safe and effective, with high technical success and long-term patency. Thromboembolic complications were high even though direct stenting was considered protective for thromboembolism formation. Particularly for infrarenal aortic stenosis, it can be recommended as the first-line treatment option for patients with obstructive atherosclerotic aortic disease.

  18. 经肱动脉行主动脉内球囊反搏支持下救治急性心肌梗死两例报道并文献复习%Treatment of Two Cases of the Acute Myocardial Infarction by Intra - aortic Balloon Pumping Via Brachial Artery

    Institute of Scientific and Technical Information of China (English)

    莫海亮; 叶少强; 李上海; 游琼; 吴铿


    急性心肌梗死病死率高,尽早及时行主动脉内球囊反搏(IABP)支持可明显降低病死率。传统经股动脉8F IABP 置入技术成熟,但易出现出血、血肿等并发症。当遇外周血管疾病、血管严重弯曲、急危重患者不能平卧时,IABP 置入禁忌或失败,可考虑经肱动脉途径行 IABP 支持。本文报道2例急性心肌梗死伴下肢动脉慢性闭塞/严重心力衰竭患者,不能平卧,采取经肱动脉途径行 IABP 植入术,效果好,没有明显并发症,表明经肱动脉途径行 IABP植入术可行、安全有效,值得临床进一步研究、观察。%Acute myocardial infarction mortality is high,and IABP support in time can obviously reduce death rate. Traditional implantation technology of 8F IABP is mature,but with complications such as bleeding,hematoma and so on. When treating patients with peripheral vascular disease,blood vessels bending severely or critical patients who cannot lie down,IABP implantation becomes operative contraindication or fails,we can consider performing IABP support via transbrachial. In this pa-per we report 2 cases of patients who suffer acute myocardial infarction accompanying chronic arterial occlusive disease and(or) severe heart failure and can not lie down. We treat them with IABP support via Brachial Artery with good effect and no obvious complications,showing that transbrachial IABP implantation is feasible,safe and effective,worth further research and clinical observation.

  19. Japan-Indo collaboration on balloon observations (United States)

    Makino, Fumiyoshi

    Japan-Indo collaboration on balloon observations of cosmic X-ray sources was started in 1969 by the late S. Hayakawa of Nagoya Univ. and B. V. Sreekantan of TIFR. Cosmic background X-ray and soft gamma-ray spectra, simultaneous X-ray and optical flux variation, and size of X-ray emitting region of Crab Nebula were observed successfully by balloon flights at Hyderabad in 1969-1975. H. Shibai of Nagoya Univ. and T. N. Rengarajan of TIFR have organized collaboration on far infrared sky survey at wavlength of 150 micron emitted from CII. By employing improved detectors, CII distribution of Orion Nebula has been obtained in good accuracy by more than ten balloon flights in 1999-2008.

  20. Near ultraviolet spectrograph for balloon platform (United States)

    Sreejith, A. G.; Safonova, Margarita; Murthy, Jayant


    Small and compact scientific payloads may be easily designed constructed and own on high altitude balloons. Despite the fact that large orbital observatories provide accurate observations and statistical studies of remote and/or faint space sources, small telescopes on board balloons or rockets are still attractive because of their low cost and rapid response time. We describe here a near ultraviolet (NUV) spectrograph designed to be own on a high{altitude balloon platform. Our basic optical design is a modified Czerny-Turner system using off the shelf optics. We compare different methods of aberration corrections in such a system. We intend the system to be portable and scalable to different telescopes. The use of reflecting optics reduces the transmission loss in UV. We plan on using an image intensified CMOS sensor operating in photon counting mode as the detector of choice.

  1. Abdominal aortic aneurysm repair - open - discharge (United States)

    ... this page: // Abdominal aortic aneurysm repair - open - discharge To use the sharing features ... References Orandi BJ, Black JH. Open repair of abdominal aortic aneurysms. In: Cameron JL, Cameron AM, eds. Current Surgical ...

  2. 75 FR 33838 - National Environmental Policy Act; Scientific Balloon Program (United States)


    ... SPACE ADMINISTRATION National Environmental Policy Act; Scientific Balloon Program AGENCY: National... Draft Programmatic Environmental Assessment (PEA) and Draft Finding of No Significant Impact (FONSI) for NASA's Scientific Balloon Program. SUMMARY: Pursuant to the National Environmental Policy Act of...

  3. Management of bicuspid aortic valve with or without involvement of ascending aorta and aortic root. (United States)

    Neragi-Miandoab, S


    Patients with a bicuspid aortic valve (BAV) constitute a heterogeneous population with variable clinical presentation and complications. More than 50% of the patients who require aortic valve replacement have a BAV, a condition that may be associated with dilation of ascending aorta and aortic insufficiency caused by cusp disease or aortic root pathology. Of the potential BAV-related complications, dilation of the aortic root and ascending aorta are among the most serious. The dilation of ascending aorta and aortic root have been the subject of controversy. Whereas some surgeons believe that the dilation of the aorta is caused by the hemodynamic properties of the BAV, others believe that the dilation of the aortic root is secondary to genetic defects associated with the BAV. Management of a BAV should be tailored to each patient's clinical condition. The surgical approach varies from aortic valve replacement to combined aortic valve and root replacement to aortic-valve-sparing root replacement.

  4. Abdominal aortic feminism. (United States)

    Mortimer, Alice Emily


    A 79-year-old woman presented to a private medical practice 2 years previously for an elective ultrasound screening scan. This imaging provided the evidence for a diagnosis of an abdominal aortic aneurysm (AAA) to be made. Despite having a number of recognised risk factors for an AAA, her general practitioner at the time did not follow the guidance set out by the private medical professional, that is, to refer the patient to a vascular specialist to be entered into a surveillance programme and surgically evaluated. The patient became symptomatic with her AAA, was admitted to hospital and found to have a tender, symptomatic, 6 cm leaking AAA. She consented for an emergency open AAA repair within a few hours of being admitted to hospital, despite the 50% perioperative mortality risk. The patient spent 4 days in intensive care where she recovered well. She was discharged after a 12 day hospital stay but unfortunately passed away shortly after her discharge from a previously undiagnosed gastric cancer.

  5. Open aortic surgery after thoracic endovascular aortic repair. (United States)

    Coselli, Joseph S; Spiliotopoulos, Konstantinos; Preventza, Ourania; de la Cruz, Kim I; Amarasekara, Hiruni; Green, Susan Y


    In the last decade, thoracic endovascular aortic aneurysm repair (TEVAR) has emerged as an appealing alternative to the traditional open aortic aneurysm repair. This is largely due to generally improved early outcomes associated with TEVAR, including lower perioperative mortality and morbidity. However, it is relatively common for patients who undergo TEVAR to need a secondary intervention. In select circumstances, these secondary interventions are performed as an open procedure. Although it is difficult to assess the rate of open repairs after TEVAR, the rates in large series of TEVAR cases (>300) have ranged from 0.4 to 7.9 %. Major complications of TEVAR that typically necessitates open distal aortic repair (i.e., repair of the descending thoracic or thoracoabdominal aorta) include endoleak (especially type I), aortic fistula, endograft infection, device collapse or migration, and continued expansion of the aneurysm sac. Conversion to open repair of the distal aorta may be either elective (as for many endoleaks) or emergent (as for rupture, retrograde complicated dissection, malperfusion, and endograft infection). In addition, in select patients (e.g., those with a chronic aortic dissection), unrepaired sections of the aorta may progressively dilate, resulting in the need for multiple distal aortic repairs. Open repairs after TEVAR can be broadly classified as full extraction, partial extraction, or full salvage of the stent-graft. Although full and partial stent-graft extraction imply failure of TEVAR, such failure is generally absent in cases where the stent-graft can be fully salvaged. We review the literature regarding open repair after TEVAR and highlight operative strategies.

  6. Particle Astrophysics in NASA's Long Duration Balloon Program

    CERN Document Server

    Gorham, Peter W


    A century after Viktor Hess' discovery of cosmic rays, balloon flights still play a central role in the investigation of cosmic rays over nearly their entire spectrum. We report on the current status of NASA balloon program for particle astrophysics, with particular emphasis on the very successful Antarctic long-duration balloon program, and new developments in the progress toward ultra-long duration balloons.

  7. There is a Text in 'The Balloon'

    DEFF Research Database (Denmark)

    Elias, Camelia


    From the Introduction: Camelia Elias' "There is a Text in 'The Balloon': Donald Barthelme's Allegorical Flights" provides its reader with a much-need and useful distinction between fantasy and the fantastic: "whereas fantasy in critical discourse can be aligned with allegory, in which a supernatu......From the Introduction: Camelia Elias' "There is a Text in 'The Balloon': Donald Barthelme's Allegorical Flights" provides its reader with a much-need and useful distinction between fantasy and the fantastic: "whereas fantasy in critical discourse can be aligned with allegory, in which...

  8. Cutting balloon angioplasty for intrastent restenosis treatment

    Directory of Open Access Journals (Sweden)

    João Orávio de Freitas Jr


    Full Text Available We describe here two patients with angiographic diagnosis of intrastent restenosis and regional myocardial ischemia. One stent restenosis was located in a native coronary artery and the other in a vein graft. Both were treated with cutting balloon angioplasty (CBA, inflated at low pressures. Angiographic success was obtained and both patients were discharged in the day after the procedure. Cutting balloon angioplasty using low inflation pressures achieved important luminal gains, in these two cases of intrastent restenosis. Further studies are necessary before the effectiveness of this procedure can be precisely defined.

  9. On the inflation of a rubber balloon (United States)

    Vandermarlière, Julien


    It is a well-known fact that it is difficult to start a balloon inflating. But after a pressure peak that occurs initially, it becomes far easier to do it! The purpose of this article is to establish the experimental pressure-radius chart for a rubber balloon and to compare it to the theoretical one. We will demonstrate that the barometer of a smartphone is a very suitable tool to reach this goal. We hope that this phenomenon will help students realize that sometimes very simple questions can lead to very interesting and counterintuitive science.

  10. High altitude balloon experiments at IIA (United States)

    Nayak, Akshata; Sreejith, A. G.; Safonova, Margarita; Murthy, Jayant

    Recent advances in balloon experiments as well as in electronics have made it possible to fly scientific payloads at costs accessible to university departments. We have begun a program of high altitude ballooning at the Indian Institute of Astrophysics, Bengaluru. The primary purpose of this activity is to test low-cost ultraviolet (UV) payloads for eventual space flight, but we will also try scientific exploration of the phenomena occurring in the upper atmosphere, including sprites and meteorite impacts. We present the results of the initial experiments carried out at the CREST campus of IIA, Hosakote, and describe our plans for the future.

  11. Aortic or Mitral Valve Replacement With the Biocor and Biocor Supra (United States)


    Aortic Valve Insufficiency; Aortic Valve Regurgitation; Aortic Valve Stenosis; Aortic Valve Incompetence; Mitral Valve Insufficiency; Mitral Valve Regurgitation; Mitral Valve Stenosis; Mitral Valve Incompetence

  12. Aortic root replacement with a pulmonary autograft

    NARCIS (Netherlands)

    R.B. Hokken (Raymond)


    textabstractAortic valve disease in the pediatric age group is usually a consequence of congenital aortic stenosis, which may be isolated or may be a part of an anomaly of the left ventricular outflow tract or the aortic root. Management of these patients is difficult. Neonates and infants with seve

  13. Auditory Risk of Exploding Hydrogen-Oxygen Balloons (United States)

    Gee, Kent L.; Vernon, Julia A.; Macedone, Jeffrey H.


    Although hydrogen-oxygen balloon explosions are popular demonstrations, the acoustic impulse created poses a hearing damage risk if the peak level exceeds 140 dB at the listener's ear. The results of acoustical measurements of hydrogen-oxygen balloons of varying volume and oxygen content are described. It is shown that hydrogen balloons may be…

  14. Ballooning behavior in the golden orbweb spider Nephilapilipes (Araneae: Nephilidae

    Directory of Open Access Journals (Sweden)

    Vanessa M.J. Lee


    Full Text Available Ballooning, a mode of aerial dispersal in spiders, is an innate behavior that requires appropriate physiological and meteorological conditions. Although only rarely reported in the golden orbweb spiders, family Nephilidae, the large geographic distributions of most nephilids—in particular of Nephila species—would imply that these spiders likely routinely disperse by ballooning in spite of giant female sizes. Here we study ballooning behavior in the golden orbweb spider Nephila pilipes (Fabricius, 1793. Specifically, we test for the propensity of spiderlings to deploy ballooning as a dispersal mechanism. We subjected a total of 59 first-instar spiderlings to a wind experiment at two wind speeds (2.17 ± 0.02 m s-1 and 3.17 ± 0.02 m s-1 under laboratory conditions. Under an average wind speed of 3.17 m s-1, none of the spiderlings exhibited pre-ballooning or ballooning behavior. However, at an average wind speed of 2.17 m s-1, 53 (89.8% spiderlings showed pre-ballooning behavior, and 17 (32.1% of the pre-ballooners ultimately ballooned. Our results concur with prior reports on spiderlings of other families that pre-ballooning behavior is a requirement for ballooning to occur. Furthermore, although we cannot rule out other dispersal mechanisms such as synanthropic spread, our findings suggest that the widespread N. pilipes uses ballooning to colonize remote oceanic islands.

  15. 21 CFR 884.5050 - Metreurynter-balloon abortion system. (United States)


    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Metreurynter-balloon abortion system. 884.5050... Devices § 884.5050 Metreurynter-balloon abortion system. (a) Identification. A metreurynter-balloon abortion system is a device used to induce abortion. The device is inserted into the uterine...


    Tabata, Minoru


    Minimally invasive aortic valve replacement (MIAVR) is defined as aortic valve replacement avoiding full sternotomy. Common approaches include a partial sternotomy right thoracotomy, and a parasternal approach. MIAVR has been shown to have advantages over conventional AVR such as shorter length of stay and smaller amount of blood transfusion and better cosmesis. However, it is also known to have disadvantages such as longer cardiopulmonary bypass and aortic cross-clamp times and potential complications related to peripheral cannulation. Appropriate patient selection is very important. Since the procedure is more complex than conventional AVR, more intensive teamwork in the operating room is essential. Additionally, a team approach during postoperative management is critical to maximize the benefits of MIAVR.

  17. Types of Breast Pumps (United States)

    ... Devices Consumer Products Breast Pumps Types of Breast Pumps Share Tweet Linkedin Pin it More sharing options ... used for feeding a baby. Types of Breast Pumps There are three basic types of breast pumps: ...

  18. Single-balloon versus double-balloon bipedicular kyphoplasty for osteoporotic vertebral compression fractures. (United States)

    Wang, Heng; Sun, Zhenzhong; Wang, Zhiwen; Jiang, Weimin


    Twenty-eight patients with osteoporotic vertebral compression fractures (OVCF) were treated with single-balloon bipedicular kyphoplasty (Group A), and 40 patients were treated with double-balloon bipedicular kyphoplasty (Group B). Visual Analogue Scale (VAS) score, vertebral height, and kyphotic angle (KA) were evaluated pre-operatively, post-operatively (3 days after surgery) and at final follow-up. Operative time, X-ray exposure frequency and costs were recorded. The mean operative time and X-ray exposure frequency in Group A were greater than in Group B (pkyphoplasty is a safe and cost-effective surgical method for the treatment of OVCF. It can achieve pain relief comparable with double-balloon bipedicular kyphoplasty. However, double-balloon bipedicular kyphoplasty is more efficacious in terms of the restoration of vertebral height and reduction of KA, and the operative time and X-ray exposure frequency are lower.

  19. Classification of Implantable Rotary Blood Pump States With Class Noise. (United States)

    Ooi, Hui-Lee; Seera, Manjeevan; Ng, Siew-Cheok; Lim, Chee Peng; Loo, Chu Kiong; Lovell, Nigel H; Redmond, Stephen J; Lim, Einly


    A medical case study related to implantable rotary blood pumps is examined. Five classifiers and two ensemble classifiers are applied to process the signals collected from the pumps for the identification of the aortic valve nonopening pump state. In addition to the noise-free datasets, up to 40% class noise has been added to the signals to evaluate the classification performance when mislabeling is present in the classifier training set. In order to ensure a reliable diagnostic model for the identification of the pump states, classifications performed with and without class noise are evaluated. The multilayer perceptron emerged as the best performing classifier for pump state detection due to its high accuracy as well as robustness against class noise.

  20. Experiments with Helium-Filled Balloons (United States)

    Zable, Anthony C.


    The concepts of Newtonian mechanics, fluids, and ideal gas law physics are often treated as separate and isolated topics in the typical introductory college-level physics course, especially in the laboratory setting. To bridge these subjects, a simple experiment was developed that utilizes computer-based data acquisition sensors and a digital gram scale to estimate the molar mass of the gas in an inflated balloon. In this experiment, the comparable density of an inflated balloon to that of atmospheric air introduces a significant role for buoyancy that must be accounted for. The ideal gas law approximation is assumed for both the isolated gas mixture within the balloon and the surrounding air, which defines the relationship between the gas pressure, volume, temperature, and molar quantity. Analysis of the forces associated with the inflated balloon with the incorporation of Archimedes' principle and the ideal gas law into Newton's second law results in an experimental method for the measurement of the molar mass and mole fraction of a gas that is easy to implement yet academically challenging for students. The following narrative describes the basic setup of this experiment, along with a sample set of data as acquired and analyzed by a typical physics student from one of my classes.

  1. Pumpkins and onions and balloon design (United States)

    Winker, J. A.

    The reach for a capability to make long flights (months) with heavy payloads (tonnes) has long been pursued. The closest we have come is with polar flights devoid of a significant diurnal cycle. Superpressure technology, with its ability to survive diurnal cycles, is an obvious choice, but materials limitations have been an obstacle to realizing these ambitious goals. Now comes an assortment of new synthetic materials, coupled with a special variety of superpressure balloon which, in combination, is poised to yield a solution for our enhanced duration/payload quest. In this paper we are looking not at materials, but only at a balloon concept. This concept is a "natural shape" oblate spheroid balloon whose shape is chosen to exploit properties of component materials, particularly newly available ones. The current variation of this concept is called a "pumpkin" balloon. The most visible work on this shape is that done by France's CNES, Japan's ISAS, and in the USA by NASA's Wallops Flight Facility. But the basic design idea is not new; it extends back at least a half century. This paper traces the origins of the shape, its evolution through various iterations, and it speculates on some of the recent thinking regarding construction details.

  2. Stratospheric Balloon Platforms for Near Space Access (United States)

    Dewey, R. G.


    For over five decades, high altitude aerospace balloon platforms have provided a unique vantage point for space and geophysical research by exposing scientific instrument packages and experiments to space-like conditions above 99% of Earth's atmosphere. Reaching altitudes in excess of 30 km for durations ranging from hours to weeks, high altitude balloons offer longer flight durations than both traditional sounding rockets and emerging suborbital reusable launch vehicles. For instruments and experiments requiring access to high altitudes, engineered balloon systems provide a timely, responsive, flexible, and cost-effective vehicle for reaching near space conditions. Moreover, high altitude balloon platforms serve as an early means of testing and validating hardware bound for suborbital or orbital space without imposing space vehicle qualifications and certification requirements on hardware in development. From float altitudes above 30 km visible obscuration of the sky is greatly reduced and telescopes and other sensors function in an orbit-like environment, but in 1g. Down-facing sensors can take long-exposure atmospheric measurements and images of Earth's surface from oblique and nadir perspectives. Payload support subsystems such as telemetry equipment and command, control, and communication (C3) interfaces can also be tested and operationally verified in this space-analog environment. For scientific payloads requiring over-flight of specific areas of interests, such as an active volcano or forest region, advanced mission planning software allows flight trajectories to be accurately modeled. Using both line-of-sight and satellite-based communication systems, payloads can be tracked and controlled throughout the entire mission duration. Under NASA's Flight Opportunities Program, NSC can provide a range of high altitude flight options to support space and geophysical research: High Altitude Shuttle System (HASS) - A balloon-borne semi-autonomous glider carries

  3. Balloon-expandable covered stent therapy of complex endovascular pathology. (United States)

    Giles, Heath; Lesar, Christopher; Erdoes, Luke; Sprouse, Richard; Myers, Stuart


    The current study was designed to investigate our hypotheses that balloon-expandable covered stents display acceptable function over longitudinal follow-up in patients with complex vascular pathology and provide a suitable alternative for the treatment of recurrent in-stent restenosis. All stents were Atrium iCast, which is a balloon-mounted, polytetrafluoroethylene-covered stent with a 6F/7F delivery system. A retrospective review was performed of 49 patients with 66 stented lesions. Data were analyzed with life tables and t-tests. The most commonly treated vessels were the iliac (61%) and renal (24%) arteries. Indications for covered stent placement were unstable atheromatous lesions (50%), recurrent in-stent restenosis (24%), aneurysm (8%), aortic bifurcation reconstruction (7.5%), dissection (4.5%), endovascular aneurysm repair-related (4.5%), and stent fracture (1.5%). Patency was assessed by angiogram or duplex ultrasonography. The primary end point was patency and secondary end points were technical success and access-site complications. Mean follow-up was 13 months (range 1.5-25). The technical success rate was 97%. Unsuccessful outcomes were due to deployment error (n=1) and stent malpositioning (n=1). The cohort (n=64) 6- and 12-month primary patency rates were 96% and 84%, respectively. Twelve-month assisted primary patency was 98%. Iliac artery stents (n=38) had a primary patency of 97% at 6 months and 84% at 12 months with an assisted primary patency of 100% at 12 months. Renal artery stents (n=16) had a primary patency of 92% at 6 months and 72% at 12 months with an assisted primary patency of 92% at 6 and 12 months. Stents placed for recurrent in-stent restenosis (n=16) had a primary patency of 85%, assisted primary patency of 93%, and a 15% restenosis rate at 12 months. Specifically, stents placed for renal artery recurrent in-stent restenosis (n=10) had a primary patency of 73%, assisted primary patency of 82%, and a restenosis rate of 27%. The

  4. Primary stenting in the treatment of focal atherosclerotic abdominal aortic stenoses

    Energy Technology Data Exchange (ETDEWEB)

    Poncyljusz, W.; Falkowski, A.; Garncarek, J.; Karasek, M.; England, S.; Zawierucha, D


    Aim: To evaluate the results of primary stent placement in focal atherosclerotic aortic stenoses using balloon expandable stents. Materials and methods: Twenty-six primary balloon expandable stent placements in the abdominal aorta were performed and reviewed. All the aortic stenoses were atherosclerotic. Patients were followed up by ankle/brachial pressure indices (ABPI) and Doppler ultrasound (US) at 24 h after procedure and at 12 and 24 months. Follow-up angiograms were performed at 12 months. Results: Twenty-six stents in 26 patients were placed in the infrarenal aorta. All procedures were technically successful and immediate clinical success was obtained. The mean ABPI significantly improved from 0.52 {+-} 0.10 to 0.94 {+-} 0.09 within 24 h after procedure, and remained at 0.90 {+-} 0.12 between 12 and 24 months follow-up (mean 18 months). There was full haemodynamic success at hospital discharge and at 12 and 24 months after the procedure. Clinical success at 12 and 24 months (mean 18 months) was defined as an improvement in the Fontaine classification by at least one class compared with the pre-procedure class and was shown to be 100%. Conclusion: In summary, we report that primary stenting is a safe and effective alternative to surgery in cases of symptomatic stenosis of the infrarenal abdominal aorta. The excellent intermediate term results suggested that we would recommend primary stenting as the treatment of choice for focal atherosclerotic stenoses of the infrarenal aorta in selected patients.

  5. Genetic and Epigenetic Regulation of Aortic Aneurysms (United States)

    Kim, Ha Won


    Aneurysms are characterized by structural deterioration of the vascular wall leading to progressive dilatation and, potentially, rupture of the aorta. While aortic aneurysms often remain clinically silent, the morbidity and mortality associated with aneurysm expansion and rupture are considerable. Over 13,000 deaths annually in the United States are attributable to aortic aneurysm rupture with less than 1 in 3 persons with aortic aneurysm rupture surviving to surgical intervention. Environmental and epidemiologic risk factors including smoking, male gender, hypertension, older age, dyslipidemia, atherosclerosis, and family history are highly associated with abdominal aortic aneurysms, while heritable genetic mutations are commonly associated with aneurysms of the thoracic aorta. Similar to other forms of cardiovascular disease, family history, genetic variation, and heritable mutations modify the risk of aortic aneurysm formation and provide mechanistic insight into the pathogenesis of human aortic aneurysms. This review will examine the relationship between heritable genetic and epigenetic influences on thoracic and abdominal aortic aneurysm formation and rupture. PMID:28116311

  6. Aortic Root Enlargement or Sutureless Valve Implantation?

    Directory of Open Access Journals (Sweden)

    Nikolaos G. Baikoussis


    Full Text Available Aortic valve replacement (AVR in patients with a small aortic annulus is a challenging issue. The importance of prosthesis–patient mismatch (PPM post aortic valve replacement (AVR is controversial but has to be avoided. Many studies support the fact that PPM has a negative impact on short and long term survival. In order to avoid PPM, aortic root enlargement may be performed. Alternatively and keeping in mind that often some comorbidities are present in old patients with small aortic root, the Perceval S suturelles valve implantation could be a perfect solution. The Perceval sutureless bioprosthesis provides reasonable hemodynamic performance avoiding the PPM and providing the maximum of aortic orifice area. We would like to see in the near future the role of the aortic root enlargement techniques in the era of surgical implantation of the sutureless valve (SAVR and the transcatheter valve implantation (TAVI.

  7. Aortic Wall Injury Related to Endovascular Therapy for Aortic Coarctation. (United States)

    Tretter, Justin T; Jones, Thomas K; McElhinney, Doff B


    Aortic wall complications can occur in unrepaired aortic coarctation (CoA) and after surgical repair or endovascular treatment. This review summarizes the available literature and current understanding of aortic wall injury (AWI) surrounding the management of CoA, focusing specifically on acute and follow-up AWI after endovascular treatment. There have been 23 reported cases of aortic rupture after endovascular treatment for CoA, including angioplasty alone, bare metal stenting, and primary covered stent therapy. Even if these published cases represent only a minority of ruptures that have actually occurred, the incidence is substantially <1%. The incidence of acute aneurysm formation was 0% to 13% after angioplasty, 0% to 5% after bare metal stent placement, and <1% after covered stent placement. The reported incidence and natural history of both acute and new AWI during follow-up after endovascular therapy for CoA varies considerably, likely secondary to ascertainment and reporting biases and inconsistent definitions. Although important AWI after endovascular treatment of CoA seems to be declining in frequency with increasing experience and improving technology, it remains one of the most important potential adverse outcomes. Long-term surveillance for new AWI and monitoring of existing AWI is mandatory, with institution of appropriate treatment when necessary. A central research focus in this population should be determination of the appropriate treatment for both native and recurrent CoA across various ages with regard to limiting recurrent CoA and preventing associated aortic wall complications, in addition to determining the appropriate treatment of various AWI. Consistent definitions and reporting are necessary to truly understand the incidence of, risk factors for, and measures protective against AWI after angioplasty or stent implantation for CoA.

  8. Remodelling of the aortic root in severe tricuspid aortic stenosis: implications for transcatheter aortic valve implantation

    Energy Technology Data Exchange (ETDEWEB)

    Stolzmann, Paul; Desbiolles, Lotus; Scheffel, Hans; Leschka, Sebastian; Marincek, Borut; Alkadhi, Hatem [University Hospital Zurich, Institute of Diagnostic Radiology, Zurich (Switzerland); Knight, Joseph; Kurtcuoglu, Vartan; Poulikakos, Dimos [Laboratory of Thermodynamics in Emerging Technologies, Department of Mechanical and Process Engineering, ETH Zurich (Switzerland); Maier, Willibald [University Hospital Zurich, Cardiovascular Center, Zurich (Switzerland); Plass, Andre [University Hospital Zurich, Clinic for Cardiovascular Surgery, Zurich (Switzerland)


    Detailed knowledge of aortic root geometry is a prerequisite to anticipate complications of transcatheter aortic valve (TAV) implantation. We determined coronary ostial locations and aortic root dimensions in patients with aortic stenosis (AS) and compared these values with normal subjects using computed tomography (CT). One hundred consecutive patients with severe tricuspid AS and 100 consecutive patients without valvular pathology (referred to as the controls) undergoing cardiac dual-source CT were included. Distances from the aortic annulus (AA) to the left coronary ostium (LCO), right coronary ostium (RCO), the height of the left coronary sinus (HLS), right coronary sinus (HRS), and aortic root dimensions [diameters of AA, sinus of Valsalva (SV), and sino-tubular junction(STJ)] were measured. LCO and RCO were 14.9 {+-} 3.2 mm (8.2-25.9) and 16.8 {+-} 3.6 mm (12.0-25.7) in the controls, 15.5 {+-} 2.9 mm (8.8-24.3) and 17.3 {+-} 3.6 mm (7.3-26.0) in patients with AS. Controls and patients with AS had similar values for LCO (P = 0.18), RCO (P = 0.33) and HLS (P = 0.88), whereas HRS (P < 0.05) was significantly larger in patients with AS. AA (r = 0.55,P < 0.001), SV (r = 0.54,P < 0.001), and STJ (r = 0.52,P < 0.001) significantly correlated with the body surface area in the controls; whereas no correlation was found in patients with AS. Patients with AS had significantly larger AA (P < 0.01) and STJ (P < 0.01) diameters when compared with the controls. In patients with severe tricuspid AS, coronary ostial locations were similar to the controls, but a transverse remodelling of the aortic root was recognized. Owing to the large distribution of ostial locations and the dilatation of the aortic root, CT is recommended before TAV implantation in each patient. (orig.)

  9. Measurements of gondola motion on a stratospheric balloon flight

    CERN Document Server

    Safonova, Margarita; Sreejith, A G; Sarpotdar, Mayuresh; Ambily, S; Prakash, Ajin; Mathew, Joice; Murthy, Jayant; Anand, Devarajan; Kapardhi, B V N; Kumar, B Suneel; Kulkarni, P M


    Balloon experiments are an economically feasible method of conducting observations in astronomy that are not possible from the ground. The astronomical payload may include a telescope, a detector, and a pointing/stabilization system. Determining the attitude of the payload is of primary importance in such applications, to accurately point the detector/telescope to the desired direction. This is especially important in generally unstable lightweight balloon flights. However, the conditions at float altitudes, which can be reached by zero pressure balloons, could be more stable, enabling accurate pointings. We have used the Inertial Measurement Unit (IMU), placed on a stratospheric zero pressure balloon, to observe 3-axis motion of a balloon payload over a fight time of 4.5 hours, from launch to the float altitude of 31.2 km. The balloon was launched under nominal atmospheric conditions on May 8th 2016, from a Tata Institute of Fundamental Research Balloon Facility, Hyderabad.

  10. Revascularização da artéria marginal com uso da artéria torácica interna direita pediculada retroaórtica sem circulação extracorpórea Off-pump grafting of the circumflex artery with pedicled retro-aortic right internal thoracic artery graft

    Directory of Open Access Journals (Sweden)

    Walter J. Gomes


    , improving survival. We present the technique of OPCAB using both pedicled ATI grafts, with the right ITA (RITA routed retro-aortic through the transverse sinus, to revascularize the branches of the circumflex artery (Cx. METHOD: Twenty-six patients, who underwent OPCAB with bilateral ATI grafts, were studied, where the left ATI (LITA was used to revascularize the left anterior descending artery (LAD and the pedicled RITA, routed through the transverse sinus and anastomosed to the branches of the Cx. Twenty-one patients were male and five female, the age ranging between 42 and 74 years. The morbidities observed in this cohort were previous myocardial infarction in 18 (69% patients, diabetes mellitus in 10 (38%, renal failure in four (7.7% and AIDS in one (3.8% patient. RESULTS: No patient presented ECG changes or enzymatic increases in the postoperative period. The grafts per patient varied from two to four (average 3.0 grafts/patient. No cases of sternal infection or dehiscence were observed. One patient had a stroke on the 4º postoperative day and died. The postoperative hospital stay varied between 3 to 12 days (average 5.8±2.0 days. No late deaths or cardiovascular events were recorded. CONCLUSIONS: This technique makes off-pump grafting of the circumflex artery branches using the pedicled RITA possible and potentially enhances the benefits of coronary artery bypass surgery.

  11. Spectrum of Aortic Valve Abnormalities Associated with Aortic Dilation Across Age Groups in Turner Syndrome (United States)

    Olivieri, Laura J.; Baba, Ridhwan Y.; Arai, Andrew E.; Bandettini, W. Patricia; Rosing, Douglas R.; Bakalov, Vladimir; Sachdev, Vandana; Bondy, Carolyn A.


    Background Congenital aortic valve fusion is associated with aortic dilation, aneurysm and rupture in girls and women with Turner syndrome (TS). Our objective was to characterize aortic valve structure in subjects with TS, and determine the prevalence of aortic dilation and valve dysfunction associated with different types of aortic valves. Methods and Results The aortic valve and thoracic aorta were characterized by cardiovascular magnetic resonance imaging in 208 subjects with TS in an IRB-approved natural history study. Echocardiography was used to measure peak velocities across the aortic valve, and the degree of aortic regurgitation. Four distinct valve morphologies were identified: tricuspid aortic valve (TAV) 64%(n=133), partially fused aortic valve (PF) 12%(n=25), bicuspid aortic valve (BAV) 23%(n=47), and unicuspid aortic valve (UAV) 1%(n=3). Age and body surface area (BSA) were similar in the 4 valve morphology groups. There was a significant trend, independent of age, towards larger BSA-indexed ascending aortic diameters (AADi) with increasing valve fusion. AADi were (mean +/− SD) 16.9 +/− 3.3 mm/m2, 18.3 +/− 3.3 mm/m2, and 19.8 +/− 3.9 mm/m2 (p<0.0001) for TAV, PF and BAV+UAV respectively. PF, BAV, and UAV were significantly associated with mild aortic regurgitation and elevated peak velocities across the aortic valve. Conclusions Aortic valve abnormalities in TS occur with a spectrum of severity, and are associated with aortic root dilation across age groups. Partial fusion of the aortic valve, traditionally regarded as an acquired valve problem, had an equal age distribution and was associated with an increased AADi. PMID:24084490

  12. Effects of rosuvastatin on expression of angiotensin-converting enzyme 2 after vascular balloon injury in rats

    Institute of Scientific and Technical Information of China (English)

    Yong-Hong Li; Qi-Xin Wang; Jing-Wei Zhou; Xian-Ming Chu; Yu-Lin Man; Ping Liu; Bei-Bei Ren; Ting-Ru Sun; Yi An


    Objective To investigate the effects and mechanisms of rosuvastatin on angiotensin -converting enzyme 2 (ACE2) in the process of neointimal formation after vascular balloon injury in rats, and to explore the effects of ACE2 and rosuvastatin in restenosis. Methods Thirty-six Wistar rats were randomly allocated into three groups: control group (n = 12), surgery group (n = 12), and statin group (n = 12). Aortic endothelial denudation of rats was performed using 2F balloon catheters. At days 14 and 28 after injury, aortic arteries were harvested to examine the following. Intimal thickening was examined by hematoxylin and eosin staining. We measured angiotensin II (Ang II) and angiotensin 1-7 (Ang-[1–7]) levels by a radioimmunological method or enzyme-linked immunosorbent assay. Protein and mRNA expression of ACE2 and Ang II type 1 receptor (AT1) were investigated by immunohistochemistry, Western blots, and Reverse transcriptase-polymerase chain reaction (RT-PCR). We measured changes in proliferating cell nuclear antigen (PCNA) by immunohistochemistry. The level of phosphorylated extracellular signal regulated kinase 1/2 (P-ERK1/2) was evaluated by Western blotting. Results Proliferation of vascular smooth muscle cells (VSMC) and intimal thickening were higher at day 14 after vascular balloon injury in the surgery group compared with the control group. Proliferation of VSMC was decreased by day 28 after injury, while intimal thickening continued. With rosuvastatin treatment, the extent of VSMC proliferation and intimal thickening was reduced at day 14 and 28 after injury. Ang II and P-ERK levels were significantly increased, Ang-(1–7) levels were significantly decreased, mRNA and protein expressions of ACE2 were significantly decreased, and AT1 expression was significantly increased at days 14 and 28 after vascular balloon injury in the surgery group compared with the control group. PCNA expression was higher in the surgery group than in the control group, and it

  13. Single center experience in endovascular aortic repair: review of technical and clinical aspects

    Directory of Open Access Journals (Sweden)

    Sinan Demirtaş


    Full Text Available Objective: The aim of this study is sharing of our endovascular aortic repair experiments in patients with high risk for surgery and contributing to literature with comparing previous report according to mortality complicationsand additional operations. Methods:Patients with endovascular aortic repair application were evaluated retrospectively. Perioperative one month mortality, additional applications during procedure, occurred complications, endoleak types, approaching anesthetical technique, diagnosis of disease, comorbid factors and demographical data registered. Results were compared with data in the literature Results: Abdominal endovascular aortic repair (EVAR applicated into 19 patients. Thoracic endovascular aor tic repair (TEVAR applicated into 11 patients. EVAR patients were operated with diagnosis of abdominal aortic aneurysm. Nine of these patients were emergely operated due to rupture. TEVAR applicated 8 patients were operated due to Type 3 Aortic Dissection and 1 patient was operated due to transsection. One month mortality of all patients were found as 10% (three atients. Endoleaks were occurred 6 patients: Three of them were Type 1a, two of them were Type1b and one of them was Type2. Balloon angioplasty applicated in two patients due to Type 1a endoleak and, in one patient due to Type 1b endoleak. Chronic renal failure was developed in one patient (3.3% due to contrast nephropathy. Reexploration was applicated in two patients (6.7% due to hematoma. Conclusion: Endovascular techniques are become frequently preferred treatment modality with the developing technology. We believed that endovascular approaches are safely preferable alternative in patients with high surgical risk as our series.

  14. Report on the Activities of National Balloon Facility, Hyderabad (United States)

    Vasudevan, Rajagopalan; Sreenivasan, S.; Suneel Kumar, B.; Kulkarni, P. M.


    More than five and half decades back, the Indian Balloon Group at Tata Institute of Fundamental Research, Mumbai started development of stratospheric zero pressure balloon technology and today it is one among the leading balloon groups in the world. For the past 40 years, the Institute has been operating a Scientific Balloon Facility at Hyderabad and carried out 478 balloon flights for various disciplines of space sciences like primary cosmic ray studies, X ray, Gamma Ray, Infra Red Astronomies and Atmospheric science maintaining 100% success rate during the past nine years. The Balloon Facility has the capability to build balloons of volume up to 750,000 Cu.M. as well as carrying out R & D in all aspects of scientific ballooning like balloon engineering, balloon material development, general and flight support instrumentation. A continued effort in R & D for ultra thin balloon material for High Altitude Sounding Flights has resulted in lowering the thickness of the proven indigenous Antrix film initially from 6 to 3.8 microns in the first phase and further reduction to 2.7 microns in the second phase. A test balloon of volume 5000 Cu.M. using the 2.7 micron film attained a record altitude of 45.0 Km. amsl with 1 Kg. GPS sonde payload. A 60,000 Cu.M. balloon fabricated out of 3.8 micron film capable of reaching 47 Km. Altitude with 10 Kg. Payload is awaiting trial. This report briefly describes our balloon activities during the past two years. In atmospheric sciences, aerosol studies were made with OPC,QCM,Aethelometer, Nephelometer,MWR, CIMEL Sun Photometer and Raman LIDAR.Measuments of vertical profile of Meteorological parameters and ozone upto stratosphere using GPS Radiosonde and Ozone sonde is made respectively.Study of Ionospheric tomography is done with CADI and CRABEX.

  15. Basal longitudinal strain predicts future aortic valve replacement in asymptomatic patients with aortic stenosis

    DEFF Research Database (Denmark)

    Carstensen, Helle Gervig; Larsen, Linnea Hornbech; Hassager, Christian


    of myocardial dysfunction and predictors of outcome in asymptomatic aortic stenosis. Aortic stenosis and ischaemic heart disease share risk factors and longitudinal function can be severely reduced in both conditions, why some of the previous findings of impaired regional longitudinal function in asymptomatic...... aortic stenosis could in fact be explained by silent ischaemic heart disease. METHODS AND RESULTS: Prospective follow-up of 104 asymptomatic patients with moderate-severe aortic stenosis defined as an aortic valve area ...: In contrast to GLS, reduced BLS is a significant predictor of future AVR in asymptomatic patients with aortic stenosis, independently of clinical characteristics, conventional echocardiographic measures, and coronary pathology....

  16. Statins for aortic valve stenosis

    Directory of Open Access Journals (Sweden)

    Luciana Thiago

    Full Text Available ABSTRACT BACKGROUND: Aortic valve stenosis is the most common type of valvular heart disease in the USA and Europe. Aortic valve stenosis is considered similar to atherosclerotic disease. Some studies have evaluated statins for aortic valve stenosis. OBJECTIVES: To evaluate the effectiveness and safety of statins in aortic valve stenosis. METHODS: Search methods: We searched the Cochrane Central Register of Controlled Trials (CENTRAL, MEDLINE, Embase, LILACS - IBECS, Web of Science and CINAHL Plus. These databases were searched from their inception to 24 November 2015. We also searched trials in registers for ongoing trials. We used no language restrictions. Selection criteria: Randomized controlled clinical trials (RCTs comparing statins alone or in association with other systemic drugs to reduce cholesterol levels versus placebo or usual care. Data collection and analysis: Primary outcomes were severity of aortic valve stenosis (evaluated by echocardiographic criteria: mean pressure gradient, valve area and aortic jet velocity, freedom from valve replacement and death from cardiovascular cause. Secondary outcomes were hospitalization for any reason, overall mortality, adverse events and patient quality of life. Two review authors independently selected trials for inclusion, extracted data and assessed the risk of bias. The GRADE methodology was employed to assess the quality of result findings and the GRADE profiler (GRADEPRO was used to import data from Review Manager 5.3 to create a 'Summary of findings' table. MAIN RESULTS: We included four RCTs with 2360 participants comparing statins (1185 participants with placebo (1175 participants. We found low-quality evidence for our primary outcome of severity of aortic valve stenosis, evaluated by mean pressure gradient (mean difference (MD -0.54, 95% confidence interval (CI -1.88 to 0.80; participants = 1935; studies = 2, valve area (MD -0.07, 95% CI -0.28 to 0.14; participants = 127; studies = 2

  17. Decreased expression of fibulin-4 in aortic wall of aortic dissection. (United States)

    Huawei, P; Qian, C; Chuan, T; Lei, L; Laing, W; Wenlong, X; Wenzhi, L


    In this research, we will examine the expression of Fibulin-4 in aortic wall to find out its role in aortic dissection development. The samples of aortic wall were obtained from 10 patients operated for acute ascending aortic dissection and five patients for chronic ascending aortic dissection. Another 15 pieces of samples from patients who had coronary artery bypass were as controls. The aortic samples were stained with aldehyde magenta dyeing to evaluate the arrangement of elastic fibers. The Fibulin-4 protein and mRNA expression were both determined by Western blot and realtime quantitative polymerase chain reaction. Compared with the control group, both in acute and chronic ascending aortic dissection, elastic fiber fragments increased and the expression of fibulin-4 protein significantly decreased (P= 0.045 < 0.05). The level of fibulin-4 mRNA decreased in acute ascending aortic dissection (P= 0.034 < 0.05), while it increased in chronic ascending aortic dissection (P=0.004 < 0.05). The increased amounts of elastic fiber fragments were negatively correlated with the expression of fibulin-4 mRNA in acute ascending aortic dissection. In conclusion, in aortic wall of ascending aortic dissection, the expression of fibulin-4 protein decreased and the expression of fibulin-4 mRNA was abnormal. Fibulin-4 may play an important role in the pathogenesis of aortic dissection.

  18. Transcatheter aortic valve implantation versus surgical aortic valve replacement for severe aortic stenosis: a meta analysis

    Institute of Scientific and Technical Information of China (English)

    WU Yi-cheng; ZHANG Jian-feng; SHEN Wei-feng; ZHAO Qiang


    Background Transcatheter aortic valve implantation (TAVI) has emerged as the treatment choice for non-operable patients with severe symptomatic aortic stenosis (AS) and may be a good alternative to surgery for those at very high or prohibitive surgical risk.We performed a meta-analysis to evaluate the comparative benefits of TAVI versus surgical aortic valve replacement (SAVR) in patients with severe AS.Methods A comprehensive literature search of PubMed,Embase,ScienceDirect and Cochrane Central Register of Controlled trials was performed,and randomized trials as well as cohort studies with propensity score analysis were included.Results One randomized trial (n=699) and six retrospective cohort studies (n=781) were selected for meta-analysis.Mortality at 30-day and 1-year follow-up was comparable between TAVI and SAVR.Despite similar incidences of stroke,myocardial infarction,re-operation for bleeding,and renal failure requiring dialysis,TAVI was associated with a lower occurrence rate of new-onset atrial fibrillation (OR 0.51,95% CI 0.33-0.78) and shorter procedural time (mean difference -67.50 minutes,95% CI-87.20 to-47.81 minutes).Post-operative aortic regurgitation and permanent pacemaker implantation were more common in patients after TAVI than in those with SAVR (OR 5.53,95% CI 3.41-8.97; OR 1.71,95% Cl 1.02-2.84,respectively).Conclusion In patients with severe symptomatic AS,TAVI and SAVR did not differ with respect to short-and mid-term survival,but the incidence of permanent pacemaker implantation and post-procedural aortic regurgitation remain relatively high after TAVI.

  19. Balloon-borne gamma-ray polarimetry

    CERN Document Server

    Pearce, Mark


    The physical processes postulated to explain the high-energy emission mechanisms of compact astrophysical sources often yield polarised soft gamma rays (X-rays). PoGOLite is a balloon-borne polarimeter operating in the 25-80 keV energy band. The polarisation of incident photons is reconstructed using Compton scattering and photoelectric absorption in an array of phoswich detector cells comprising plastic and BGO scintillators, surrounded by a BGO side anticoincidence shield. The polarimeter is aligned to observation targets using a custom attitude control system. The maiden balloon flight is scheduled for summer 2011 from the Esrange Space Centre with the Crab and Cygnus X-1 as the primary observational targets.

  20. Pump characteristics and applications

    CERN Document Server

    Volk, Michael


    Providing a wealth of information on pumps and pump systems, Pump Characteristics and Applications, Third Edition details how pump equipment is selected, sized, operated, maintained, and repaired. The book identifies the key components of pumps and pump accessories, introduces the basics of pump and system hydraulics as well as more advanced hydraulic topics, and details various pump types, as well as special materials on seals, motors, variable frequency drives, and other pump-related subjects. It uses example problems throughout the text, reinforcing the practical application of the formulae

  1. [Surgical technique of aortic valve replacement for small aortic annulus in elderly patients]. (United States)

    Hata, T; Fujiwara, K; Furukawa, H; Tsushima, Y; Yoshitaka, H; Kuinose, M; Minami, H; Ishida, A; Tamura, K; Totsugawa, T; Kanemitsu, H; Ozawa, M


    Recent reports have shown that aortic valve replacement in elderly patients over 65 years with atherosclerotic aortic stenosis and a small aortic annulus is possible by using a small sized bioprosthesis (Carpentier-Edwards pericardial valve). Here we present out surgical technique. Firstly, the native calcified aortic valve was removed completely to gain total exposure of the surrounding aortic root and sinus of Valsalva like Bentall procedure. Secondly, a small sized bioprosthesis was implanted with intermittent noneverting mattress 2-0 sutures with spaghetti and small polytetrafluoroethylene (PTFE) felt. Aortic annulus is the dilated by inserting Hegar dilator sizing from 25 to 27 mm. Therefore, aortic valve replacement for small aortic annulus in intra- or supra-annular position should be easily accomplished. Good surgical results and hemodynamic state were achieved in 25 consecutive cases using this technique.

  2. Burn Injury Arise From Flying Balloon Toys


    Yalcin Kulahci; Fatih Zor; Mehmet Bozkurt; Serdar Ozturk; Mustafa Sengezer


    Many of peoples are faced minor or major burn injuries in their life. Even the most widespread burn cause is flame injuries, too different burn cause pointed out in literature like Acetylen burns. The cases which imply in literature, mostly causes from explosion of high pressure acetylene tube, metal oxygene patch flame or carbide lamp using from cave explorers. An interesting acetylene burn cause in Turkey was publised by the authors. This cases was to come into being from flying toy balloon...

  3. Double balloon enteroscopy examinations in general anesthesia

    Institute of Scientific and Technical Information of China (English)

    Laszlo; Zubek; Lena; Szabo; Peter; Laszlo; Lakatos; Janos; Papp; Janos; Gal; Gabor; Elo


    AIM:To demonstrate that the double balloon enteroscopy(DBE) can be safely performed in general anesthesia with intubation.METHODS:We performed a retrospective examination between August 2005 and November 2008 amongpatients receiving intubation narcosis due to DBE examination.The patients were grouped based on sex,age and physical status.Anesthesia records includedduration of anesthesia,quantity of medication usedand anesthesia-related complications.We determinedthe frequency of complications in the differen...

  4. MAXIS Balloon Observations of Electron Microburst Precipitation (United States)

    Millan, R. M.; Hunter, A. E.; McCarthy, M. P.; Lin, R. P.; Smith, D. M.


    Quantifying and understanding losses is an integral part of understanding relativistic electron variability in the radiation belts. SAMPEX observations indicate that electron microburst precipitation is a major loss mechanism during active periods; the loss of relativistic electrons during a six hour period due to microburst precipitation was recently estimated to be comparable to the total number of trapped electrons in the outer zone (Lorentzen et al., 2001). Microburst precipitation was first observed from a balloon (Anderson and Milton, 1964), but these early measurements were only sensitive to MAXIS 2000 long duration balloon campaign. MAXIS was launched from McMurdo Station in Antarctica carrying a germanium spectrometer, a BGO scintillator and two X-ray imagers designed to measure the bremsstrahlung produced by precipitating electrons. The balloon circumnavigated the south pole in 18 days covering magnetic latitudes ranging from 58o-90o South. During the week following a moderate geomagnetic storm (with Dst reaching -91 nT), MAXIS detected a total of over 16 hours of microburst precipitation. We present high resolution spectra obtained with the MAXIS germanium spectrometer which allow us to determine the precipitating electron energy distribution. The precipitating distribution will then be compared to the trapped distribution measured by the GPS and LANL satellites. We also examine the spatial distribution of the precipitation.

  5. Long Duration Balloon Charge Controller Stack Integration (United States)

    Clifford, Kyle

    NASA and the Columbia Scientific Balloon Facility are interested in updating the design of the charge controller on their long duration balloon (LDB) in order to enable the charge controllers to be directly interfaced via RS232 serial communication by a ground testing computers and the balloon's flight computer without the need to have an external electronics stack. The design involves creating a board that will interface with the existing boards in the charge controller in order to receive telemetry from and send commands to those boards, and interface with a computer through serial communication. The inputs to the board are digital status inputs indicating things like whether the photovoltaic panels are connected or disconnected; and analog inputs with information such as the battery voltage and temperature. The outputs of the board are 100ms duration command pulses that will switch relays that do things like connect the photovoltaic panels. The main component of this design is a PIC microcontroller which translates the outputs of the existing charge controller into serial data when interrogated by a ground testing or flight computer. Other components involved in the design are an AD7888 12-bit analog to digital converter, a MAX3232 serial transceiver, various other ICs, capacitors, resistors, and connectors.

  6. Report on the Brazilian Scientific Balloon Program (United States)

    Braga, Joao


    We report on the recent scientific ballooning activities in Brazil, and present the plans for the next few years. Recent technological developments, especially on telecommunications and gondola attitude control systems will be reported. We also present the recent progress achieved in the development of the protoMIRAX balloon experiment. protoMIRAX is a balloon-borne hard X-ray imaging telescope under development at INPE as a pathfinder for the MIRAX (Monitor e Imageador de Raios X) satellite mission. The experiment consists essentially in a hard X-ray coded-aperture imager to operate in the 20-200 keV energy range. The detector plane is a square array of 196 10mm x 10mm x 2mm CdZnTe (CZT) planar detectors. A collimator defines a fully-coded field-of-view of 20 x 20 degrees, with 7 x 7 degrees of full sensitivity and an angular resolution of 1.7 degrees. We describe the final stages of development and testing of the front-end electronics, with charge preamplifiers, LNAs, shapers and Wilkinson-type ADCs customized for these detectors. We also show detailed Monte Carlo simulations of the flight background and the expected flight images of bright sources performed with the use of GEANT4.

  7. Numerical Modelling Of Pumpkin Balloon Instability (United States)

    Wakefield, D.

    Tensys have been involved in the numerical formfinding and load analysis of architectural stressed membrane structures for 15 years. They have recently broadened this range of activities into the `lighter than air' field with significant involvement in aerostat and heavy-lift hybrid airship design. Since early 2004 they have been investigating pumpkin balloon instability on behalf of the NASA ULDB programme. These studies are undertaken using inTENS, an in-house finite element program suite based upon the Dynamic Relaxation solution method and developed especially for the non-linear analysis and patterning of membrane structures. The paper describes the current state of an investigation that started with a numerical simulation of the lobed cylinder problem first studied by Calladine. The influence of material properties and local geometric deformation on stability is demonstrated. A number of models of complete pumpkin balloons have then been established, including a 64-gore balloon with geometry based upon Julian Nott's Endeavour. This latter clefted dramatically upon initial inflation, a phenomenon that has been reproduced in the numerical model. Ongoing investigations include the introduction of membrane contact modelling into inTENS and correlation studies with the series of large-scale ULDB models currently in preparation.

  8. Identification and classification of physiologically significant pumping states in an implantable rotary blood pump. (United States)

    Karantonis, Dean M; Lovell, Nigel H; Ayre, Peter J; Mason, David G; Cloherty, Shaun L


    In a clinical setting it is necessary to control the speed of rotary blood pumps used as left ventricular assist devices to prevent possible severe complications associated with over- or underpumping. The hypothesis is that by using only the noninvasive measure of instantaneous pump impeller speed to assess flow dynamics, it is possible to detect physiologically significant pumping states (without the need for additional implantable sensors). By varying pump speed in an animal model, five such states were identified: regurgitant pump flow, ventricular ejection (VE), nonopening of the aortic valve over the cardiac cycle (ANO), and partial collapse (intermittent and continuous) of the ventricle wall (PVC-I and PVC-C). These states are described in detail and a strategy for their noninvasive detection has been developed and validated using (n = 6) ex vivo porcine experiments. Employing a classification and regression tree, the strategy was able to detect pumping states with a high degree of sensitivity and specificity: state VE-99.2/100.0% (sensitivity/specificity); state ANO-100.0/100.0%; state PVC-I- 95.7/91.2%; state PVC-C-69.7/98.7%. With a simplified binary scheme differentiating suction (PVC-I, PVC-C) and nonsuction (VE, ANO) states, both such states were detected with 100% sensitivity.

  9. Metabolic and hemodynamic effects of saline infusion to maintain volemia on temporary abdominal aortic occlusion

    Directory of Open Access Journals (Sweden)

    Fábio Ferreira Amorim


    Full Text Available OBJECTIVE: To analyze hemodynamic and metabolic effects of saline solution infusion in the maintenance of blood volume in ischemia-reperfusion syndrome during temporary abdominal aortic occlusion in dogs. METHODS: We studied 20 dogs divided into 2 groups: the ischemia-reperfusion group (IRG, n=10 and the ischemia-reperfusion group with saline solution infusion aiming at maintaining mean pulmonary arterial wedge pressure between 10 and 20 mmHg (IRG-SS, n=10. All animals were anesthetized with sodium thiopental and maintained on spontaneous ventilation. Occlusion of the supraceliac aorta was obtained with inflation of a Fogarty catheter inserted through the femoral artery. After 60 minutes of ischemia, the balloon was deflated, and the animals were observed for another 60 minutes of reperfusion. RESULTS: IRG-SS dogs did not have hemodynamic instability after aortic unclamping, and the mean systemic blood pressure and heart rate were maintained. However, acidosis worsened, which was documented by a greater reduction of arterial pH that occurred especially due to the absence of a respiratory response to metabolic acidosis that was greater with the adoption of this procedure. CONCLUSION: Saline solution infusion to maintain blood volume avoided hemodynamic instability after aortic unclamping. This procedure, however, caused worsening in metabolic acidosis in this experimental model.

  10. Aortic endograft sizing in trauma patients with hemodynamic instability

    NARCIS (Netherlands)

    Jonker, Frederik H. W.; Verhagen, Hence J. M.; Mojibian, Hamid; Davis, Kimberly A.; Moll, Frans L.; Muhs, Bart E.


    Objectives: To investigate changes in aortic diameter in hemodynamically unstable trauma patients and the implications for sizing of thoracic endovascular aortic repair (TEVAR) in patients with traumatic thoracic aortic injury (TTAI). Methods: We retrospectively evaluated all trauma patients that we

  11. Indexing aortic valve area by body surface area increases the prevalence of severe aortic stenosis

    DEFF Research Database (Denmark)

    Jander, Nikolaus; Gohlke-Bärwolf, Christa; Bahlmann, Edda


    To account for differences in body size in patients with aortic stenosis, aortic valve area (AVA) is divided by body surface area (BSA) to calculate indexed AVA (AVAindex). Cut-off values for severe stenosis are......To account for differences in body size in patients with aortic stenosis, aortic valve area (AVA) is divided by body surface area (BSA) to calculate indexed AVA (AVAindex). Cut-off values for severe stenosis are...

  12. Novel Use of an Apical-Femoral Wire Rail to Assist With Transfemoral Transcatheter Aortic Valve Replacement (United States)

    Don, Creighton W.; Kim, Michael S.; Verrier, Edward D.; Aldea, Gabriel S.; Dean, Larry S.; Reisman, Mark; Mokadam, Nahush A.


    The inability to reposition or retrieve balloon-expandable transcatheter aortic valves once they have been deployed requires implantation of the valve in the descending aorta or open surgical procedures to extract the valve. We describe the challenging transfemoral delivery of an Edwards Lifesciences Sapien valve wherein we had difficulty crossing the aortic valve and the guidewire position was compromised. We performed a transapical puncture to snare the guidewire and create a left ventricular to femoral wire rail, allowing us to deliver the transfemoral transcatheter valve, salvaging a situation where we would have been required to implant the valve in the descending aorta. We believe this is the first time this technique has been reported and represents an important method to facilitate delivery of transcatheter valves where guidewire support is insufficient or lost. PMID:24907088

  13. Transcatheter aortic valve replacement for bicuspid aortic stenosis 13years post heart transplant. (United States)

    Julien, Maureen B; Desai, Nimesh; Brozena, Susan; Herrmann, Howard C


    Despite the widespread use of transcatheter aortic valve replacement (TAVR) for moderate and high-risk patients with severe aortic stenosis, it is utilized less frequently in patients with bicuspid aortic valves (BAV). Orthotopic heart transplant (OHT) donors tend to be younger and may have undiagnosed BAV. We present a case of successful TAVR in a patient with BAV thirteen years after OHT.

  14. Transcatheter valve-in-valve implantation due to severe aortic regurgitation in a degenerated aortic homograft

    DEFF Research Database (Denmark)

    Olsen, Lene Kjaer; Engstrøm, Thomas; Søndergaard, Lars


    a successful valve-in-valve implantation of a CoreValve aortic valve prosthesis through the right subclavian artery in a case of severe aortic regurgitation within a degenerated aortic homograft. The case exemplifies the possibilities of expanding the indications for TAVI, as well as other vascular access...

  15. New-onset atrial fibrillation after surgical aortic valve replacement and transcatheter aortic valve implantation

    DEFF Research Database (Denmark)

    Jørgensen, Troels Højsgaard; Thygesen, Julie Bjerre; Thyregod, Hans Gustav;


    Surgical aortic valve replacement (SAVR) and, more recently, transcatheter aortic valve implantation (TAVI) have been shown to be the only treatments that can improve the natural cause of severe aortic valve stenosis. However, after SAVR and TAVI, the incidence of new-onset atrial fibrillation...

  16. New-Onset Atrial Fibrillation After Surgical Aortic Valve Replacement and Transcatheter Aortic Valve Implantation

    DEFF Research Database (Denmark)

    Jørgensen, Troels Højsgaard; Thygesen, Julie Bjerre; Thyregod, Hans Gustav;


    Surgical aortic valve replacement (SAVR) and, more recently, transcatheter aortic valve implantation (TAVI) have been shown to be the only treatments that can improve the natural cause of severe aortic valve stenosis. However, after SAVR and TAVI, the incidence of new-onset atrial fibrillation...

  17. The Efficacy of Autologous Femoropopliteal Vein Reconstruction for Primary Aortic and Aortic Graft Infection

    NARCIS (Netherlands)

    Dirven, M.; Jagt, M.F.P. van der; Barendregt, W.B.; Vliet, D. van der


    BACKGROUND: The objective of our study was to analyze the efficacy of autologous superficial femoropopliteal vein reconstruction for primary aortic or aortic graft infection. METHODS: We performed a retrospective analysis of 14 patients treated for an infected aortic prosthesis or primary infected a

  18. Low-gradient aortic stenosis. (United States)

    Clavel, Marie-Annick; Magne, Julien; Pibarot, Philippe


    An important proportion of patients with aortic stenosis (AS) have a 'low-gradient' AS, i.e. a small aortic valve area (AVA <1.0 cm(2)) consistent with severe AS but a low mean transvalvular gradient (<40 mmHg) consistent with non-severe AS. The management of this subset of patients is particularly challenging because the AVA-gradient discrepancy raises uncertainty about the actual stenosis severity and thus about the indication for aortic valve replacement (AVR) if the patient has symptoms and/or left ventricular (LV) systolic dysfunction. The most frequent cause of low-gradient (LG) AS is the presence of a low LV outflow state, which may occur with reduced left ventricular ejection fraction (LVEF), i.e. classical low-flow, low-gradient (LF-LG), or preserved LVEF, i.e. paradoxical LF-LG. Furthermore, a substantial proportion of patients with AS may have a normal-flow, low-gradient (NF-LG) AS: i.e. a small AVA-low-gradient combination but with a normal flow. One of the most important clinical challenges in these three categories of patients with LG AS (classical LF-LG, paradoxical LF-LG, and NF-LG) is to differentiate a true-severe AS that generally benefits from AVR vs. a pseudo-severe AS that should be managed conservatively. A low-dose dobutamine stress echocardiography may be used for this purpose in patients with classical LF-LG AS, whereas aortic valve calcium scoring by multi-detector computed tomography is the preferred modality in those with paradoxical LF-LG or NF-LG AS. Although patients with LF-LG severe AS have worse outcomes than those with high-gradient AS following AVR, they nonetheless display an important survival benefit with this intervention. Some studies suggest that transcatheter AVR may be superior to surgical AVR in patients with LF-LG AS.

  19. Aortic dilatation in children with systemic hypertension. (United States)

    Gupta-Malhotra, Monesha; Devereux, Richard B; Dave, Archana; Bell, Cynthia; Portman, Ronald; Milewicz, Diana


    The aim of the study was to determine the presence of aortic dilatation in hypertensive children, the prevalence of which is 4% to 10% in hypertensive adults. Prospectively enrolled multiethnic children, untreated for their hypertension, underwent an echocardiogram to exclude congenital heart disease and evaluate for end-organ damage and aortic size. The aorta was measured in the parasternal long-axis view at three levels: the sinus of Valsalva, supra-tubular junction, and the ascending aorta. Aortic dilatation was determined by z-score >2 at any one of the levels measured. Hypertension was defined as blood pressure above the 95th percentile based on the Fourth Working Group criteria confirmed by 24-hour ambulatory blood pressure monitoring. Among 142 consecutive hypertensive children (median age, 14 years; 45% females) aortic dilatation was detected in 2.8% (95% confidence interval, 1%-7%; median age, 16 years; 100% females). Children with aortic dilatation, when compared with those without, had significantly more aortic valve insufficiency (P = .005) and left ventricular hypertrophy (P = .018). Prevalence of aortic dilatation was 2.8% and was associated with significantly more aortic insufficiency and left ventricular hypertrophy in comparison to those without aortic dilatation.

  20. Hybrid treatment of penetrating aortic ulcer

    Energy Technology Data Exchange (ETDEWEB)

    Lara, Juan Antonio Herrero; Martins-Romeo, Daniela de Araujo; Escudero, Carlos Caparros; Falcon, Maria del Carmen Prieto; Batista, Vinicius Bianchi, E-mail: [Unidade de Gestao Clinica (UGC) de Diagnostico por Imagem - Hosppital Universitario Virgen Macarena, Sevilha (Spain); Vazquez, Rosa Maria Lepe [Unit of Radiodiagnosis - Hospital Nuestra Senora de la Merced, Osuna, Sevilha (Spain)


    Penetrating atherosclerotic aortic ulcer is a rare entity with poor prognosis in the setting of acute aortic syndrome. In the literature, cases like the present one, located in the aortic arch, starting with chest pain and evolving with dysphonia, are even rarer. The present report emphasizes the role played by computed tomography in the diagnosis of penetrating atherosclerotic ulcer as well as in the differentiation of this condition from other acute aortic syndromes. Additionally, the authors describe a new therapeutic approach represented by a hybrid endovascular surgical procedure for treatment of the disease. (author)

  1. Aortic dissection: magnetic resonance imaging. (United States)

    Amparo, E G; Higgins, C B; Hricak, H; Sollitto, R


    Fifteen patients with suspected or known aortic dissection were imaged with magnetic resonance (MR). Thirteen of these patients were eventually shown to have dissection. In most instances the diagnosis was established by aortography and/or computed tomography (CT) prior to the MR study. Surgical proof (6/13) and/or aortographic proof (10/13) were available in 11/13 patients with aortic dissection. MR demonstrated the intimal flap and determined whether the dissection was type A or type B. In addition, MR: differentiated between the true and false lumens; determined the origins of the celiac, superior mesenteric, and renal arteries from the true or false lumen in the cases where the dissection extended into the abdominal aorta (8/12); allowed post-surgical surveillance of the dissection; and identified aortoannular ectasia in the three patients who had Marfan syndrome. In addition to the 13 cases with dissection, there were two cases in whom the diagnosis of dissection was excluded by MR. Our early experience suggests that MR can serve as the initial imaging test in clinically suspected cases of aortic dissection and that the information provided by MR is sufficient to manage many cases. Additionally, MR obviates the use of iodinated contrast media.

  2. A prospective, randomised trial of transapical transcatheter aortic valve implantation vs. surgical aortic valve replacement in operable elderly patients with aortic stenosis

    DEFF Research Database (Denmark)

    Nielsen, Hans Henrik Møller; Klaaborg, Kaj E; Nissen, Henrik


    In a prospective randomised trial we aimed to compare transapical transcatheter aortic valve implantation (a-TAVI) with surgical aortic valve replacement (SAVR) in operable elderly patients.......In a prospective randomised trial we aimed to compare transapical transcatheter aortic valve implantation (a-TAVI) with surgical aortic valve replacement (SAVR) in operable elderly patients....

  3. LMFBR with booster pump in pumping loop (United States)

    Rubinstein, H.J.


    A loop coolant circulation system is described for a liquid metal fast breeder reactor (LMFBR) utilizing a low head, high specific speed booster pump in the hot leg of the coolant loop with the main pump located in the cold leg of the loop, thereby providing the advantages of operating the main pump in the hot leg with the reliability of cold leg pump operation.

  4. Heat pump technology

    CERN Document Server

    Von Cube, Hans Ludwig; Goodall, E G A


    Heat Pump Technology discusses the history, underlying concepts, usage, and advancements in the use of heat pumps. The book covers topics such as the applications and types of heat pumps; thermodynamic principles involved in heat pumps such as internal energy, enthalpy, and exergy; and natural heat sources and energy storage. Also discussed are topics such as the importance of the heat pump in the energy industry; heat pump designs and systems; the development of heat pumps over time; and examples of practical everyday uses of heat pumps. The text is recommended for those who would like to kno


    NARCIS (Netherlands)



    Prolonged angioplasty balloon inflation with an autoperfusion balloon for failed conventional coronary angioplasty, was compared with emergency surgery for this condition. Restenosis was assessed 6 weeks after successful intervention with the autoperfusion balloon. Forty consecutive patients with pe

  6. Aortic valve replacement for aortic stenosis with a small aortic annulus in a patient having Werner's syndrome and liver cirrhosis. (United States)

    Sogawa, M; Kasuya, S; Yamamoto, K; Koshika, M; Oguma, F; Hayashi, J


    Werner's syndrome is a rare genetic disease characterized by premature aging and scleroderma-like involvement of the skin. We report a case of aortic valve replacement for severely calcified aortic valve stenosis with a small annulus in a patient suffering from Werner's syndrome and liver cirrhosis

  7. Dry vacuum pumps (United States)

    Sibuet, R.


    For decades and for ultimate pressure below 1 mbar, oil-sealed Rotary Vane Pumps have been the most popular solution for a wide range of vacuum applications. In the late 80ies, Semiconductor Industry has initiated the development of the first dry roughing pumps. Today SC applications are only using dry pumps and dry pumping packages. Since that time, pumps manufacturers have developed dry vacuum pumps technologies in order to make them attractive for other applications. The trend to replace lubricated pumps by dry pumps is now spreading over many other market segments. For the Semiconductor Industry, it has been quite easy to understand the benefits of dry pumps, in terms of Cost of Ownership, process contamination and up-time. In this paper, Technology of Dry pumps, its application in R&D/industries, merits over conventional pumps and future growth scope will be discussed.

  8. Aortic annuloplasty with aortic root reconstruction to prevent patient-prosthesis mismatch. (United States)

    Hopkins, Richard A


    Part of the ongoing argument concerning patient-prosthesis mismatch (PPM) following aortic valve replacement (AVR) is due to the perception that aortic annulus enlargement procedures increase the risk and technical difficulty of aortic valve surgery. Here, an aortic root reconstruction that involves enlargement of the annulus and tailoring of the aortic root to accommodate larger stented prostheses is presented that has been personally performed in 196 patients with no technique-related surgical deaths or complications, and thus can be carried out without additional risk. This aortic root enlargement aortoplasty and annuloplasty method can be calibrated to all AVRs involving stented manufactured prostheses when these are deemed the prosthesis of choice for the patient with a relatively small annulus and/or aortic root, severe left ventricular hypertrophy, compromised LV function or a very active lifestyle, to achieve predicted EOA values > or = 1.00 cm2/m2.

  9. [Unicuspid Aortic Valve Stenosis Combined with Aortic Coarctation;Report of a Case]. (United States)

    Kubota, Takehiro; Wakasa, Satoru; Shingu, Yasushige; Matsui, Yoshiro


    Unicuspid aortic valve in an adult is extremely rare. In addition, 90% of the patients with aortic coarctation are reported to die before the age 50. A 60-year-old woman was admitted to our hospital for further examination of exertional dyspnea which had begun one year before. She had been under medical treatment for hypertension since early thirties, and had been also diagnosed with moderate aortic stenosis at 50 years of age. She was at 1st diagnosed with aortic coarctation combined with bicuspid aortic valve stenosis. The aortic valve was then found unicuspid and was replaced under cardiopulmonary bypass with perfusion to both the ascending aorta and the femoral artery. Repair of aortic coarctation was performed 3 months later through left thoracotomy without extracorporeal circulation due to the rich collateral circulation. She had no postoperative complications, and hypertension as well as ankle-brachial index improved to the normal levels.

  10. Fluid Dynamics in Rotary Piston Blood Pumps. (United States)

    Wappenschmidt, Johannes; Sonntag, Simon J; Buesen, Martin; Gross-Hardt, Sascha; Kaufmann, Tim; Schmitz-Rode, Thomas; Autschbach, Ruediger; Goetzenich, Andreas


    Mechanical circulatory support can maintain a sufficient blood circulation if the native heart is failing. The first implantable devices were displacement pumps with membranes. They were able to provide a sufficient blood flow, yet, were limited because of size and low durability. Rotary pumps have resolved these technical drawbacks, enabled a growing number of mechanical circulatory support therapy and a safer application. However, clinical complications like gastrointestinal bleeding, aortic insufficiency, thromboembolic complications, and impaired renal function are observed with their application. This is traced back to their working principle with attenuated or non-pulsatile flow and high shear stress. Rotary piston pumps potentially merge the benefits of available pump types and seem to avoid their complications. However, a profound assessment and their development requires the knowledge of the flow characteristics. This study aimed at their investigation. A functional model was manufactured and investigated with particle image velocimetry. Furthermore, a fluid-structure interaction computational simulation was established to extend the laboratory capabilities. The numerical results precisely converged with the laboratory measurements. Thus, the in silico model enabled the investigation of relevant areas like gap flows that were hardly feasible with laboratory means. Moreover, an economic method for the investigation of design variations was established.

  11. Stratospheric composition from balloon based measurements

    Energy Technology Data Exchange (ETDEWEB)

    Mencaraglia, F.; Carli, B. [Ist. per le Ricerche sulle Onde Elettromagnetiche, Firenze (Italy); Bonetti, A.; Ciarpallini, P. [Univ. di Firenze (Italy); Carlotti, M.; Lepri, G. [Univ. di Bologna (Italy); Alboni, F.; Cortesi, U.; Ridolfi, M. [Fondazione per la Metereologia Applicata, Firenze (Italy)


    Measurements of the composition of the earth`s atmosphere is of fundamental importance for the study of atmospheric chemistry and for developing models that can predict the evolution of the atmosphere itself. Here, the chemical composition of the lower stratosphere has been measured using a polarizing interferometer operating in the far infrared and submillimetric spectral region. The instrument was flown three times (in 1992, 1993 and 1994) from the NSBF balloon base (Fort Sumner, New Mexico) in coincidence with overpasses of the UARS satellite, for a total of about 50 hours of measurements. In this paper the authors report some of the results obtained from the data analysis made up to now.

  12. Double-balloon endoscopy: Who needs it?

    DEFF Research Database (Denmark)

    Hendel, J.W.; Vilmann, P.; Jensen, T.


    Objective. Double-balloon endoscopy (DBE) made the small bowel accessible to inspection and therapy in its entirety. However, DBE is a time-consuming procedure that requires a highly skilled endoscopist, several nurses and - more often than not - anesthesiological support. This makes the selectio...... within the next 12 months. Conclusions. CE can be applied as a screening procedure for DBE and allows for an approximately two-thirds reduction in the need for DBE as well as enabling a choice to be made between the oral and anal route Udgivelsesdato: 2008...

  13. Pneumothorax, music and balloons: A case series

    Directory of Open Access Journals (Sweden)

    Shiferaw Dejene


    Full Text Available We describe two cases of spontaneous pneumothorax in young healthy adults with no underlying structural lung disease. The onset of pneumothorax was following physical activity including playing musical instruments and blowing of balloons. There is sparse data evaluating the pathophysiology of primary spontaneous pneumothorax in relation to increased mouth pressures. These cases highlight the possible physical effect of valsalva manoeuvre on transpulmonary pressures, and the potential risk of developing pneumothorax in otherwise healthy individuals. This aspect of pneumothorax development is worthy of further exploration, to better elucidate the mechanism and enhance our understanding of this common respiratory presentation.

  14. Ballooning Spiders: The Case for Electrostatic Flight

    CERN Document Server

    Gorham, Peter W


    We consider general aspects of the physics underlying the flight of Gossamer spiders, also known as ballooning spiders. We show that existing observations and the physics of spider silk in the presence of the Earth's static atmospheric electric field indicate a potentially important role for electrostatic forces in the flight of Gossamer spiders. A compelling example is analyzed in detail, motivated by the observed "unaccountable rapidity" in the launching of such spiders from H.M.S. Beagle, recorded by Charles Darwin during his famous voyage.

  15. Thrombus aspiration catheter is a Dottering balloon. (United States)

    Sheshagiri Rao, D; Barik, Ramachandra; Prasad, Akula Siva


    Coronary angiogram in a young man with history of STEMI with delayed presentation revealed subtotal occlusion of left anterior descending artery (LAD) with large thrombotic filling defect distal to the critical lesion. PCI was preferred without delay because of ongoing chest pain. Several runs of thrombus aspiration failed to detect any visible thrombus. However, the immediate angiogram after thrombus aspiration showed complete distal embolization of the thrombus which could have been achieved by Dottering or balloon dilatation. In contrary to the general perception, does thrombus aspiration push more thrombus than it can aspirate?

  16. Severe aortic stenosis: diagnosis, treatment and prognosis

    NARCIS (Netherlands)

    M.W.A. van Geldorp (Martijn)


    textabstractDegenerative aortic stenosis is the most common valvular heart disease in developed countries. The prevalence of severe aortic stenosis increases with age from 1% in people below 65 years of age to nearly 6% in people over the age of 85. Since the population life expectancy continues to

  17. Transcatheter Aortic Valve Replacement in Europe

    DEFF Research Database (Denmark)

    Mylotte, Darren; Osnabrugge, Ruben L J; Windecker, Stephan;


    The authors sought to examine the adoption of transcatheter aortic valve replacement (TAVR) in Western Europe and investigate factors that may influence the heterogeneous use of this therapy.......The authors sought to examine the adoption of transcatheter aortic valve replacement (TAVR) in Western Europe and investigate factors that may influence the heterogeneous use of this therapy....

  18. Thoracic aortic catastrophes : towards the endovascular solution

    NARCIS (Netherlands)

    Jonker, F.H.W.


    Descending thoracic aortic catastrophes include a variety of acute pathologies of the descending thoracic aorta, which are all associated with high morbidity and mortality rates, requiring immediate intervention. For this thesis, we explored the management and outcomes of several thoracic aortic cat

  19. Thoraco-abdominal aortic aneurysm branched repair

    NARCIS (Netherlands)

    Verhoeven, E. L. G.; Tielliu, I. F. J.; Ferreira, M.; Zipfel, B.; Adam, D. J.


    Open thoraco-abdominal aortic aneurysm repair is a demanding procedure with high impact on the patient and the operating team. Results from expert centres show mortality rates between 3-21%, with extensive morbidity including renal failure and paraplegia. Endovascular repair of abdominal aortic aneu

  20. Comparative in Vitro Research of the Human Aortic Bioprosthesis

    Directory of Open Access Journals (Sweden)

    Dawidowska K.


    Full Text Available Evaluate of the usefulness and reliability of structures based on the analysis of recorded parameters determining the flow through the Human Aortic Bioprosthesis (HAB have been dealt with. By flow parameters changes determining the performance environment of prosthesis analyzed change of the motion dynamics of the valve leaflets as a function of pressure, thereby determining the degree of alignment of the prosthesis to the performance conditions. Based on the gathered measurement data a comparative analysis of flow rate valve prostheses for different frequency values of the piston pump imitating the heart, different ejection capacity and pressure conditioning work environment prosthesis were studied. Interpretation of the recorded image gave the basis for determining the Effective Orifice Area (EOC.

  1. Flight Qualification of the NASA's Super Pressure Balloon (United States)

    Cathey, Henry; Said, Magdi; Fairbrother, Debora

    Designs of new balloons to support space science require a number of actual flights under various flight conditions to qualify them to as standard balloon flight offerings to the science community. Development of the new Super Pressure Balloon for the National Aeronautics and Space Administration’s Balloon Program Office has entailed employing new design, analysis, and production techniques to advance the state of the art. Some of these advances have been evolutionary steps and some have been revolutionary steps requiring a maturing understanding of the materials, designs, and manufacturing approaches. The NASA Super Pressure Balloon development end goal is to produce a flight vehicle that is qualified to carry a ton of science instrumentation, at an altitude greater than 33 km while maintaining a near constant pressure altitude for extended periods of up to 100 days, and at any latitude on the globe. The NASA’s Balloon Program Office has pursued this development in a carefully executed incremental approach by gradually increasing payload carrying capability and increasing balloon volume to reach these end goal. A very successful test flight of a ~200,700 m3 balloon was launch in late 2008 from Antarctica. This balloon flew for over 54 days at a constant altitude and circled the Antarctic continent almost three times. A larger balloon was flown from Antarctica in early 2011. This ~422,400 m3 flew at a constant altitude for 22 days making one circuit around Antarctica. Although the performance was nominal, the flight was terminated via command to recover high valued assets from the payload. The balloon designed to reach the program goals is a ~532,200 m3 pumpkin shaped Super Pressure Balloon. A test flight of this balloon was launched from the Swedish Space Corporation’s Esrange Balloon Launch Facilities near Kiruna, Sweden on 14 August, 2012. This flight was another success for this development program. Valuable information was gained from this short test

  2. Valvular and aortic diseases in osteogenesis imperfecta. (United States)

    Lamanna, Arvin; Fayers, Trevor; Clarke, Sophie; Parsonage, William


    Osteogenesis imperfecta (OI) is an inheritable connective tissue disorder caused by defective collagen synthesis with the principal manifestations of bone fragility. OI has been associated with left sided valvular regurgitation and aortic dilation. Valve and aortic surgery are technically feasible in patients with OI but are inherently high risk due to the underlying connective tissue defect. This report reviews the valvular and aortic pathology associated with OI and their management. We describe two cases of patients with OI who have significant aortic and mitral valve regurgitation, one of whom has been managed conservatively and the other who has undergone successful mitral valve repair and aortic valve replacement. The latter case represents the fifth case of mitral valve repair in a patient with OI reported in the medical literature.

  3. Stroke in Patients With Aortic Stenosis

    DEFF Research Database (Denmark)

    Greve, Anders Møller; Dalsgaard, Morten; Bang, Casper N


    BACKGROUND AND PURPOSE: There are limited data on risk stratification of stroke in aortic stenosis. This study examined predictors of stroke in aortic stenosis, the prognostic implications of stroke, and how aortic valve replacement (AVR) with or without concomitant coronary artery bypass grafting...... influenced the predicted outcomes. METHODS: Patients with mild-to-moderate aortic stenosis enrolled in the Simvastatin and Ezetimibe in Aortic Stenosis (SEAS) study. Diabetes mellitus, known atherosclerotic disease, and oral anticoagulation were exclusion criteria. Ischemic stroke was the primary end point...... death (HR, 8.1; 95% CI, 4.7-14.0; Paortic stenosis not prescribed oral anticoagulation, atrial fibrillation, AVR with concomitant coronary artery bypass grafting, and CHA2DS2-VASc score were the major predictors of stroke. Incident stroke was strongly associated...

  4. Transcatheter aortic valve replacement in elderly patients

    Institute of Scientific and Technical Information of China (English)

    Dimytri Siqueira; Alexandre Abizaid; Magaly Arrais J.; Eduardo Sousa


    Aortic stenosis is the most common native valve disease, affecting up to 5% of the elderly population. Surgical aortic valve replacement reduces symptoms and improves survival, and is the definitive therapy in patients with symptomatic severe aortic stenosis. However, despite the good results of classic surgery, risk is markedly increased in elderly patients with co-morbidities. Transcatheter aortic valve replacement (TAVR) allows implantation of a prosthetic heart valve within the diseased native aortic valve without the need for open heart surgery and cardiopulmonary bypass, offering a new therapeutic option to elderly patients considered at high surgical risk or with contraindications to surgery. To date, several multicenter registries and a randomized trial have confirmed the safety and efficacy of TAVR in those patients. In this chapter, we review the background and clinical applications of TAVR in elderly patients.

  5. Dynamic heart phantom with functional mitral and aortic valves (United States)

    Vannelli, Claire; Moore, John; McLeod, Jonathan; Ceh, Dennis; Peters, Terry


    Cardiac valvular stenosis, prolapse and regurgitation are increasingly common conditions, particularly in an elderly population with limited potential for on-pump cardiac surgery. NeoChord©, MitraClipand numerous stent-based transcatheter aortic valve implantation (TAVI) devices provide an alternative to intrusive cardiac operations; performed while the heart is beating, these procedures require surgeons and cardiologists to learn new image-guidance based techniques. Developing these visual aids and protocols is a challenging task that benefits from sophisticated simulators. Existing models lack features needed to simulate off-pump valvular procedures: functional, dynamic valves, apical and vascular access, and user flexibility for different activation patterns such as variable heart rates and rapid pacing. We present a left ventricle phantom with these characteristics. The phantom can be used to simulate valvular repair and replacement procedures with magnetic tracking, augmented reality, fluoroscopy and ultrasound guidance. This tool serves as a platform to develop image-guidance and image processing techniques required for a range of minimally invasive cardiac interventions. The phantom mimics in vivo mitral and aortic valve motion, permitting realistic ultrasound images of these components to be acquired. It also has a physiological realistic left ventricular ejection fraction of 50%. Given its realistic imaging properties and non-biodegradable composition—silicone for tissue, water for blood—the system promises to reduce the number of animal trials required to develop image guidance applications for valvular repair and replacement. The phantom has been used in validation studies for both TAVI image-guidance techniques1, and image-based mitral valve tracking algorithms2.

  6. Unusual balloon rupture during direct stenting with a TaxusExpress stent in a venous graft complicated by vessel rupture: a device-related fatal event

    DEFF Research Database (Denmark)

    Christiansen, Evald H


    proximally with a diameter of 4.5 mm, and the balloon ruptured. Angiography showed rupture of the vessel proximal to the implanted stent, and the patient developed severe hypotension. The rupture was treated with a covered stent and pericardiocentesis was performed with evacuation of 600 mL blood. However......, it was not possible to resuscitate the patient, who died due to severe pump failure and incessant ventricular fibrillation. Udgivelsesdato: 2007-Feb...

  7. 21 CFR 870.1350 - Catheter balloon repair kit. (United States)


    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Catheter balloon repair kit. 870.1350 Section 870... repair kit. (a) Identification. A catheter balloon repair kit is a device used to repair or replace the... effect the repair or replacement. (b) Classification. Class III (premarket approval). (c) Date PMA...

  8. Reversible transient apical ballooning syndrome with coronary lesions

    Institute of Scientific and Technical Information of China (English)

    Yunshan Cao; Min Zhang; Xiang Li; Ping Xie; Lynn Cronin


    Transient apical ballooning syndrome(Tako-Tsubo syndrome or ampulla cardiomyopathy) occurs predominantly in women over 60 years of age with a history of recent physical or psychological stress. We present a case of a male patient with reversible transient apical ballooning syndrome with significant coronary lesions and other ECG changes that did not explain the clinical symptoms.

  9. Centrifugal pump handbook

    CERN Document Server

    Pumps, Sulzer


    This long-awaited new edition is the complete reference for engineers and designers working on pump design and development or using centrifugal pumps in the field. This authoritative guide has been developed with access to the technical expertise of the leading centrifugal pump developer, Sulzer Pumps. In addition to providing the most comprehensive centrifugal pump theory and design reference with detailed material on cavitation, erosion, selection of materials, rotor vibration behavior and forces acting on pumps, the handbook also covers key pumping applications topics and operational

  10. [Modern aortic surgery in Marfan syndrome--2011]. (United States)

    Kallenbach, K; Schwill, S; Karck, M


    Marfan syndrome is a hereditary disease with a prevalence of 2-3 in 10,000 births, leading to a fibrillin connective tissue disorder with manifestations in the skeleton, eye, skin, dura mater and in particular the cardiovascular system. Since other syndromes demonstrate similar vascular manifestations, but therapy may differ significantly, diagnosis should be established using the revised Ghent nosology in combination with genotypic analysis in specialized Marfan centres. The formation of aortic root aneurysms with the subsequent risk of acute aortic dissection type A (AADA) or aortic rupture limits life expectancy in patients with Marfan syndrome. Therefore, prophylactic replacement of the aortic root needs to be performed before the catastrophic event of AADA can occur. The goal of surgery is the complete resection of pathological aortic tissue. This can be achieved with excellent results by using a (mechanically) valved conduit that replaces both the aortic valve and the aortic root (Bentall operation). However, the need for lifelong anticoagulation with Coumadin can be avoided using the aortic valve sparing reimplantation technique according to David. The long-term durability of the reconstructed valve is favourable, and further technical improvements may improve longevity. Although results of prospective randomised long-term studies comparing surgical techniques are lacking, the David operation has become the surgical method of choice for aortic root aneurysms, not only at the Heidelberg Marfan Centre. Replacement of the aneurysmal dilated aortic arch is performed under moderate hypothermic circulatory arrest combined with antegrade cerebral perfusion using a heart-lung machine, which we also use in thoracic or thoracoabdominal aneurysms. Close post-operative follow-up in a Marfan centre is pivotal for the early detection of pathological changes on the diseased aorta.

  11. Reoperation on aortic disease in patients with previous aortic valve surgery

    Institute of Scientific and Technical Information of China (English)

    SUN Xiao-gang; ZHANG Liang; YU Cun-tao; QIAN Xiang-yang; CHANG Qian


    Background Aortic valve replacement (AVR) is a safe and effective method in the treatment of aortic valve diseases.This study aimed to increase the understanding on re-treatment of aortic diseases after aortic valve surgery through a retrospective analysis of 47 related cases.Methods Forty-seven patients (38 males and 9 females) with previous aortic valve surgery have received reoperation on aorta from January 2003 to June 2012,and the mean interval time of re-intervention to aortic disease was 6 years ((6.0± 3.8) years).The secondary aortic surgery included aortic root replacement (14 cases),ascending aorta replacement (10 cases),aortic root/ascending aorta plus total arch replacement with stented elephant trunk implantation (21 cases),and total thoracoabdominal aorta replacement (2 cases).All these patients have received outpatient re-exams or follow-up by phone calls.Results After the initial aortic valve replacement,patients suffered from aortic dissection (25 cases,53%),ascending aortic aneurysm (12 cases,26%) or aortic root aneurysm (10 cases,21%).Diameter in ascending aorta increased (5.2±7.1) mm per year and aortic sinus (3.3±3.1) mm per year.The annual growth value of diameter in ascending aorta was higher in patients with rheumatic heart disease than that in Marfan syndrome (P<0.05).All 47 patients have received reoperation on aorta.One patient died in operating room because aortic dissection seriously involved right coronary artery.Seven patients had renal insufficiency after operation; neurological complications occurred in 14 patients including 7 patients with stroke and the others with transient brain dysfunction.All patients were followed up,the mean survival time was (97.25±17.63) months,95% confidence interval was 55.24-73.33 months.Eight cases were died during follow-up and five-year survival rate was 83%.Conclusion To reduce the aortic adverse events after first aortic valve surgery,it is necessary to actively treat and strictly

  12. A Rare and Serious Unforeseen Complication of Cutting Balloon Angioplasty

    Directory of Open Access Journals (Sweden)

    Praveen Vemula


    Full Text Available Cutting balloon angioplasty (CBA is one of the adept ways of treating “in-stent restenosis.” Various complications related to cutting balloon angioplasty have been reported including arterial rupture, delayed perforation and fracture of microsurgical blades. Here we report a very unusual and inadvertent extraction of a stent previously deployed in the ramus intermedius coronary branch by a cutting balloon catheter. This required repeat stenting of the same site for an underlying dissection. Even though stent extraction is a rare complication it can be serious due to dissection, perforation, and closure of the artery. Physicians performing coronary artery interventions would need to be aware of this rare and serious complication especially if any difficulty is encountered while withdrawing the cutting balloon. Therefore, after removal, cutting balloon should be examined thoroughly for possible stent dislodgment or extraction when used for “in-stent restenosis.”

  13. A New Paradigm in Space Based Experiments Using Rubber Balloons

    CERN Document Server

    Chakrabarti, Sandip K; Palit, Sourav; Chakraborty, Subhankar; Mondal, Sushanta; Bhattacharyya, Arnab; Middya, Susanta; Chakrabarti, Sonali


    Indian Centre for Space Physics is engaged in long duration balloon borne experiments with typical payloads less than ~ 3kg. Low cost rubber balloons are used. In a double balloon system, the booster balloon lifts the orbiter balloon to its cruising altitude where data is taken for a long time. Here we present results of muon detections and recent solar activities, including the light curves and flare spectra in the 20-100keV range. We not only show that we have successfully obtained several flares and there spectra at different altitudes, we also found that the high energy X-ray flux of strong flares at altitudes of 10-13 km (the flight altitude of commercial planes) could be more than the contribution due to cosmic rays.

  14. An overview of instrumentation capabilities for Scientific ballooning in India (United States)

    Devarajan, Anand; Reddy Vizapur, Anmi; Rao Tanneeru, Venkateswara; Bangaru, Kapardhi; Trivedi, Dharmesh; Rodi, Ashish; Ojha, Devendra; Koli, Santosh


    The Balloon Facility of Tata Institute of Fundamental Research (TIFR-BF) in India, launches scientific balloons for research in the field of astronomy, astrobiology and atmospheric sciences. TIFR-BF not only has the capability to design, fabricate and launch zero-pressure balloons, but also provide operational and engineering support for launching them. The Control Instrumentation Group (CIG) at the balloon facility handles all electronics related to telemetry, telecommand, tracking, real-time data display, data storage, air-safety and payload recovery. In the recent past, it has designed and developed customized electronics and payload orientation mechanism to meet specific experimental objectives. Small, inexpensive and rugged industrial grade radio data modems were successfully deployed in balloon flights for low bit rate data and image telemetry. This paper will provide an overview and in-flight performance of some of the recent developments in instrumentation and electronics systems. Our plans for future upgradations will also be discussed.

  15. Quantitative image analysis for planning of aortic valve replacement

    NARCIS (Netherlands)

    Elattar, M.A.I.M.


    Aortic stenosis is the most common and frequent cause of sudden death among all valvular heart diseases. Symptomatic aortic stenosis is considered to be a fatal disease if left untreated. Aortic valve replacement is the mainstay of treatment of symptomatic aortic stenosis. Traditional treatment of s

  16. Global kinetic ballooning mode simulations in BOUT++ (United States)

    Ma, C. H.; Xu, X. Q.


    We report on simulation results of a 3+1 gyro-Landau-fluid (GLF) model in BOUT++ framework, which contributes to increasing the physics understanding of the edge turbulence. We find that there is no second stability region of kinetic ballooning modes (KBM) in the concentric circular geometry. The first unstable β of KBM decreases below the ideal ballooning mode threshold with increasing {ηi} . In order to study the KBM in the real tokamak equilibrium, we find that the approximation of shifted circular geometry (β \\ll {{\\varepsilon}2} ) is not valid for a high β global equilibrium near the second stability region of KBM. Thus we generate a series of real equilibria from a global equilibrium solver CORSICA, including both Shafranov shift and elongation effects, but not including bootstrap current. In these real equilibria, the second stability region of KBM are observed in our global linear simulations. The most unstable mode for different β are the same while the mode number spectrum near the second stability region is wider than the case near the first stability region. The nonlinear simulations show that the energy loss of an ELM keeps increasing with β, because the linear drive of the turbulence remains strong for the case near the second stability region during profile evolution.

  17. A constitutive equation for stratospheric balloon materials (United States)

    Rand, J.; Sterling, J.

    The selection of a suitable material for use as a reliable stratospheric balloon gas barrier and structural component is based on a variety of desired properties. In order to achieve the required combination of weight per unit area, helium permeation, strength, flexibility and toughness at low temperatures, low density polyethylene has been used for the last half century. During the last decade, linear low density polyethylene (LLDPE) has been found to have even better properties for this application. Thin films extruded from this type resin have been found to have time dependent properties which should be understood in order to make an intelligent analysis of the balloon. This paper describes the current effort to characterize a 38 micron coextrusion of LLDPE as a nonlinearly viscoelastic material. The resulting constitutive equation may be used to accurately describe the time dependent creep and/or relaxation of this film when subjected to a biaxial state of stress. Recent laboratory data have been used to modify an existing model of LLDPE to account for differences caused by the coextrusion process. The new model will facilitate structure design optimization and reliability assessment, and may further be utilized as a predictive tool to benefit in-flight operations. Unfortunately, current structural analysis techniques based on linear elastic properties will predict stresses in excess of those which actually exist. An example will be presented which demonstrates the magnitude of this error when nonlinear behavior is ignored.

  18. EUSO-Balloon: The first flight (United States)

    Scotti, Valentina; Osteria, Giuseppe


    EUSO-Balloon is a pathfinder mission for JEM-EUSO, the near-UV telescope proposed to be installed on board the International Space Station (ISS). The main objective of this pathfinder mission is to perform a full scale end-to-end test of all the key technologies of JEM-EUSO detectors and to measure the UV background. The JEM-EUSO instrument consists of UV telescope designed to focus the signal of the UV tracks generated by Extreme Energy Cosmic Rays propagating in Earth's atmosphere, onto a finely pixelized UV camera. The EUSO-Balloon instrument, smaller than the one designed for the ISS, was launched on August 2014 from Timmins (Ontario, Canada). The flight lasted about five hours and the instrument reached a float altitude of about 40 km. From this altitude the telescope registered, at a rate of 400 000 frames/s, the nightglow background on forests, lakes and clouds, as well as city lights and artificial air showers tracks generated by means of a laser installed on an helicopter flying inside its field of view. In this contribution we will describe the instrument and its performance during the first flight.

  19. EUSO-Balloon: The first flight

    Energy Technology Data Exchange (ETDEWEB)

    Scotti, Valentina, E-mail:; Osteria, Giuseppe


    EUSO-Balloon is a pathfinder mission for JEM-EUSO, the near-UV telescope proposed to be installed on board the International Space Station (ISS). The main objective of this pathfinder mission is to perform a full scale end-to-end test of all the key technologies of JEM-EUSO detectors and to measure the UV background. The JEM-EUSO instrument consists of UV telescope designed to focus the signal of the UV tracks generated by Extreme Energy Cosmic Rays propagating in Earth's atmosphere, onto a finely pixelized UV camera. The EUSO-Balloon instrument, smaller than the one designed for the ISS, was launched on August 2014 from Timmins (Ontario, Canada). The flight lasted about five hours and the instrument reached a float altitude of about 40 km. From this altitude the telescope registered, at a rate of 400 000 frames/s, the nightglow background on forests, lakes and clouds, as well as city lights and artificial air showers tracks generated by means of a laser installed on an helicopter flying inside its field of view. In this contribution we will describe the instrument and its performance during the first flight.

  20. Aortic root size and prevalence of aortic regurgitation in elite strength trained athletes. (United States)

    Babaee Bigi, Mohammad Ali; Aslani, Amir


    Athletes involved in mainly static or isometric exercise (e.g., weight lifting, power lifting, and bodybuilding) develop pressure overloads due to the high systemic arterial pressure found in this type of exercise. It is hypothesized that chronically elevated aortic wall tension in strength-trained athletes is associated with aortic dilatation and regurgitation. The aim of this study was to evaluate aortic root size and the prevalence of aortic regurgitation in elite strength-trained athletes. The cohort included 100 male athletes (mean age 22.1 +/- 3.6 years; all were finalists or medalists in the country) and 128 healthy age- and height-matched subjects (the control group). Aortic root diameters at end-diastole were measured at 4 locations: (1) the aortic annulus, (2) the sinuses of Valsalva, (3) the sinotubular junction, and (4) the maximal diameter of the proximal ascending aorta. Aortic root diameters at all levels were significantly greater in the strength-trained athletes (p 18 and 36 and 54 months), progressive enlargement was found at all aortic diameters. In conclusion, aortic root diameters in all segments of the aortic root were significantly greater in elite strength-trained athletes compared with an age- and height-matched population.

  1. [Aortic valve replacement as an independent predictive factor for later development of aortic dissection]. (United States)

    von Kodolitsch, Y; Simic, O; Bregenzer, T; Dresler, C; Haverich, A; Nienaber, C A


    Dissection of the ascending aorta (type A) following later after aortic valve replacement has been described with increasing frequency. This study analyzes the role of aortic valve replacement for the evolution of late dissection. In a series of 80 consecutive patients with type A dissection, a previous aortic valve replacement had been performed in 12 cases (15%). In addition to arterial hypertension (p syndrome (p factor for type A dissection. Dissection occurred 3 +/- 4 years after aortic valve replacement with a clinical and anatomical profile similar to classic dissection as proven by comparison to a group of 62 patients with classic dissection associated with arterial hypertension or Marfan syndrome. With 75% and 66%, respectively, 30 day and 1 year survival of patients with dissection following later after aortic valve replacement was similar to patients with classic type A dissection. Extensive thinning and/or fragility (p associated with a high risk for late dissection; this finding was substantiated by comparison to a control group of 10 consecutive patients with a similarly dilated aortic root but no dissection. Type and diameter of valve prostheses, cross-clamp time, NYHA functional class, and left ventricular ejection fraction were unrelated to late dissection. Previous aortic valve replacement is an independent predisposing factor for a dissection of the ascending aorta later. At the time of aortic valve replacement, prophylactic replacement or wrapping of the ascending aorta should be considered in patients with a thinned/fragile aortic wall even without a markedly dilated aortic root.

  2. Aortic valve and ascending aortic root modeling from 3D and 3D+t CT (United States)

    Grbic, Saša; Ionasec, Razvan I.; Zäuner, Dominik; Zheng, Yefeng; Georgescu, Bogdan; Comaniciu, Dorin


    Aortic valve disorders are the most frequent form of valvular heart disorders (VHD) affecting nearly 3% of the global population. A large fraction among them are aortic root diseases, such as aortic root aneurysm, often requiring surgical procedures (valve-sparing) as a treatment. Visual non-invasive assessment techniques could assist during pre-selection of adequate patients, planning procedures and afterward evaluation of the same. However state of the art approaches try to model a rather short part of the aortic root, insufficient to assist the physician during intervention planning. In this paper we propose a novel approach for morphological and functional quantification of both the aortic valve and the ascending aortic root. A novel physiological shape model is introduced, consisting of the aortic valve root, leaflets and the ascending aortic root. The model parameters are hierarchically estimated using robust and fast learning-based methods. Experiments performed on 63 CT sequences (630 Volumes) and 20 single phase CT volumes demonstrated an accuracy of 1.45mm and an performance of 30 seconds (3D+t) for this approach. To the best of our knowledge this is the first time a complete model of the aortic valve (including leaflets) and the ascending aortic root, estimated from CT, has been proposed.

  3. Bicuspid Aortic Valve Disease and Ascending Aortic Aneurysms: Gaps in Knowledge

    Directory of Open Access Journals (Sweden)

    Katie L. Losenno


    Full Text Available The bicuspid aortic valve is the most common congenital cardiac anomaly in developed nations. The abnormal bicuspid morphology of the aortic valve results in valvular dysfunction and subsequent hemodynamic derangements. However, the clinical presentation of bicuspid aortic valve disease remains quite heterogeneous with patients presenting from infancy to late adulthood with variable degrees of valvular stenosis and insufficiency and associated abnormalities including aortic coarctation, hypoplastic left heart structures, and ascending aortic dilatation. Emerging evidence suggests that the heterogeneous presentation of bicuspid aortic valve phenotypes may be a more complex matter related to congenital, genetic, and/or connective tissue abnormalities. Optimal management of patients with BAV disease and associated ascending aortic aneurysms often requires a thoughtful approach, carefully assessing various risk factors of the aortic valve and the aorta and discerning individual indications for ongoing surveillance, medical management, and operative intervention. We review current concepts of anatomic classification, pathophysiology, natural history, and clinical management of bicuspid aortic valve disease with associated ascending aortic aneurysms.

  4. Aorta Balloon Occlusion in Trauma: Three Cases Demonstrating Multidisciplinary Approach Already on Patient’s Arrival to the Emergency Room

    Energy Technology Data Exchange (ETDEWEB)

    Hörer, Tal M., E-mail: [Örebro University, Department of Cardiothoracic and Vascular Surgery, Örebro University Hospital (Sweden); Hebron, Dan [Hillel Yaffe Medical Center, Department of Radiology (Israel); Swaid, Forat [Bnai-Zion Medical Center, Department of General Surgery (Israel); Korin, Alexander [Hillel Yaffe Medical Center, Trauma Unit (Israel); Galili, Offer [Hillel Yaffe Medical Center, Department of Vascular Surgery (Israel); Alfici, Ricardo [Hillel Yaffe Medical Center, Surgical Division (Israel); Kessel, Boris [Hillel Yaffe Medical Center, Trauma Unit (Israel)


    PurposeTo describe the usage of aortic balloon occlusion (ABO), based on a multidisciplinary approach in severe trauma patients, emphasizing the role of the interventional radiologist in primary trauma care.MethodsWe briefly discuss the relevant literature, the technical aspects of ABO in trauma, and a multidisciplinary approach to the bleeding trauma patient. We describe three severely injured trauma patients for whom ABO was part of initial trauma management.ResultsThree severely injured multi-trauma patients were treated by ABO as a bridge to surgery and embolization. The procedures were performed by an interventional radiologist in the early stages of trauma management.ConclusionsThe interventional radiologist and the multidisciplinary team approach can be activated already on severe trauma patient arrival. ABO usage and other endovascular methods are becoming more widely spread, and can be used early in trauma management, without delay, thus justifying the early activation of this multidisciplinary approach.

  5. In vitro validation of flow measurements in an aortic nitinol stent graft by velocity-encoded MRI

    Energy Technology Data Exchange (ETDEWEB)

    Rengier, Fabian, E-mail: [University Hospital Heidelberg, Department of Diagnostic and Interventional Radiology, Im Neuenheimer Feld 110, 69120 Heidelberg (Germany); German Cancer Research Center (dkfz) Heidelberg, Department of Radiology, Im Neuenheimer Feld 280, 69120 Heidelberg (Germany); Delles, Michael, E-mail: [Karlsruhe Institute of Technology (KIT), Department of Informatics, Institute for Anthropomatics, Adenauerring 2, 76131 Karlsruhe (Germany); Weber, Tim Frederik, E-mail: [University Hospital Heidelberg, Department of Diagnostic and Interventional Radiology, Im Neuenheimer Feld 110, 69120 Heidelberg (Germany); Boeckler, Dittmar, E-mail: [University Hospital Heidelberg, Department of Vascular and Endovascular Surgery, Im Neuenheimer Feld 110, 69120 Heidelberg (Germany); Ley, Sebastian, E-mail: [University Hospital Heidelberg, Department of Diagnostic and Interventional Radiology, Im Neuenheimer Feld 110, 69120 Heidelberg (Germany); Kauczor, Hans-Ulrich, E-mail: [University Hospital Heidelberg, Department of Diagnostic and Interventional Radiology, Im Neuenheimer Feld 110, 69120 Heidelberg (Germany); Tengg-Kobligk, Hendrik von, E-mail: [University Hospital Heidelberg, Department of Diagnostic and Interventional Radiology, Im Neuenheimer Feld 110, 69120 Heidelberg (Germany); German Cancer Research Center (dkfz) Heidelberg, Department of Radiology, Im Neuenheimer Feld 280, 69120 Heidelberg (Germany)


    Purpose: To validate flow measurements within an aortic nickel-titanium (nitinol) stent graft using velocity-encoded cine magnetic resonance imaging (VEC MRI) and to assess intraobserver agreement of repeated flow measurements. Materials and methods: An elastic tube phantom mimicking the descending aorta was developed with the possibility to insert an aortic nitinol stent graft. Different flow patterns (constant, sinusoidal and pulsatile aortic flow) were applied by a gear pump. A two-dimensional phase-contrast sequence was used to acquire VEC perpendicular cross-sections at six equidistant levels along the phantom. Each acquisition was performed twice with and without stent graft, and each dataset was analysed twice by the same reader. The percental difference of the measured flow volume to the gold standard (pump setting) was defined as the parameter for accuracy. Furthermore, the intraobserver agreement was assessed. Results: Mean accuracy of flow volume measurements was -0.45 {+-} 1.63% without stent graft and -0.18 {+-} 1.45% with stent graft. Slightly lower accuracy was obtained for aortic flow both without (-2.31%) and with (-1.29%) stent graft. Accuracy was neither influenced by the measurement position nor by repeated acquisitions. There was significant intraobserver agreement with an intraclass correlation coefficient of 0.87 (without stent graft, p < 0.001) and 0.80 (with stent graft, p < 0.001). The coefficient of variance was 0.25% without stent graft and 0.28% with stent graft. Conclusion: This study demonstrated high accuracy and excellent intraobserver agreement of flow measurements within an aortic nitinol stent graft using VEC MRI. VEC MRI may give new insights into the haemodynamic consequences of endovascular aortic repair.


    NARCIS (Netherlands)



    Some of the newer over-the-wire coronary angioplasty catheters have shaft sizes of 3.0 French (F) or less. The inner diameter of modern 8-F guiding catheters is large enough to accommodate two of such balloon catheters. We report a kissing balloon procedure with two over-the-wire catheters through a

  7. Two-Year Outcomes in Patients With Severe Aortic Valve Stenosis Randomized to Transcatheter Versus Surgical Aortic Valve Replacement

    DEFF Research Database (Denmark)

    Søndergaard, Lars; Steinbrüchel, Daniel Andreas; Ihlemann, Nikolaj


    BACKGROUND: The Nordic Aortic Valve Intervention (NOTION) trial was the first to randomize all-comers with severe native aortic valve stenosis to either transcatheter aortic valve replacement (TAVR) with the CoreValve self-expanding bioprosthesis or surgical aortic valve replacement (SAVR), inclu...... population. CLINICAL TRIAL REGISTRATION: URL: Unique identifier: NCT01057173....

  8. Repair for acquired aortic valve disease. (United States)

    Antunes, M J


    The favorable results of mitral valvuloplasty when compared with valve replacement have renewed the interest of many surgeons in aortic valve repair. However, these efforts have, for the most part, been unsuccessful. Also, the results of aortic valve replacement are usually better than those of mitral valve replacement. Yet, some patients appear to derive benefit from a conservative aortic valve procedure. The best examples are mild or moderate aortic valve disease associated with mitral valve or coronary artery disease, which constitute the primary indication for operation, where "prophylactic" aortic valve replacement does not appear justifiable. Other possible indications for aortic valvuloplasty includes patient's lack of compliance or contraindication to anticoagulation in young patients. Senile aortic stenosis, in very old patients with a small annulus, preserved leaflet morphology and nonsignificant commissural fusion should be considered for repair. However, since the procedure is not easily reproducible and the results not uniformly predictable, it cannot be recommended for generalized use. Nonetheless, experienced surgeons should be encouraged to continue these efforts.

  9. Aortic reconstruction with bovine pericardial grafts

    Directory of Open Access Journals (Sweden)

    Silveira Lindemberg Mota


    Full Text Available INTRODUCTION: Glutaraldehyde-treated crimped bovine pericardial grafts are currently used in aortic graft surgery. These conduits have become good options for these operations, available in different sizes and shapes and at a low cost. OBJECTIVE:To evaluate the results obtained with bovine pericardial grafts for aortic reconstruction, specially concerning late complications. METHOD: Between January 1995 and January 2002, 57 patients underwent different types of aortic reconstruction operations using bovine pericardial grafts. A total of 29 (50.8% were operated on an urgent basis (mostly acute Stanford A dissection and 28 electively. Thoracotomy was performed in three patients for descending aortic replacement (two patients and aortoplasty with a patch in one. All remaining 54 underwent sternotomy, cardiopulmonary bypass and aortic resection. Deep hypothermia and total circulatory arrest was used in acute dissections and arch operations. RESULTS: Hospital mortality was 17.5%. Follow-up was 24.09 months (18.5 to 29.8 months confidence interval and complication-free actuarial survival curve was 92.3% (standard deviation ± 10.6. Two patients lately developed thoracoabdominal aneurysms following previous DeBakey II dissection and one died from endocarditis. One "patch" aortoplasty patient developed local descending aortic pseudoaneurysm 42 months after surgery. All other patients are asymptomatic and currently clinically evaluated with echocardiography and CT scans, showing no complications. CONCLUSION: Use of bovine pericardial grafts in aortic reconstruction surgery is adequate and safe, with few complications related to the conduits.

  10. Genetic Algorithm for Analysis of Abdominal Aortic Aneurysms in Radiology Reports

    Energy Technology Data Exchange (ETDEWEB)

    Patton, Robert M [ORNL; Beckerman, Barbara G [ORNL; Treadwell, Jim N [ORNL; Potok, Thomas E [ORNL


    An abdominal aortic aneurysm is a problem in which the wall of the artery that supplies blood to the abdomen and lower extremities expands under pressure or balloons outward. Patients must undergo surgery to repair such aneurysm, and there is currently no known indicator of success or failure from this surgery. Our work uses a genetic algorithm to analyze radiology reports from these patients to look for common patterns in the language used as well as common features of both successful and unsuccessful surgieries. The results of the genetic algorithm show that patients with complications or unusual characteristics can be identified from a set of radiology reports without the use of search keywords, clustering, categorization, or ontology. This allows medical researchers to search and identify interesting patient records without the need for explicitly defining what interesting patient records are.

  11. Hybrid treatment of recurring thoracoabdominal aortic aneurysm concomitant with retrograde type A aortic dissection

    Institute of Scientific and Technical Information of China (English)

    ZHANG Min-hong; GUO Wei; DU Xin; XIONG Jiang


    So far, standard therapy of complex thoracoabdominal aortic disease is open surgical repair requiring aortic clamping and replacement of the involved segment.Despite significant improvements, morbidity and mortality of open surgery remain high.I As a result, open surgery is often withheld owing to severe comorbidities of the patients. Endovascular technique has emerged as an alternative for treatment of these diseases in high risk patients,2 and has enlarged the options of treatment of complex aortic diseases. However, an endovascular approach alone is often deemed unsuitable for some complex aortic disorders because of the close proximity of the supraaortic or visceral branches. A hybrid open-endovascular approach has therefore been proposed as a viable alternative. We present here a unique patient with recurring thoracoabdominal aortic aneurysm (TAAA) concomitant with an aortic dissection (AD) treated by a hybrid open-endovascular approach.

  12. Alternative backing up pump for turbomolecular pumps (United States)

    Myneni, Ganapati Rao


    As an alternative to the use of a mechanical backing pump in the application of wide range turbomolecular pumps in ultra-high and extra high vacuum applications, palladium oxide is used to convert hydrogen present in the evacuation stream and related volumes to water with the water then being cryo-pumped to a low pressure of below about 1.e.sup.-3 Torr at K. Cryo-pumping is achieved using a low cost Kleemenco cycle cryocooler, a somewhat more expensive thermoelectric cooler, a Venturi cooler or a similar device to achieve the required minimization of hydrogen partial pressure.

  13. Valvular Aortic Stenosis: A Proteomic Insight

    Directory of Open Access Journals (Sweden)

    Fernando Vivanco


    Full Text Available Calcified aortic valve disease is a slowly progressive disorder that ranges from mild valve thickening with no obstruction of blood flow, known as aortic sclerosis, to severe calcification with impaired leaflet motion or aortic stenosis. In the present work we describe a rapid, reproducible and effective method to carry out proteomic analysis of stenotic human valves by conventional 2-DE and 2D-DIGE, minimizing the interference due to high calcium concentrations. Furthermore, the protocol permits the aortic stenosis proteome to be analysed, advancing our knowledge in this area. Summary: Until recently, aortic stenosis (AS was considered a passive process secondary to calcium deposition in the aortic valves. However, it has recently been highlighted that the risk factors associated with the development of calcified AS in the elderly are similar to those of coronary artery disease. Furthermore, degenerative AS shares histological characteristics with atherosclerotic plaques, leading to the suggestion that calcified aortic valve disease is a chronic inflammatory process similar to atherosclerosis. Nevertheless, certain data does not fit with this theory making it necessary to further study this pathology. The aim of this study is to develop an effective protein extraction protocol for aortic stenosis valves such that proteomic analyses can be performed on these structures. In the present work we have defined a rapid, reproducible and effective method to extract proteins and that is compatible with 2-DE, 2D-DIGE and MS techniques. Defining the protein profile of this tissue is an important and challenging task that will help to understand the mechanisms of physiological/pathological processes in aortic stenosis valves.

  14. Aortic stenosis: From diagnosis to optimal treatment

    Directory of Open Access Journals (Sweden)

    Tavčiovski Dragan


    Full Text Available Aortic stenosis is the most frequent valvular heart disease. Aortic sclerosis is the first characteristic lesion of the cusps, which is considered today as the process similar to atherosclerosis. Progression of the disease is an active process leading to forming of bone matrix and heavily calcified stiff cusps by inflammatory cells and osteopontin. It is a chronic, progressive disease which can remain asymptomatic for a long time even in the presence of severe aortic stenosis. Proper physical examination remains an essential diagnostic tool in aortic stenosis. Recognition of characteristic systolic murmur draws attention and guides further diagnosis in the right direction. Doppler echocardiography is an ideal tool to confirm diagnosis. It is well known that exercise tests help in stratification risk of asymptomatic aortic stenosis. Serial measurements of brain natriuretic peptide during a follow-up period may help to identify the optimal time for surgery. Heart catheterization is mostly restricted to preoperative evaluation of coronary arteries rather than to evaluation of the valve lesion itself. Currently, there is no ideal medical treatment for slowing down the disease progression. The first results about the effect of ACE inhibitors and statins in aortic sclerosis and stenosis are encouraging, but there is still not enough evidence. Onset symptoms based on current ACC/AHA/ESC recommendations are I class indication for aortic valve replacement. Aortic valve can be replaced with a biological or prosthetic valve. There is a possibility of percutaneous aortic valve implantation and transapical operation for patients that are contraindicated for standard cardiac surgery.

  15. Mycotic Aneurysm of the Aortic Arch

    Directory of Open Access Journals (Sweden)

    Ji Hye Seo


    Full Text Available A mycotic aneurysm of the thoracic aorta is rare. We report a case of mycotic aneurysm that developed in the aortic arch. An 86-year-old man was admitted with fever and general weakness. Blood culture yielded methicillin-resistant Staphylococcus aureus. Chest X-ray showed an enlarged aortic arch, and computed tomography scan revealed an aneurysm in the aortic arch. The patient was treated only with antibiotics and not surgically. The size of the aneurysm increased rapidly, resulting in bronchial obstruction and superimposed pneumonia. The patient died of respiratory failure.

  16. Bacillus cereus endocarditis in native aortic valve. (United States)

    Ngow, H A; Wan Khairina, W M N


    Bacillus cereus endocarditis is rare. It has been implicated in immunocompromised individuals, especially in intravenous drug users as well as in those with a cardiac prosthesis. The patient was a 31-year-old ex-intravenous drug addict with a past history of staphylococcal pulmonary valve endocarditis, who presented with symptoms of decompensated cardiac failure. Echocardiography showed severe aortic regurgitation with an oscillating vegetation seen on the right coronary cusp of the aortic valve. The blood cultures grew Bacillus cereus. We report this as a rare case of Bacillus cereus endocarditis affecting a native aortic valve.

  17. The future of aortic surgery in Europe

    DEFF Research Database (Denmark)

    Czerny, Martin; Bachet, Jean; Bavaria, Joseph;


    the interested reader with an overview of how aortic surgery and (perhaps more accurately) aortic medicine has evolved in Europe, and its present standing; also to provide a glimpse into the future, trying to disseminate the thoughts of a group of people actively involved in the development of aortic medicine......At least every ten years, each specialty should reflect upon its past, its present and its future, in order to be able to reconfirm the direction in which it is headed, to adopt suggestions from inside and outside and, consequently, to improve. As such, the aim of this manuscript is to provide...

  18. Design and Calibrations of the Protomirax Balloon Telescope and the Brazilian Scientific Balloon Program (United States)

    Braga, Joao; D'Amico, Flavio; Avila, Manuel


    In this presentation we report on the recent scientific ballooning activities in Brazil, including important international collaborations, and present our plan for the next few years. We also present the recent progress achieved in the design of the detector system of the protoMIRAX balloon experiment and report on the scientific balloon activities in Brazil. protoMIRAX is a balloon-borne X-ray imaging telescope under development at INPE as a pathfinder for the MIRAX (Monitor e Imageador de Raios X) satellite mission. The experiment consists essentially in an X-ray (30-200 keV) coded-aperture imager which employs a square array of 196 10mm x 10mm x 2mm CdZnTe (CZT) planar detectors made by eV Products in the USA. A collimator defines a fully-coded field-of-view of 20o x 20o, with 4o x 4o of full sensitivity. The final angular resolution will depend on the mask pattern used. In this paper we describe the design and development of the detector plane, including the front-end electronics. Preamplifiers and shaping amplifiers, customized for these detectors, were designed and built at INPE. Laboratory spectral measurements show an energy resolution of 12.0% at 60 keV, of which 10.6% is due to intrinsic electronics noise measured with a pulser at similar pulse height levels. We present spectral results obtained in the laboratory as well as initial calibration results of the acquisition system designed to get positions and energies in the detector plane. We show simulations of the coded-aperture images with different mask designs and iterative reconstruction methods.

  19. Stent graft implantation in an aortic pseudoaneurysm associated with a fractured Cheatham-Platinum stent in aortic coarctation. (United States)

    Kuhelj, Dimitrij; Berden, Pavel; Podnar, Tomaž


    We report a case of aortic pseudoaneurysm associated with a fractured bare Cheatham-Platinum stent following stenting for aortic coarctation. These complications were recognised 6 years after the implantation procedure and were successfully managed by percutaneous stent graft implantation. Staged approach for stent dilatation might prevent development of aortic pseudoaneurysms. In addition, careful follow-up is warranted after stenting for aortic coarctation, particularly in patients with recognised aortic wall injury.

  20. Transcatheter Aortic Valve Implantation Assisted with Microcatheter: A New Method to Avoid Coronary Artery Obstruction

    Institute of Scientific and Technical Information of China (English)

    Xiang Chen; Guo-Jun Chu; Fei-Yu Wang; Yu-Feng Zhu; Ben Zhang; Xian-Xian Zhao; Yong-Wen Qin


    Background:Lack of fluoroscopic landmarks can make valve deployment more difficult in patients with absent aortic valve (AV)calcification.The goal of this article was to evaluate the feasibility and effectiveness oftranscatheter implantation of a valved stent into the AV position of a goat,assisted with a microcatheter which provides accurate positioning of coronary artery ostia to help valved stent deployment.Methods:The subjects were 10 healthy goats in this study.A microcatheter was introduced into the distal site of right coronary artery (RCA)through femoral artery sheath.A minimal thoracic surgery approach was used to access the apex of the heart.The apex of the left ventricle was punctured; a delivery catheter equipped with the valved stent was introduced over a stiffguidewire into the aorta arch.We could accurately locate the RCA ostia through the microcatheter placed in the RCA under fluoroscopy.After correct valve position was confirmed,the valved stent was implanted after rapid inflation of the balloon.The immediate outcome of the function of the valved stents was evaluated after implantation.Results:All ten devices were successfully implanted into the AV position of the goats.Immediate observation after the procedure showed that the valved stents were in the desired position after implantation by angiography,echocardiogram.No obstruction of coronary artery ostia occurred,and no moderate to severe aortic regurgitation was observed.Conclusions:When the procedure of transcatheter implantation of a balloon-expandable valved stent into the AV position of goats is assisted with microcatheter positioning coronary artery ostia,the success rate of operation can be increased in those with noncalcified AV.

  1. Balloon observations of spatial coherence in the Global Circuit (United States)

    Holzworth, R. H.; Polar Patrol Balloon Team

    The first campaign of the Polar Patrol Balloon (PPB) experiment (1st-PPB) was carried out at Syowa Station in Antarctica during 1990-1991 and 1992-1993. Based on the results of the 1st-PPB experiment, the next campaign (2nd-PPB) was carried out in the austral summer of 2002-2003. This paper will present the global circuit results from the 2nd-PPB experiment. In that experiment, three balloons were launched for the purpose of upper atmosphere physics observation (3 balloons). Payloads of these 3 flights were identical with each other, and were launched as close together in time as allowed by weather conditions to constitute a cluster of balloons during their flights. Such a "Balloon Cluster" is suitable to observe temporal evolution and spatial distribution of phenomena in the ionospheric regions and boundaries that the balloons traversed during their circumpolar trajectory. More than 20 days of simultaneous fair weather 3-axis electric field and stratospheric conductivity data were obtained at geomagnetic latitudes ranging from sub-auroral to the polar cap. Balloon separation varied from ˜ 60 to ˜ 500 km. This paper will present the global circuit observations with emphasis on the times of apparent spatial variation in the vertical fair weather field.

  2. Large electromagnetic pumps. [LMFBR

    Energy Technology Data Exchange (ETDEWEB)

    Kilman, G.B.


    The development of large electromagnetic pumps for the liquid metal heat transfer systems of fission reactors has progressed for a number of years. Such pumps are now planned for fusion reactors and solar plants as well. The Einstein-Szilard (annular) pump has been selected as the preferred configuration. Some of the reasons that electromagnetic pumps may be preferred over mechanical pumps and why the annular configuration was selected are discussed. A detailed electromagnetic analysis of the annular pump, based on slug flow, is presented. The analysis is then used to explore the implications of large size and power on considerations of electromagnetic skin effect, geometric skin effect and the cylindrical geometry.

  3. Patient-prosthesis mismatch: surgical aortic valve replacement versus transcatheter aortic valve replacement in high risk patients with aortic stenosis. (United States)

    Ghanta, Ravi K; Kron, Irving L


    Patient prosthesis mismatch (PPM) can occur when a prosthetic aortic valve has an effective orifice area (EOA) less than that of a native valve. A recent study by Zorn and colleagues evaluated the incidence and significance of PPM in high risk patients with severe aortic stenosis who were randomized to transcatheter aortic valve replacement (TAVR) or surgical aortic valve replacement (SAVR). TAVR is associated with decreased incidence of severe PPM compared to traditional SAVR valves. Severe PPM increases risk for death at 1 year postoperatively in high risk patients. The increased incidence of PPM is largely due to differences in valve design and should encourage development of newer SAVR valves to reduce risk for PPM. In addition more vigorous approaches to root enlargement in small annulus should be performed with SAVR to prevent PPM.

  4. Surgical phantom for off-pump mitral valve replacement (United States)

    McLeod, A. Jonathan; Moore, John; Guiraudon, Gerard M.; Jones, Doug L.; Campbell, Gordon; Peters, Terry M.


    Off-pump, intracardiac, beating heart surgery has the potential to improve patient outcomes by eliminating the need for cardiopulmonary bypass and aortic cross clamping but it requires extensive image guidance as well as the development of specialized instrumentation. Previously, developments in image guidance and instrumentation were validated on either a static phantom or in vivo through porcine models. This paper describes the design and development of a surgical phantom for simulating off-pump mitral valve replacement inside the closed beating heart. The phantom allows surgical access to the mitral annulus while mimicking the pressure inside the beating heart. An image guidance system using tracked ultrasound, magnetic instrument tracking and preoperative models previously developed for off-pump mitral valve replacement is applied to the phantom. Pressure measurements and ultrasound images confirm the phantom closely mimics conditions inside the beating heart.

  5. Geodesic Acoustic Propagation and Ballooning Mode Formalism (United States)

    Li, M. B.; Diamond, P. H.; Young, G. G.; Arakawa, M.


    Relevance of ballooning formalism (BMF) in nonlinear interaction of toroidal electromagnetic drift waves in the presence of zonal flows and Geodesic Acoustic Oscillation (GAO) is critically examined from a physical argument of radial propagation of wave packets. To achieve the quasi-translational invariance of poloidal harmonics which is necessary for the BMF, the geodesic curvature induced transfer [1] of fluctuation energy in radial direction should occur faster than the time scale of physical interest. Of course, this does not happen necessarily in drift-Alfven (DALF) turbulence simulations [2]. This observation casts considerable doubts on the applicability of various codes based on the BMF concept to nonlinear electromagnetic problems. [1] B. Scott, Phys. Letters A 320 (2003) 53. [2] B. Scott, New J. Phys 7 (2005) 92.

  6. The Norwegian Sounding Rocket and Balloon Program (United States)

    Skatteboe, Rolf


    The status and recent developments of the Norwegian Sounding Rocket and Balloon Program are presented with focus on national activities and recent achievements. The main part of the Norwegian program is sounding rocket launches conducted by Andøya Rocket Range from the launch facilities on Andøya and at Svalbard. For the majority of the programs, the scientific goal is investigation of processes in the middle and upper atmosphere. The in situ measurements are supplemented by a large number of ground-based support instruments located at the ALOMAR Observatory. The ongoing and planned projects are described and the highlights of the latest completed projects are given. The scientific program for the period 2001-2003 will be reviewed. Several new programs have been started to improve the services available to the international science comunity. The Hotel Payload project and MiniDusty are important examples that will be introduced in the paper. Available space related infrastructure is summarized.

  7. Intragastric balloon: ethics, medical need and cosmetics. (United States)

    Kotzampassi, Katerina; Shrewsbury, Anne D


    The development of the intragastic balloon as a safe, noninvasive, alternative method to weight reduction raises all the ethical questions routinely faced by practitioners of other forms of cosmetic surgery. In the case of the morbidly, severely or merely obese, the surgeon is faced with a medical decision in a situation defined by medical parameters. The case of the overweight or normal may, however, create an ethical dilemma in which the doctor is forced to make decisions of a nonmedical nature, for which his training has not prepared him, and relating essentially to his personal attitudes and moral beliefs, culture and the recognition that 'if I don't, somebody else--possibly less competent--will'.

  8. Results of the first EUSO-Balloon flight (United States)

    Miyamoto, H.; Bertaina, M.; JEM-EUSO Collaboration


    EUSO-Balloon, a balloon-borne diffractive fluorescence telescope, was launched by the French Space Agency ONES from the Timmins base in Ontario (Canada) on August 25th in 2014. After reaching the floating altitude of about 38 km, EUSO-Balloon imaged the UV background for more than 5 hours before descending to ground using the key technologies of JEM-EUSO. A detailed and precise measurement of the UV background in different atmospheric and ground conditions was achieved. The instrument proved the capability of detecting Extensive Air Showers (EAS) by observing laser tracks with similar characteristics. This contribution will summarise the first results obtained concerning all the topics described above.

  9. Balloon dilation of congenital supravalvular pulmonic stenosis in a dog (United States)

    Treseder, Julia R.


    Percutaneous balloon valvuloplasty is considered the standard of care for treatment of valvular pulmonic stenosis, a common congenital defect in dogs. Supravalvular pulmonic stenosis is a rare form of pulmonic stenosis in dogs and standard treatment has not been established. Although, there have been reports of successful treatment of supravalvular pulmonic stenosis with surgical and stenting techniques, there have been no reports of balloon dilation to treat dogs with this condition. Here, a case of supravalvular pulmonic stenosis diagnosed echocardiographically and angiographically in which a significant reduction in pressure gradient was achieved with balloon dilation alone is presented. PMID:27297421

  10. An investigation of electrostatically deposited radionuclides on latex balloons

    Energy Technology Data Exchange (ETDEWEB)

    Price, T.; Caly, A., E-mail: [Univ. of Ontario Inst. of Technology, Oshawa, Ontario (Canada)


    Use of Canadian Nuclear Society (CNS) education material for a community science education event to promote science awareness, science culture and literacy (Science Rendezvous 2011) lead to investigation of observed phenomena. Experiments are done on balloons that are electrostatically charged then left to collect particulate. Alpha spectroscopy was performed to identify alpha emitting radioisotopes present on the balloons. The time dependent behaviour of the activity was investigated. Additionally, the Alpha activity of the balloon was compared to Beta activity. The grounds for further investigations are proposed. (author)

  11. Intragastric balloon for morbid obesity causing chronic gastric dilatation

    Energy Technology Data Exchange (ETDEWEB)

    Pretolesi, F.; Derchi, L.E. [Dept. of Radiology, University of Genoa (Italy); Redaelli, G.; Papagni, L. [IRCCS, Ist. Auxologico Italiano, Milan (Italy)


    We describe the radiographic findings observed in a morbidly obese and diabetic patient with an intragastric air-filled balloon introduced as a therapeutic measure to reduce food intake. The balloon was associated with chronic gastric dilatation and had to be removed 3 months after insertion. However, together with diet and behavioural therapy, it proved effective in reducing body weight and ameliorating glycaemic control. Although rarely used, intragastric balloons for the treatment of morbid obesity are still encountered in radiological practice. Radiologists must be able to recognize them and to understand their complications. (orig.)

  12. Dissecting aortic aneurysm in maintenance hemodialysis patients

    Directory of Open Access Journals (Sweden)

    Ounissi M


    Full Text Available The dissecting aortic aneurysm (DAA is a rare pathology that may result in fatal outcome. We report follow up of three cases of DAA patients undergoing maintenance hemo-dialysis who were managed conservatively.

  13. Valve selection in aortic valve endocarditis (United States)

    Zubrytska, Yana


    Aortic prosthetic valve endocarditis (PVE) is a potentially life-threatening disease. Mortality and incidence of infective endocarditis have been reduced in the past 30 years. Medical treatment of aortic PVE may be successful in patients who have a prompt response after antibiotic treatment and who do not have prosthetic dysfunction. In advanced stages, antibiotic therapy alone is insufficient to control the disease, and surgical intervention is necessary. Surgical treatment may be lifesaving, but it is still associated with considerable morbidity and mortality. The aim of surgery is to perform a radical excision of all infected and necrotic tissue, reconstruction of the left ventricle outflow tract, and replacement of the aortic valve. There is no unanimous consensus on which is the optimal prosthesis to implant in this context, and several surgical techniques have been suggested. We aim to analyze the efficacy of the surgical treatment and discuss the issue of valve selection in patients with aortic valve endocarditis.

  14. Type B Aortic Dissection: Management Updates

    Directory of Open Access Journals (Sweden)

    Naghmeh Moshtaghi


    Full Text Available Acute aortic dissection (AAD is the most frequent catastrophic event of the aorta; it occurs nearly three times as frequently as the rupture of abdominal aortic aneurysm. Sixty percent of dissection cases are classified as proximal or type A and 40% as distal or type B, according to the Stanford Classification. The most frequent causes of death in acute type B dissection are aortic rupture and malperfusion syndrome.We herein review recent data suggesting different management modalities of type B aortic dissection, including medical, surgical, and endovascular treatments. Although medical therapy is still the standard approach in uncomplicated cases, there are subgroups of patients who may benefit from endovascular management. Endovascular techniques or surgery are valuable options for complicated cases. Hybrid suites, multidisciplinary approaches, and good imaging techniques can be considered as the key to success in this regard.

  15. Medical image of the week: aortic ring

    Directory of Open Access Journals (Sweden)

    Wong C


    Full Text Available No abstract available. Article truncated after 150 words. A 78 year old man presented with altered mental status and was found to have an intraventricular hemorrhage. He was intubated for airway protection. On the post-intubation chest radiograph (Figure 1, the patient was noted to have a widening of the right paratracheal stripe. A CT chest (Figure 2 was obtained to characterize this finding and revealed an aortic ring which encircles the trachea and esophagus. Vascular rings are uncommon congenital abnormalities, accounting for approximately 1% of congenital heart disease. Complete vascular rings can occur with a right aortic arch with a ligamentum arteriosum or with a double aortic arch, such as with our patient (1. This ring can cause airway compression, stridor, esophageal compression, or no symptoms at all. As the embryo develops, the left fourth pharyngeal arch normally persists to become the aortic arch while the right fourth pharyngeal arch regresses. If both fourth pharyngeal arches persist, a ...

  16. Global Strain in Severe Aortic Valve Stenosis

    DEFF Research Database (Denmark)

    Dahl, Jordi S; Videbæk, Lars; Poulsen, Mikael K


    BACKGROUND: -Global longitudinal systolic strain (GLS) is often reduced in aortic stenosis despite normal ejection fraction. The importance of reduced preoperative GLS on long-term outcome after aortic valve replacement (AVR) is unknown. METHODS AND RESULTS: -A total of 125 patients with severe...... aortic stenosis and ejection fraction >40% scheduled for AVR were evaluated preoperatively and divided into 4 groups according to GLS quartiles. Patients were followed up for 4 years. The primary endpoint was major adverse cardiac events (MACE) defined as cardiovascular mortality and cardiac......Score, history with ischemic heart disease and ejection fraction. CONCLUSIONS: -In patients with symptomatic severe aortic stenosis undergoing AVR reduced GLS provides important prognostic information beyond standard risk factors. Clinical Trial Registration-URL: Unique identifier...

  17. Minimally Invasive Transcatheter Aortic Valve Replacement (TAVR)

    Medline Plus

    Full Text Available Watch a Broward Health surgeon perform a minimally invasive Transcatheter Aortic Valve Replacement (TAVR) Click Here to view the BroadcastMed, Inc. Privacy Policy and Legal Notice © 2017 BroadcastMed, Inc. ...

  18. Proton pump inhibitors (United States)

    Proton pump inhibitors (PPIs) are medicines that work by reducing the amount of stomach acid made by ... Proton pump inhibitors are used to: Relieve symptoms of acid reflux, or gastroesophageal reflux disease (GERD). This ...

  19. Immediate Outcome of Balloon Mitral Valvuloplasty with JOMIVA Balloon during Pregnancy (United States)

    Ramasamy, Ramona; Kaliappan, Tamilarasu; Gopalan, Rajendiran; Palanimuthu, Ramasmy; Anandhan, Premkrishna


    Introduction Rheumatic mitral stenosis is the most common Valvular Heart Disease encountered during pregnancy. Balloon Mitral Valvuloplasty (BMV) is one of the treatment option available if the symptoms are refractory to the medical management and the valve anatomy is suitable for balloon dilatation. BMV with Inoue balloon is the most common technique being followed worldwide. Over the wire BMV is a modified technique using Joseph Mitral Valvuloplasty (JOMIVA) balloon catheter which is being followed in certain centres. Aim To assess the immediate post procedure outcome of over the wire BMV with JOMIVA balloon. Materials and Methods Clinical and echocardiographic parameters of pregnant women with significant mitral stenosis who underwent elective BMV with JOMIVA balloon in our institute from 2005 to 2015 were analysed retrospectively. Severity of breathlessness (New York Heart Association Functional Class), and duration of pregnancy was included in the analysis. Pre procedural echocardiographic parameters which included severity of mitral stenosis and Wilkin’s scoring were analysed. Clinical, haemodynamic and echocardiographic outcomes immediately after the procedure were analysed. Results Among the patients who underwent BMV in our Institute 38 were pregnant women. Twenty four patients (63%) were in New York Heart Association (NYHA) Class III. All of them were in sinus rhythm except two (5%) who had atrial fibrillation. Thirty four patients (89.5%) were in second trimester of pregnancy at the time of presentation and four (10.5%) were in third trimester. Echocardiographic analysis of the mitral valve showed that the mean Wilkin’s score was 7.3. Mean mitral valve area pre procedure was 0.8 cm2. Mean gradient across the valve was 18 mmHg. Ten patients (26.5%) had mild mitral regurgitation and none had more than mild mitral regurgitation. Thirty six patients had pulmonary hypertension as assessed by tricuspid regurgitation jet velocity. All of them underwent BMV

  20. Complete interruption of the aortic arch

    Energy Technology Data Exchange (ETDEWEB)

    Park, Sung Hak; Park, In Kyu; Lee, Won Hwa; Kim, Yong Joo; Kang, Duk Sik; Lee, Jong Tae [Kyungpook National University College of Medicine, Taegu (Korea, Republic of)


    Complete interrupture of the aortic arch is one of the least common cardiac malformation. In this condition, continuity between the ascending and descending protions of the aorta is not present, and the descending aorta is supplied through a reversing patent ductus arteriosus. In the majority of the patients a ventricular septal defect is present. Authors have experienced a case of the complete interruption of aortic arch, interruption between the left carotid and the left subclavian artery.

  1. Effect of age on aortic atherosclerosis

    Institute of Scientific and Technical Information of China (English)

    Michael A. Chen; Miwa Kawakubo; Patrick M. Colletti; Dongxiang Xu; Laurie LaBree Dustin; Robert Detrano; Stanley P Azen; Nathan D. Wong; Xue-Qiao Zhao


    Objective To examine the association of atherosclerosis burden in the survivors of an asymptomatic elderly cohort study and its relationship to other coronary risk factors (specifically, age) by evaluating aortic atherosclerotic wall burden by magnetic resonance imaging (MRI). Methods A total of 312 participants in an ongoing observational cohort study underwent cardiac and descending thoracic aorta imaging by MRI. Maximum wall thickness was measured and the mean wall thickness calculated. Wall/outer wall ratio was used as a normalized wall index (NWI) adjusted for artery size difference among participants. Percent wall volume (PWV) was calculated as NWI × 100. Results In this asymptomatic cohort (mean age: 76 years), the mean (SD) aortic wall area and wall thickness were 222 ± 45 mm2 and 2.7 ± 0.4 mm, respectively. Maximum wall thickness was 3.4 ± 0.6 mm, and PWV was 32% ± 4%. Women appeared to have smaller wall area, but after correcting for their smaller artery size, had significantly higher PWV than men (P = 0.03). Older age was associated with larger wall area (P = 0.04 for trend) with similar PWVs. However, there were no statistically significant associations between standard risk factors, Framingham global risk, or metabolic syndrome status, therapy for cholesterol or hypertension, coronary or aortic calcium score, and the aortic wall burden. Aortic calcification was associated with coronary calcification. Conclusions Asymptomatic elderly in this cohort had a greater descending thoracic aortic wall volume that correlated with age, and women had a significantly increased PWV compared to men. In these survivors, the atherosclerotic aortic wall burden was not significantly associated with traditional risk factors or with coronary or aortic calcium scores or coronary calcium progression. Results suggest that age, or as yet unidentified risk factor(s), may be responsible for the increase in atherosclerosis.

  2. Aortic coarctation repair in the adult. (United States)

    Cardoso, Goncalo; Abecasis, Miguel; Anjos, Rui; Marques, Marta; Koukoulis, Giovanna; Aguiar, Carlos; Neves, José Pedro


    Aortic coarctation can be repaired surgically or percutaneously. The decision should be made according to the anatomy and location of the coarctation, age of the patient, presence of other cardiac lesions, and other anatomic determinants (extensive collaterals or aortic calcification). This article reviews the different therapeutic options available, explaining the differences between children and adults, describing different approaches to the same disease, exemplified by three cases of nonclassic surgical approach and one percutaneous treatment.

  3. Aortic Dissection Cases Presenting with Neurological Deficit

    Directory of Open Access Journals (Sweden)

    Sibel Mumcu


    Full Text Available Aortic dissection can be fatal in case of underdiagnosis, and early treatment is essential for the survival. Although acute onset of chest or back pain is most common presenting symptoms, some patients might present with atypical findings such as acute stroke, mesenteric ischaemia, renal failure or myocardial infarction. Here, we report two cases presenting emergency room with atypical findings of aortic dissection which diagnosis is made during etiologic work up for ischemic stroke.

  4. Surveillance intervals for small abdominal aortic aneurysms

    DEFF Research Database (Denmark)

    Bown, Matthew J; Sweeting, Michael J; Brown, Louise C


    Small abdominal aortic aneurysms (AAAs [3.0 cm-5.4 cm in diameter]) are monitored by ultrasound surveillance. The intervals between surveillance scans should be chosen to detect an expanding aneurysm prior to rupture.......Small abdominal aortic aneurysms (AAAs [3.0 cm-5.4 cm in diameter]) are monitored by ultrasound surveillance. The intervals between surveillance scans should be chosen to detect an expanding aneurysm prior to rupture....

  5. Pump for Saturated Liquids (United States)

    Elliott, D. G.


    Boiling liquids pumped by device based on proven components. Expanding saturated liquid in nozzle and diverting its phases along separate paths in liquid/vapor separator raises pressure of liquid. Liquid cooled in process. Pump makes it unnecessary to pressurize cryogenic liquids in order to pump them. Problems of introducing noncondensable pressurizing gas avoided.

  6. Complications of Aortic Stenting in Patients below 20 Years Old: Immediate and Intermediate Follow-Up

    Directory of Open Access Journals (Sweden)

    Akbar Molaei


    Full Text Available Background: Optimal timing and mode of treatment for patients with coarctation of the aorta (COA remain controversial, particularly in children. Surgery, balloon dilatation, and stent implantation have all proven effective in the treatment of moderate or severe obstruction. The aim of this study was to investigate the complications of COA stenting angioplasty in pediatric patients. Methods: This retrospective, descriptive study was conducted on patients less than 20 years of age who underwent aortic stenting angioplasty because of congenital COA in the pediatric catheterization laboratory of Rajaie cardiovascular, medical and research Center, Tehran between 2005 and 2010. Results: A total of 26 patients (18 [65.4%] males and 9 [34.6%] females with congenital COA who had undergone aortic stenting angioplasty were recruited. Nineteen (73.1% of these patients had native COA and 7 (26.9% had recurrent COA. Most of the early complications were minor and temporary; only one patient developed early major complications. During the follow-up, whereas none of the native group patients developed late complications, in the re-COA group 28.57% of the patients had re-stenosis and 14.28% had chronic systemic hypertension, requiring drug therapy. Conclusion: Our investigation into post-stenting complications in patients with native COA and re-COA showed that endovascular stenting could be an effective and safe method, even in young patients with native COA.

  7. 10 meter Sub-Orbital Large Balloon Reflector (LBR) Project (United States)

    National Aeronautics and Space Administration — Besides serving as a launch vehicle, the carrier balloon provides a stable mount for the enclosed telescope. Looking up, the LBR will serve as a telescope. Looking...

  8. Ohmic scaling based on current diffusive ballooning mode

    Energy Technology Data Exchange (ETDEWEB)

    Yagi, Masatoshi; Itoh, Sanae [Kyushu Univ., Kasuga, Fukuoka (Japan). Research Inst. for Applied Mechanics; Fukuyama, Atsushi; Itoh, Kimitaka


    Based on the anomalous transport model due to current diffusive ballooning mode turbulence, the global energy confinement time in a tokamak with Ohmic heating is theoretically studied. Relations to empirical scaling laws are also discussed. (author)

  9. Design Evolution and Methodology for Pumpkin Super-Pressure Balloons (United States)

    Farley, Rodger

    The NASA Ultra Long Duration Balloon (ULDB) program has had many technical development issues discovered and solved along its road to success as a new vehicle. It has the promise of being a sub-satellite, a means to launch up to 2700 kg to 33.5 km altitude for 100 days from a comfortable mid-latitude launch point. Current high-lift long duration ballooning is accomplished out of Antarctica with zero-pressure balloons, which cannot cope with the rigors of diurnal cycles. The ULDB design is still evolving, the product of intense analytical effort, scaled testing, improved manufacturing, and engineering intuition. The past technical problems, in particular the s-cleft deformation, their solutions, future challenges, and the methodology of pumpkin balloon design will generally be described.

  10. Low Cost Variable Conductance Heat Pipe for Balloon Payload Project (United States)

    National Aeronautics and Space Administration — While continuously increasing in complexity, the payloads of terrestrial high altitude balloons need a thermal management system to reject their waste heat and to...

  11. [The effect of halothane and enflurane as well as of propanidid and ketamin on the aortic baroreceptor discharge of decerebrated cats (author's transl)]. (United States)

    Hagenau, W; Pietsch, D; Arndt, J O


    The effect of halothane, enflurane, propanidid and ketamine on the sensitivity of the aortic baroreceptors and its quantitative relationship with arterial pressure were studied in decerebrated cats. Receptor response curves (single baroreceptor fibres of the depressor nerve) were constructed by plotting the average discharge rate (spikes/sec) against the aortic mean pressure and the effect of the anaesthetics on them was analysed. The blood pressure was changed over wide ranges by inflating a balloon placed in the thoracic part of the descending aorta through a femoral artery. Receptor sensitivity increased with halothane and enflurane, yet it decreased with propanidid. It remained uneffected duringanesthesia with ketamine. Thus, different anesthetics act differently on the afferent impulse traffic of baroreceptors. The possible role of these effects on blood pressure control during anaesthesia is discussed.

  12. Aortic events in a nationwide Marfan syndrome cohort

    DEFF Research Database (Denmark)

    Groth, Kristian A; Krag, Kirstine Stochholm; Hove, Hanne;


    BACKGROUND: Marfan syndrome is associated with morbidity and mortality due to aortic dilatation and dissection. Preventive aortic root replacement has been the standard treatment in Marfan syndrome patients with aortic dilatation. In this study, we present aortic event data from a nationwide Marfan...... syndrome cohort. METHOD: The nationwide cohort of Danish Marfan syndrome patients was established from the Danish National Patient Registry and the Cause of Death Register, where we retrieved information about aortic surgery and dissections. We associated aortic events with age, sex, and Marfan syndrome...

  13. The Hubble party balloon and the expanding universe (United States)

    Zendri, G.; Rosi, T.; Oss, S.


    We show that the metaphor of the inflated balloon used to describe expanding space-time according to the Hubble law can be transformed into a simple laboratory experiment. We obtain, in terms of measured recession speeds and distances of ink dots drawn on a party balloon, easy renditions of various cosmological models, such as the static one and the Einstein-De Sitter universe.

  14. Small Research Balloons in a Physics Course for Education Majors (United States)

    Bruhweiler, F. C.; Verner, E.; Long, T.; Montanaro, E.


    At The Catholic Univ. of America, we teach an experimental physics course entitled Physics 240: The Sun-Earth Connection, which is designed for the undergraduate education major. The emphasis is on providing hands-on experience and giving the students an exciting experience in physics. As part of this course, in the Spring 2013 semester, we instituted a project to plan, build, launch, and retrieve a small (~1.3 kg) research balloon payload. The payload flown was a small GPS unit that sent its position to an Internet site, a small wide-angle high-resolution video camera, and an analog refrigerator thermometer placed in the field of view of the camera. All data were stored on the camera sim-card. Students faced the problems of flying a small research balloon in the congested, densely populated Northeast Corridor of the US. They used computer simulators available on the Web to predict the balloon path and flight duration given velocities for the Jet Stream and ground winds, as well as payload mass and amount of helium in the balloon. The first flight was extremely successful. The balloon was launched 140 km NW of Washington DC near Hagerstown, MD and touched down 10 miles (16 km) NW of York, PA, within 1.6 km of what was predicted. The balloon reached 73,000 ft (22,000 m) and the thermometer indicated temperatures as low as -70 degrees Fahrenheit (-57 C) during the flight. Further balloon flights are planned in conjunction with this course. Additional exercises and experiments will be developed centered around these flights. Besides learning that science can be exciting, students also learn that science is not always easily predictable, and that these balloon flights give an understanding of many of problems that go into real scientific space missions. This project is supported in part by an educational supplement to NASA grant NNX10AC56G

  15. Analysis of current diffusive ballooning mode in tokamaks

    Energy Technology Data Exchange (ETDEWEB)

    Uchida, Morihisa [Faculty of Engineering, Okayama University, Okayama (Japan); Fukuyama, Atsushi [Kyoto Univ. (Japan). Dept. of Nuclear Engineering; Itoh, Kimitaka [National Inst. for Fusion Science, Toki, Gifu (Japan); Itoh, Sanae-I.; Yagi, Masatoshi [Kyushu Univ., Fukuoka (Japan). Research Inst. for Applied Mechanics


    The effect of finite gyroradius on the current diffusive ballooning mode is examined. Starting from the reduced MHD equations including turbulent transports, coupling with drift motion and finite gyroradius effect of ions, we derive a ballooning mode equation with complex transport coefficients. The eigenfrequency, saturation level and thermal diffusivity are evaluated numerically from the marginal stability condition. Preliminary results of their parameter dependence are presented. (author)

  16. Intrauterine tamponade balloon use in the treatment of uterine inversion


    Haeri, Sina; Rais, Sheliza; Monks, Brian


    Uterine inversion is a rare but life-threatening obstetrical emergency that occurs when the fundus of the uterus prolapses through the cervix, hence turning the uterus inside out. In this case report, we present our experience using an intrauterine tamponade balloon for management of uterine inversion, and a review of the literature. The utility of an intrauterine tamponade balloon in cases of uterine inversion, especially when maternal medical conditions preclude the use of uterotonics, or r...

  17. Transcatheter Aortic Valve Replacement With Early- and New-Generation Devices in Bicuspid Aortic Valve Stenosis

    DEFF Research Database (Denmark)

    Yoon, Sung-Han; Lefèvre, Thierry; Ahn, Jung-Ming


    BACKGROUND: Few studies have evaluated the clinical outcomes of transcatheter aortic valve replacement (TAVR) in patients with bicuspid aortic valve stenosis (AS). Particularly, limited data exist comparing the results of TAVR with new-generation devices versus early-generation devices. OBJECTIVE...

  18. Arterial elastance and heart-arterial coupling in aortic regurgitation are determined by aortic leak severity

    NARCIS (Netherlands)

    Segers, P; Morimont, P; Kolh, P; Stergiopulos, N; Westerhof, N; Verdonck, P


    Background In aortic valve regurgitation (AR), aortic leak severity modulates left ventricle (LV) arterial system interaction. The aim of this study was to assess (1) how arterial elastance (E-a), calculated as the ratio of LV end-systolic pressure and stroke volume, relates to arterial properties a

  19. Repositioning of an Intraventricular Dislocated Aortic Valve during Transcatheter Aortic Valve Implantation

    NARCIS (Netherlands)

    Natour, Ehsan; Douglas, Yvonne L.; Jainandunsing, Jayant S.; Schurer, Remco A. J.; van der Werf, Hendrik W.; van den Heuvel, Ad F. M.


    The case is presented of a 75-year-old man referred for transcatheter aortic valve implantation. During the procedure the prosthetic aortic valve became dislocated into the left ventricle shortly after expansion. The subsequent steps taken to reposition the valve using only materials at hand are des

  20. Effect of candesartan treatment on left ventricular remodeling after aortic valve replacement for aortic stenosis

    DEFF Research Database (Denmark)

    Dahl, Jordi S; Videbaek, Lars; Poulsen, Mikael K


    In hypertension, angiotensin receptor blockers can augment regression of left ventricular (LV) hypertrophy. It is not known whether this also is the case after aortic valve replacement (AVR) for severe aortic stenosis (AS). To test the hypothesis that treatment with candesartan in addition...

  1. Aortic annulus and ascending aorta: Comparison of preoperative and periooperative measurement in patients with aortic stenosis

    Energy Technology Data Exchange (ETDEWEB)

    Smid, Michal [Cardiology Department of Internal Medicine, School of Medicine Plzen, Charles University Prague and University Hospital Plzen, alej Svobody 80, 304 60 Plzen (Czech Republic)], E-mail:; Ferda, Jiri [Department of Radiology, School of Medicine Plzen, Charles University Prague and University Hospital Plzen, alej Svobody 80, 304 60 Plzen (Czech Republic)], E-mail:; Baxa, Jan [Department of Radiology, School of Medicine Plzen, Charles University Prague and University Hospital Plzen, alej Svobody 80, 304 60 Plzen (Czech Republic)], E-mail:; Cech, Jakub [Cardiology Department of Internal Medicine, School of Medicine Plzen, Charles University Prague and University Hospital Plzen, alej Svobody 80, 304 60 Plzen (Czech Republic)], E-mail:; Hajek, Tomas [Department of Cardiac Surgery, School of Medicine Plzen, Charles University Prague and University Hospital Plzen, alej Svobody 80, 304 60 Plzen (Czech Republic)], E-mail:; Kreuzberg, Boris [Department of Radiology, School of Medicine Plzen, Charles University Prague and University Hospital Plzen, alej Svobody 80, 304 60 Plzen (Czech Republic)], E-mail:; Rokyta, Richard [Cardiology Department of Internal Medicine, School of Medicine Plzen, Charles University Prague and University Hospital Plzen, alej Svobody 80, 304 60 Plzen (Czech Republic)], E-mail:


    Background: Precise determination of the aortic annulus size constitutes an integral part of the preoperative evaluation prior to aortic valve replacement. It enables the estimation of the size of prosthesis to be implanted. Knowledge of the size of the ascending aorta is required in the preoperative analysis and monitoring of its dilation enables the precise timing of the operation. Our goal was to compare the precision of measurement of the aortic annulus and ascending aorta using magnetic resonance (MR), multidetector-row computed tomography (MDCT), transthoracic echocardiography (TTE), and transoesophageal echocardiography (TEE) in patients with degenerative aortic stenosis. Methods and results: A total of 15 patients scheduled to have aortic valve replacement were enrolled into this prospective study. TTE was performed in all patients and was supplemented with TEE, CT and MR in the majority of patients. The values obtained were compared with perioperative measurements. For the measurement of aortic annulus, MR was found to be the most precise technique, followed by MDCT, TTE, and TEE. For the measurement of ascending aorta, MR again was found to be the most precise technique, followed by MDCT, TEE, and TTE. Conclusion: In our study, magnetic resonance was found to be the most precise technique for the measurement of aortic annulus and ascending aorta in patients with severe degenerative aortic stenosis.

  2. General Considerations of Ruptured Abdominal Aortic Aneurysm: Ruptured Abdominal Aortic Aneurysm


    Lee, Chung Won; Bae, Miju; Chung, Sung Woon


    Although development of surgical technique and critical care, ruptured abdominal aortic aneurysm still carries a high mortality. In order to obtain good results, various efforts have been attempted. This paper reviews initial management of ruptured abdominal aortic aneurysm and discuss the key point open surgical repair and endovascular aneurysm repair.

  3. Introduction (Special Issue on Scientific Balloon Capabilities and Instrumentation) (United States)

    Gaskin, Jessica A.; Smith, I. S.; Jones, W. V.


    In 1783, the Montgolfier brothers ushered in a new era of transportation and exploration when they used hot air to drive an un-tethered balloon to an altitude of 2 km. Made of sackcloth and held together with cords, this balloon challenged the way we thought about human travel, and it has since evolved into a robust platform for performing novel science and testing new technologies. Today, high-altitude balloons regularly reach altitudes of 40 km, and they can support payloads that weigh more than 3,000 kg. Long-duration balloons can currently support mission durations lasting 55 days, and developing balloon technologies (i.e. Super-Pressure Balloons) are expected to extend that duration to 100 days or longer; competing with satellite payloads. This relatively inexpensive platform supports a broad range of science payloads, spanning multiple disciplines (astrophysics, heliophysics, planetary and earth science.) Applications extending beyond traditional science include testing new technologies for eventual space-based application and stratospheric airships for planetary applications.

  4. Development of a tiny tandem balloon system for atmospheric observation (United States)

    Saito, Yoshitaka; Yamada, Kazuhiko; Fujiwara, Masatomo


    A tandem balloon system with a combination of a zero-pressure balloon on top and a super-pressure balloon on the bottom has a unique trajectory characteristic, with different flight altitudes between day and night and thus with ascending and descending motions at dawn and dusk, respectively. This characteristic provides a unique opportunity to explore the atmosphere, e.g., the upper tropospheric and lower stratospheric region with cross-tropopause measurements twice a day. We started development of a tiny tandem balloon system using a 10 m^{3} super-pressure balloon and a 100 m^{3} zero-pressure balloon, with a capability of carrying 3 kg of payload. One of the scientific targets is to measure water vapor, cloud particles, and temperature around the tropical tropopause which is the entry point of the stratospheric and mesospheric meridional circulation. For the data transfer, the iridium satellite communication module, SBD9603 is used. In this paper, the current status of the development will be reported.

  5. Aortenklappeninsuffizienz – Operationsindikationen und Möglichkeiten der Aortenklappenrekonstruktion // Aortic Regurgitation – Aortic Valve Repair

    Directory of Open Access Journals (Sweden)

    Schachner T


    Full Text Available Aortic valve repair for aortic regurgitation has evolved at dedicated centres. It is a valuable alternative to aortic valve replacement and offers good long term results. Tricuspid, as well as bicuspid aortic valves, are suitable for repair. These techniques of aortic valve repair can be combined with reconstruction of concomitant aneurysmal disease of the ascending aorta or the sinus valsalvae. In particular, younger patients can benefit from a life without oral anticoagulation. p bKurzfassung: /bDie Aortenklappenrekonstruktion bei bestehender Aortenklappeninsuffizienz hat sich in spezialisierten Zentren zu einer guten Behandlungsalternative zum Aortenklappenersatz entwickelt. Es können sowohl bikuspide als auch trikuspide Aortenklappen rekonstruiert werden. Bei Vorliegen eines Aortenaneurysmas können Techniken der Aortenklappenrekonstruktion mit dem Ersatz von Aorta ascendens oder Sinus valsalvae kombiniert werden. In spezialisierten Zentren können gute Langzeitergebnisse erzielt werden, die vor allem jüngeren Patienten ein Leben ohne orale Antikoagulation ermöglichen.

  6. Combined surgical and catheter-based treatment of extensive thoracic aortic aneurysm and aortic valve stenosis

    DEFF Research Database (Denmark)

    De Backer, Ole; Lönn, Lars; Søndergaard, Lars


    endovascular aneurysm repair (TEVAR) has changed and extended management options in thoracic aorta disease, including in those patients deemed unfit or unsuitable for open surgery. Accordingly, transcatheter aortic valve replacement (TAVR) is increasingly used to treat patients with symptomatic severe aortic...... valve stenosis (AS) who are considered at high risk for surgical aortic valve replacement. In this report, we describe the combined surgical and catheter-based treatment of an extensive TAA and AS. To our knowledge, this is the first report of hybrid TAA repair combined with TAVR.......An extensive thoracic aortic aneurysm (TAA) is a potentially life-threatening condition and remains a technical challenge to surgeons. Over the past decade, repair of aortic arch aneurysms has been accomplished using both hybrid (open and endovascular) and totally endovascular techniques. Thoracic...

  7. Aortic root, not valve, calcification correlates with coronary artery calcification in patients with severe aortic stenosis

    DEFF Research Database (Denmark)

    Henein, Michael; Hällgren, Peter; Holmgren, Anders


    BACKGROUND: The underlying pathology in aortic stenosis (AS) and coronary artery stenosis (CAS) is similar including atherosclerosis and calcification. We hypothesize that coronary artery calcification (CAC) is likely to correlate with aortic root calcification (ARC) rather than with aortic valve...... calcification (AVC), due to tissue similarity between the two types of vessel rather than with the valve leaflet tissue. MATERIAL AND METHODS: We studied 212 consecutive patients (age 72.5 ± 7.9 years, 91 females) with AS requiring aortic valve replacement (AVR) in two Heart Centers, who underwent multidetector...... cardiac CT preoperatively. CAC, AVC and ARC were quantified using Agatston scoring. Correlations were tested by Spearman's test and Mann-Whitney U-test was used for comparing different subgroups; bicuspid (BAV) vs tricuspid (TAV) aortic valve. RESULTS: CAC was present in 92%, AVC in 100% and ARC in 82...

  8. Patch annulo-aortoplasty in an adult patient with congenital supravalvular aortic stenosis and a small aortic annulus. (United States)

    Morimoto, Naoto; Morimoto, Keisuke; Morimoto, Yoshihisa; Tanaka, Akiko; Sakamoto, Toshihito; Okada, Kenji; Okita, Yutaka


    A 39-year-old woman with familial homozygous hypercholesterolemia had supravalvular and valvular aortic stenosis. Modified Nick's procedure and aortic valve replacement was performed to relieve both the supravalvular and annular stenoses. At surgery, the ascending aorta was found to be narrowing at the level of the sinotubular junction, which was compatible with congenital supravalvular aortic stenosis. Histological examination of the aortic cusps showed sclerotic change due to hypercholesterolemia. These findings indicated that familial homozygous hypercholesterolemia caused valvular aortic stenosis and exacerbated congenital supravalvular aortic stenosis.

  9. Incidental moderate mitral regurgitation in patients undergoing aortic valve replacement for aortic stenosis: review of guidelines and current evidence. (United States)

    Ramakrishna, Harish; Kohl, Benjamin A; Jassar, Arminder S; Augoustides, John G T


    Recent evidence has shown that moderate mitral regurgitation is common and clinically relevant in patients presenting for surgical and transcatheter aortic valve replacement for aortic stenosis. Prospective multicenter clinical trials are now indicated to resolve the clinical equipoise about whether or not mitral valve intervention also is indicated at the time of aortic valve intervention. Advances in three-dimensional transesophageal echocardiography, transcatheter mitral interventions, and surgical aortic valve replacement, including the advent of sutureless valves, likely will expand the therapeutic possibilities for moderate mitral regurgitation in the setting of aortic valve interventions for severe aortic stenosis.

  10. Measurement and determinants of infrarenal aortic thrombus volume

    Energy Technology Data Exchange (ETDEWEB)

    Golledge, Jonathan; Wolanski, Philippe [James Cook University, The Vascular Biology Unit, Townsville, Queensland (Australia); Townsville Hospital, Townsville, Queensland (Australia); Parr, Adam [James Cook University, The Vascular Biology Unit, Townsville, Queensland (Australia); Buttner, Petra [James Cook University, School of Public Health and Tropical Medicine, Townsville, Queensland (Australia)


    Intra-luminal thrombus has been suggested to play a role in the progression of abdominal aortic aneurysm (AAA). The aims of this study were twofold. Firstly, to assess the reproducibility of a computer tomography (CT)-based technique for measurement of aortic thrombus volume. Secondly, to examine the determinants of infrarenal aortic thrombus volume in a cohort of patients with aortic dilatation. A consecutive series of 75 patients assessed by CT angiography with maximum aortic diameter {>=}25 mm were recruited. Intra-luminal thrombus volume was measured by a semi-automated workstation protocol based on a previously defined technique to quantitate aortic calcification. Intra- and inter-observer reproducibility were assessed using correlation coefficients, coefficient of variation and Bland-Altman plots. Infrarenal aortic thrombus volume percentage was related to clinical, anatomical and blood characteristics of the patients using univariate and multivariate tests. Infrarenal aortic thrombus volume was related to the severity of aortic dilatation assessed by total aortic volume (r=0.87, P<0.0001) or maximum aortic diameter (r=0.74, P< 0.0001). We therefore examined the clinical determinates of aortic thrombus expressed as a percentage of total aortic volume. Aortic thrombus percentage was negatively correlated with serum high density lipoprotein (HDL, r=-0.31). By ordinal multiple logistic regression analysis serum HDL below median ({<=}1.2 mM) was associated with aortic thrombus percentage in the upper quartile adjusting for other risk factors (odds ratio 5.3, 95% CI 1.1-25.0). Infrarenal aortic thrombus volume can be measured reproducibly on CT. Serum HDL, which can be therapeutically raised, may play a role in discouraging aortic thrombus accumulation with implications in terms of delaying progression of AAA. (orig.)

  11. Catching Comet's Particles in the Earth's Atmosphere by Using Balloons (United States)

    Potashko, Oleksandr; Viso, Michel

    The project is intended to catch cometary particles in the atmosphere by using balloons. The investigation is based upon knowledge that the Earth crosses the comet’s tails during the year. One can catch these particles at different altitudes in the atmosphere. So, we will be able to gradually advance in the ability to launch balloons from low to high altitudes and try to catch particles from different comet tails. The maximum altitude that we have to reach is 40 km. Both methods - distance observation and cometary samples from mission Stardust testify to the presence of organic components in comet’s particles. It would be useful to know more details about this organic matter for astrobiology; besides, the factor poses danger to the Earth. Moreover, it is important to prove that it is possible to get fundamental scientific results at low cost. In the last 5 years launching balloons has become popular and this movement looks like hackers’ one - as most of them occur without launch permission to airspace. The popularity of ballooning is connected with low cost of balloon, GPS unit, video recording unit. If you use iPhone, you have a light solution with GPS, video, picture and control function in one unit. The price of balloon itself begins from $50; it depends on maximum altitude, payload weight and material. Many university teams realized balloon launching and reached even stratosphere at an altitude of 33 km. But most of them take only video and picture. Meanwhile, it is possible to carry out scientific experiments by ballooning, for example to collect comet particles. There is rich experience at the moment of the use of mineral, chemical and isotopic analysis techniques and data of the comet’s dust after successful landing of StarDust capsule with samples in 2006. Besides, we may use absolutely perfect material to catch particles in the atmosphere, which was used by cosmic missions such as Stardust and Japanese Hayabusa. As to balloon launches, we could use

  12. Aneurismas da aorta Aortic aneurysms

    Directory of Open Access Journals (Sweden)

    Januário M Souza


    Full Text Available Entre janeiro de 1979 e janeiro de 1992, foram realizadas 212 operações para correção de aneurismas e de dissecções da aorta. Neste trabalho serão analisados 104 procedimentos cirúrgicos (em 97 pacientes para correção de aneurismas. A idade dos pacientes variou de 14 a 79 anos (média 59,5 anos e o sexo predominante foi o masculino, com 75 pacientes. Os aneurismas localizavam-se na aorta ascendente em 46 pacientes, na croça em 8, na aorta descendente em 8, na aorta toráco-abdominal em 8, na aorta abdominal em 21, na aorta descendente e abdominal em 2, na aorta ascendente e tóraco-abdominal em 2, na aorta ascendente e descendente em 1, na aorta ascendente, croça e descendente em 1. Doenças cardiovasculares associadas estavam presentes em 39 pacientes, sendo valvopatia aórtica em 18 (excluídos os pacientes com ectasiaânulo-aórtíca, insuficiência coronária em 17, coarctação da aorta em 2, persistência do canal arterial em 1 e valvopatia mitral e aórtica em 1. A mortalidade imediata (hospitalar e/ou 30 dias foi de 14,4%, sendo de 27,7% (5/18 para pacientes com mais de 70 anos e de 11,3% (9/79 para pacientes com idade inferior a 70 anos. Os aneurismas localizados na aorta ascendente e croça foram operados como o auxílio de circulação extracorpórea. Parada circulatória e hipotermia profunda foram utilizadas em todos os pacientes com aneurisma da croça. O estudo tomográfico e angiográfico deve ser de toda a aorta, pela possibilidade de aneurismas de localizações múltiplas.Among 212 patients undergoing operation for aortic aneurysm and aortic dissection between January 1979 and January 1992, 97 were operated on for aneurysms. The aneurysms were localized in: ascending aorta in 46 patients, transverse aortic arch in 8, descending aorta in 8, thoracoabdominal aorta in 8, abdominal (infrarenal aorta in 21, descending and abdominal aorta in 2, ascending and thoracoabdominal aorta in 2, ascending and descending in 1

  13. A comparison of balloon-expandable-stent implantation with balloon angioplasty in patients with coronary artery disease. Benestent Study Group.


    Serruys, P.W.; de Jaegere, P; Kiemeneij, F.; Macaya, C; Rutsch, W; Heyndrickx, G.; Emanuelsson, H.; Marco, J.; Legrand, Victor; Materne, P.


    BACKGROUND: Balloon-expandable coronary-artery stents were developed to prevent coronary restenosis after coronary angioplasty. These devices hold coronary vessels open at sites that have been dilated. However, it is unknown whether stenting improves long-term angiographic and clinical outcomes as compared with standard balloon angioplasty. METHODS: A total of 520 patients with stable angina and a single coronary-artery lesion were randomly assigned to either stent implantation (262 patients)...

  14. Vasopressor mechanisms in acute aortic coarctation hypertension

    Directory of Open Access Journals (Sweden)

    Salgado H.C.


    Full Text Available Angiotensin II (ANG II and vasopressin (AVP act together with the mechanical effect of aortic constriction in the onset of acute aortic coarctation hypertension. Blockade of ANG II and AVP V1 receptors demonstrated that ANG II acts on the prompt (5 min rise in pressure whereas AVP is responsible for the maintenance (30-45 min of the arterial pressure elevation during aortic coarctation. Hormone assays carried out on blood collected from conscious rats submitted to aortic constriction supported a role for ANG II in the early stage and a combined role for both ANG II and AVP in the maintenance of proximal hypertension. As expected, a role for catecholamines was ruled out in this model of hypertension, presumably due to the inhibitory effect of the sinoaortic baroreceptors. The lack of afferent feedback from the kidneys for AVP release from the central nervous system in rats with previous renal denervation allowed ANG II to play the major role in the onset of the hypertensive response. Median eminence-lesioned rats exhibited a prompt increase in proximal pressure followed by a progressive decline to lower hypertensive levels, revealing a significant role for the integrity of the neuroaxis in the maintenance of the aortic coarctation hypertension through the release of AVP. In conclusion, the important issue raised by this model of hypertension is the likelihood of a link between some vascular territory - probably renal - below the coarctation triggering the release of AVP, with this vasoconstrictor hormone participating with Ang II and the mechanical effect of aortic constriction in the acute aortic coarctation hypertension

  15. Atherosclerotic Aortic Plaques Detected by Transesophageal Echocardiography

    Institute of Scientific and Technical Information of China (English)

    赵云; 朱文玲; 倪超; 郭丽琳; 曾勇; 方理刚


    Objective To evaluate the predictive value of atherosclerotic aortic plaques in coronary artery disease (CAD) Methods In 50patients with suspected coronary artery disease, transesophageal echocardiography was performed to examine their thoracic aortas 2 weeks before or after coronary angiography. In the cases of coronary angiography studied, stenosis of the coronary artery ≥ 50 % was considered to be due to coronary artery disease,whereas the thickness of the intima ≥ 1.3 mm was taken to be the criteria for the presence of an atherosclerotic aortic plaque on the transesophageal echocardiographic test. Results Among the 50 patients, 37 cases were diagnosed as CAD and 13 cases were considered to be normal. The plaques of the thoracic aorta were observed in 34cases in the CAD group and 3 cases in the normal group. The sensitivity and specificity of aortic plaques for CAD were 91.9 % and 76.9%, respectively. The positive and negative predictive values of the aortic plaques for CAD were 91.9% and 76.9%, respectively. The accuracy was 88.0%. 80 percent of the patients with single- yes sel disease had thoracic aortic plaques, 92 percent of the patients with two-vessel disease and 100 percent of the patients with three-vessel disease had thoracic aortic plaques. There was a significant difference in the thickness of aortic intimas between the normal group and the CAD group. Conclusions Detectingatherosclerotic plaques in the thoracic aorta with transesophageal echocardiography may be of great value in predicting the presence and extent of coronary artery disease.

  16. [New technique of concomitant replacement of the aortic valve and the ascending aorta with enlargement of the aortic annulus for congenital bicuspid aortic valve]. (United States)

    Takahara, Shingo; Fukasawa, Manabu; Kawahara, Yu; Suzuki, Kotaro; Kobayashi, Yuriko


    Congenital bicuspid aortic valve (BAV) is one of the most common congenital heart diseases, with a high incidence of associated valvular lesions and aortic abnormalities including aortic stenosis( AS), aortic regurgitation, aortic dilatation, and aortic dissection. Patients with BAV and AS often have a small aortic annulus. We encountered a case of BAV in which a 51-year-old woman with severe AS having a small aortic annulus and a dilated ascending aorta required surgical intervention. We performed the surgery using new technique that involved concomitant replacement of the aortic valve and the ascending aorta with enlargement of the aortic annulus using a single uniquely-shaped graft to avoid prosthesis patient mismatch. We trimmed the proximal end of the straight graft in shape of 2 teardrops hanging on it to fit the cut annulus. It requires only a single suture line to replace the ascending aorta and enlarge the aortic annulus, which entails a decreased risk of bleeding during surgery. We believe that it could be applicable to many cases requiring concomitant surgery.

  17. Burn Injury Arise From Flying Balloon Toys

    Directory of Open Access Journals (Sweden)

    Yalcin Kulahci


    Full Text Available Many of peoples are faced minor or major burn injuries in their life. Even the most widespread burn cause is flame injuries, too different burn cause pointed out in literature like Acetylen burns. The cases which imply in literature, mostly causes from explosion of high pressure acetylene tube, metal oxygene patch flame or carbide lamp using from cave explorers. An interesting acetylene burn cause in Turkey was publised by the authors. This cases was to come into being from flying toy balloons flame. 80 person was injured from flying toy ballons flame in a meeting in 2002. Although this potential risks of acetylene, helium have not any of some risk. But helium was provided from other countries and have more price. The injuries which caused from acetylene burns like 1st -2nd degree burns. Consequently that was known helium is more avaliable for using in toy sector, and never cause burn injuries like this. [TAF Prev Med Bull 2007; 6(4.000: 291-296

  18. Balloon borne arcsecond pointer feasibility study (United States)

    Ward, Philip R.; Deweese, Keith D.


    A major hurdle in extending the range of experiments for which balloon vehicles are useful has been the imposition of the gondola dynamics on the accuracy with which an instrument can be kept pointed at a celestial target. In this paper, the foundation for a high fidelity controller simulation is presented and it is shown that sub-arcsecond pointing stability can be achieved for a large instrument pointing at an inertial target. The flexibility of the flight train is represented through generalized modal analysis. A multiple controller scheme is introduced with a coarse azimuth pointer and a pitch-yaw gimbal mount for fine pointing. An analysis and demonstration of the necessity in eliminating static friction are provided along with a solution to eliminate static friction from the system dynamics. A control scheme involving linear accelerometers for enhanced disturbance rejection is also presented. This paper establishes that the proposed control strategy can be made robustly stable with significant design margins. Also demonstrated is the efficacy of the proposed system in rejecting disturbances larger than those considered realistic.

  19. Ballooning mode spectrum in general toroidal systems

    Energy Technology Data Exchange (ETDEWEB)

    Dewar, R.L.; Glasser, A.H.


    A WKB formalism for constructing normal modes of short-wavelength ideal hydromagnetic, pressure-driven instabilities (ballooning modes) in general toroidal magnetic containment devices with sheared magnetic fields is developed. No incompressibility approximation is made. A dispersion relation is obtained from the eigenvalues of a fourth order system of ordinary differential equations to be solved by integrating along a line of force. Higher order calculations are performed to find the amplitude equation and the phase change at a caustic. These conform to typical WKB results. In axisymmetric systems, the ray equations are integrable, and semiclassical quantization leads to a growth rate spectrum consisting of an infinity of discrete eigenvalues, bounded above by an accumulation point. However, each eigenvalue is infinitely degenerate. In the nonaxisymmetric case, the rays are unbounded in a four dimensional phase space, and semiclassical quantization breaks down, leading to broadening of the discrete eigenvalues and accumulation point of the axisymmetric case into continuum bands. Analysis of a model problem indicates that the broadening of the discrete eigenvalues is numerically very small, the dominant effect being broadening of the accumulation point.

  20. Burn Injury Arise From Flying Balloon Toys

    Directory of Open Access Journals (Sweden)

    Yalcin Kulahci


    Full Text Available Many of peoples are faced minor or major burn injuries in their life. Even the most widespread burn cause is flame injuries, too different burn cause pointed out in literature like Acetylen burns. The cases which imply in literature, mostly causes from explosion of high pressure acetylene tube, metal oxygene patch flame or carbide lamp using from cave explorers. An interesting acetylene burn cause in Turkey was publised by the authors. This cases was to come into being from flying toy balloons flame. 80 person was injured from flying toy ballons flame in a meeting in 2002. Although this potential risks of acetylene, helium have not any of some risk. But helium was provided from other countries and have more price. The injuries which caused from acetylene burns like 1st -2nd degree burns. Consequently that was known helium is more avaliable for using in toy sector, and never cause burn injuries like this. [TAF Prev Med Bull. 2007; 6(4: 291-296

  1. Optical coherence tomography monitoring of angioplasty balloon inflation in a deployment tester (United States)

    Azarnoush, Hamed; Vergnole, Sébastien; Bourezak, Rafik; Boulet, Benoit; Lamouche, Guy


    We present an innovative integration of an intravascular optical coherence tomography probe into a computerized balloon deployment system to monitor the balloon inflation process. The high-resolution intraluminal imaging of the balloon provides a detailed assessment of the balloon quality and, consequently, a technique to improve the balloon manufacturing process. A custom-built swept-source optical coherence tomography system is used for real-time imaging. A semicompliant balloon with a nominal diameter of 4 mm is fabricated for the experiments. Imaging results correspond to balloon deployment in air and inside an artery phantom. A characterization of the balloon diameter, wall thickness, compliance, and elastic modulus is provided, based on image segmentation. Using the images obtained from the probe pullback, a three-dimensional visualization of the inflated balloon is presented.

  2. Experience with the Sarns centrifugal pump in postcardiotomy ventricular failure. (United States)

    Curtis, J J; Walls, J T; Schmaltz, R; Boley, T M; Nawarawong, W; Landreneau, R J


    The reported clinical use of the Sarns centrifugal pump (Sarns, Inc./3M, Ann Arbor, Mich.) as a cardiac assist device for postcardiotomy ventricular failure is limited. During a 25-month period ending November 1988, we used 40 Sarns centrifugal pumps as univentricular or biventricular cardiac assist devices in 27 patients who could not be weaned from cardiopulmonary bypass despite maximal pharmacologic and intraaortic balloon support. Eighteen men and nine women with a mean age of 60.4 years (28 to 83) required assistance. Left ventricular assist alone was used in 12 patients, right ventricular assist in 2, and biventricular assist in 13. The duration of assist ranged from 2 to 434 hours (median 45). Centrifugal assist was successful in weaning 100% of the patients. Ten of 27 patients (37%) improved hemodynamically, allowing removal of the device(s), and 5 of 27 (18.5%) survived hospitalization. Survival of patients requiring left ventricular assist only was 33.3% (4/12). Complications were common and included renal failure, hemorrhage, coagulopathy, ventricular arrhythmias, sepsis, cerebrovascular accident, and wound infection. During 3560 centrifugal pump hours, no pump thrombosis was observed. The Sarns centrifugal pump is an effective assist device when used to salvage patients who otherwise cannot be weaned from cardiopulmonary bypass. Statistical analysis of preoperative patient characteristics, operative risk factors, and postoperative complications failed to predict which patients would be weaned from cardiac assist or which would survive.

  3. MicroRNAs, fibrotic remodeling, and aortic aneurysms (United States)

    Milewicz, Dianna M.


    Aortic aneurysms are a common clinical condition that can cause death due to aortic dissection or rupture. The association between aortic aneurysm pathogenesis and altered TGF-β signaling has been the subject of numerous investigations. Recently, a TGF-β–responsive microRNA (miR), miR-29, has been identified to play a role in cellular phenotypic modulation during aortic development and aging. In this issue of JCI, Maegdefessel and colleagues demonstrate that decreasing the levels of miR-29b in the aortic wall can attenuate aortic aneurysm progression in two different mouse models of abdominal aortic aneurysms. This study highlights the relevance of miR-29b in aortic disease but also raises questions about its specific role. PMID:22269322

  4. Notch signaling in descending thoracic aortic aneurysm and dissection

    NARCIS (Netherlands)

    Zou, S.; Ren, P.; Nguyen, M.; Coselli, J.S.; Shen, Y.H.; Lemaire, S.A.


    BACKGROUND: Descending thoracic aortic aneurysm and dissection (DTAAD) is characterized by progressive medial degeneration, which may result from excessive tissue destruction and insufficient repair. Resistance to tissue destruction and aortic self-repair are critical in preventing medial degenerati

  5. Intragastric balloon followed by diet vs intragastric balloon followed by another balloon: a prospective study on 100 patients. (United States)

    Genco, Alfredo; Cipriano, Massimiliano; Bacci, Vincenzo; Maselli, Roberta; Paone, Emanuela; Lorenzo, Michele; Basso, Nicola


    Aim of this study is to compare the efficacy of BioEnterics Intragastric Balloon (BIB®) followed by diet with BIB followed by another BIB. A prospective study was designed: a homogeneous group of 100 obese patients (age range 25-35, BMI range 40.0-44.9, M/F ratio 1/4) was allocated into two groups according to procedure: BIB (6 months) followed by diet therapy (7 months; group A = 50 pts), BIB positioning followed by another BIB after 1 month (group B = 50 pts). Baseline demographics were similar in both groups (Group A 10M/40F; mean age 31.4 ± 2.6; range 25-35; mean weight 106.3 ± 12.5 Kg; range 88-150; mean BMI 42.6±2.7 Kg/m(2); range 40.2-43.8; Group B 10M/40F; mean age 32.1 ± 2.1; range 25-35; mean weight 107.1 ± 11.9 Kg; range 90-150; mean BMI 42.9 ± 2.3; range 40.2-43.9). In both groups, weight loss parameters (Kg, BMI, and % EBL) were considered. Statistics were by Fisher's exact test (p < 0.05 was considered significant). At the time of 1st BIB removal, weight loss parameters in both groups were not significantly different: Group A: mean weight was 83.7±19.1 (range 52-151); mean BMI 34.2 ± 3.9 (range 32.4-43.8); and mean %EBL 43.5 ± 21.1 (range 0-68). Group B: mean weight was 84.9 ± 18.3 (range 50-148); mean BMI 34.8 ± 3.3 (range 32.4-43.8); and mean % EBL 45.2 ± 22.5% (range 0-68). At the study end, weight loss parameters were significantly lower in patients who underwent consecutive BIB (p < 0.05): mean BMI was 30.9 ± 7.2 Kg/m(2) (range 24-40), and 35.9 ± 9.7 Kg/m(2) (range 34-42); mean % EBL was 51.9 ± 24.6% (range 0-100) and 25.1 ± 26.2% (range 0-100) in group B and A, respectively. As compared with diet, a second intragastric balloon can be positioned without difficulties, achieving good results with continuous weight loss.

  6. Rapid prototyping in aortic surgery. (United States)

    Bangeas, Petros; Voulalas, Grigorios; Ktenidis, Kiriakos


    3D printing provides the sequential addition of material layers and, thus, the opportunity to print parts and components made of different materials with variable mechanical and physical properties. It helps us create 3D anatomical models for the better planning of surgical procedures when needed, since it can reveal any complex anatomical feature. Images of abdominal aortic aneurysms received by computed tomographic angiography were converted into 3D images using a Google SketchUp free software and saved in stereolithography format. Using a 3D printer (Makerbot), a model made of polylactic acid material (thermoplastic filament) was printed. A 3D model of an abdominal aorta aneurysm was created in 138 min, while the model was a precise copy of the aorta visualized in the computed tomographic images. The total cost (including the initial cost of the printer) reached 1303.00 euros. 3D imaging and modelling using different materials can be very useful in cases when anatomical difficulties are recognized through the computed tomographic images and a tactile approach is demanded preoperatively. In this way, major complications during abdominal aorta aneurysm management can be predicted and prevented. Furthermore, the model can be used as a mould; the development of new, more biocompatible, less antigenic and individualized can become a challenge in the future.

  7. Flow in an Aortic Coarctation (United States)

    Loma, Luis; Miller, Paul; Hertzberg, Jean


    Coarctation of the aorta is a congenital cardiovascular defect that causes a constriction in the descending thoracic aorta. To gain a better understanding of the cause of post-surgical problems, a rigid glass and a compliant in vitro model of the aortic arch and descending aorta with a coarctation were constructed. Near-physiologic compliance was obtained using a silicone elastomer. Stereoscopic PIV was used to obtain 3D velocity maps. Results show a high speed turbulent jet formed at the exit of the coarctation. Flow in the rigid model was significantly different from in the compliant model. In the rigid model, the jet was symmetric, creating a toroidal recirculation area. In the compliant model, the jet was directed towards the medial wall, inducing flow reversal only at the lateral wall. Peak velocities and turbulence intensities were higher in the rigid model, however shear rate values in the compliant model were significantly above both the rigid model and normal in vivo values at the medial wall. In both models the reattachment region fluctuated, creating oscillatory shear.

  8. A Clinicopathological Study on Aortic Valves in Children

    Institute of Scientific and Technical Information of China (English)

    HUANG Ping; WANG Hongwei; ZHANG Zhenlu; HU Xiufen; LI Yanping; CHENG Peixuan; LIU Jianying


    In order to investigate the clinicopathological characteristics of aortic valve disease in children, all the native surgically excised aortic valves obtained between January 2003 and December 2005 were studied macroscopically and microscopically. The patients' medical records were reviewed and the clinical information was extracted. According to preoperative echocardiography, intraoperative assessment, and postoperative pathology, combined with clinical symptoms and signs, aortic valve diseases were divided into three categories: aortic stenosis (AS), aortic insufficiency (AI), and aortic stenosis with insufficiency (AS-AI). The etiology was determined according to the macroscopic, microscopic and clinical findings. The results showed that among 70 aortic valves, patient age ranged from 6 to 18 years, with a mean of 15.4 years, and there were 56 boys and 14 girts (male: female=4:1). Forty-four children only had pure aortic valve disease, and the other 26 children had aortic valve disease associated with other heart valve diseases. There were 5 cases of AS (7.14%), 60 cases of AI (85.71%) and 5 cases of AS-AI (7.14%). The causes were congenital aortic valve malformation (32 cases, 45.71%), rheumatic disease (28 cases, 40%), infective endocarditis (7 cases,10%), Marfan syndrome (2 cases, 2.86%), and undetermined (1 case, 1.43%). It was concluded that the common causes of aortic valve disease in order of frequency in children were congenital aortic valve malformation, rheumatic disease, infective endocarditis, and Marfan syndrome. AI was more common in children with aortic valve disease. Compared with adult patients, congenital bicuspid aortic valve in children was often AI. Histologically, the leaflets of congenital bicuspid aortic valve were mainly myxomatous, fibrosis and calcification less seen. AI was frequently found in rheumatic disease, mostly associated with other heart valve diseases. Macroscopic and microscopic examinations together with clinical

  9. Transcatheter aortic valve implantation: status and challenges. (United States)

    Fishbein, Gregory A; Schoen, Frederick J; Fishbein, Michael C


    Calcific aortic valve disease of the elderly is the most prevalent hemodynamically-significant valvular disease, and the most common lesion requiring valve replacement in industrialized countries. Transcatheter aortic valve implantation is a less invasive alternative to classical aortic valve replacement that can provide a therapeutic option for high-risk or inoperable patients with aortic stenosis. These devices must be biocompatible, have excellent hemodynamic performance, be easy to insert, be securely anchored without sutures, and be durable, without increased risk of thrombosis or infection. To date, complications are related to the site of entry for insertion, the site of implantation (aorta, coronary ostia, base of left ventricle), and to the structure and design of the inserted device. However, as with any novel technology unanticipated complications will develop. Goals for future development will be to make the devices more effective, more durable, safer, and easier to implant, so as to further improve outcome for patients with severe aortic stenosis. The pathologist participating in research and development, and examination of excised devices will have a critical role in improving outcome for these patients.

  10. Extradural balloon obliteration of the empty sella report of three cases (intrasellar balloon obliteration). (United States)

    Gazioğlu, N; Akar, Z; Ak, H; Işlak, C; Koçer, N; Seçkin, M S; Kuday, C


    Empty sella syndrome is an anatomical and clinical entity composed of intrasellar reposition of the CSF and compression of the pituitary tissue, resulting in a clinical picture of headache, visual field defect, CSF rhinorrhea and some mild endocrinological disturbances. While some cases are primary with no appreciable aetiology, secondary cases are associated with prior operation or radiotherapy of the region. In our series, 3 patients with primary empty sella syndrome were treated by the current approach of extradural filling of the sellar cavity. This technique was first described by Guiot and widely accepted thereafter. We used a detachable silicon balloon filled with HEMA or liquid silicone for obliteration of the sellar cavity and obtained clinically satisfactory results without complications. Visual symptoms regressed and headache disappeared. But at long term follow-up all the balloons were found to be deflated. Despite the facility and efficacy of the technique we do not recommend it in the treatment of the empty sella because the filling of the sella is only transient and relapses may occur.

  11. Balloon dacryocystoplasty: Incomplete versus complete obstruction of the nasolacrimal system

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jeong Min; Lee, Sang Hoon; Han, Young Min; Chung, Gyung Ho; Kim, Chong Soo; Choi, Ki Chul [Chung Ang University College of Medicine, Seoul (Korea, Republic of); Song, Ho Young [Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of)


    Balloon dilatation of nasolacrimal drainage apparatus was attempted for the treatment of stenoses or obstructures of the nasolacrimal system in 49 eyes of 41 consecutive patients with complete obstructions and 16 eyes of 14 patients with incomplete obstructions. These two groups were compared with regards to the effectiveness of balloon dacryocystoplasty. All patients suffered from severe epiphora had already undergone multiple probings. A 0.018 inch hair or ball guide wire was introduced through the superior punctum into the inferior meatus of the nasal cavity and pulled out through the nasal aperture using a hemostat under nasal endoscopy. A deflated angiography balloon catheter was then introduced in a retrograde direction and dilated under fluoroscopic control. No major complications occurred in any of the patients. At 7 days after balloon dilatation, 25 of 49 eyes with complete obstruction demonstrated improvement in epiphora (initial success rate: 51.0%) and among them 17 eyes showed complete resolution of symptoms. Reocclusion occurred in 12 of the 25 eyes with initial improvement at the 2 months follow up. For the 16 eyes with incomplete obstruction, and improvement of epiphora was attained in 11 eyes (initial success rate 68.8%): 5 of these eyes showed complete resolution of epiphora, and 3 was failed to maintain initial improvement at the 2 month follow up. Although this study demonstrate that results of balloon dacryocystoplasty are not encouraging because of the high failure and recurrence rate, balloon dacryocystoplasty is a simple and safe nonsurgical technique that can be used to treat for obstructions of the nasolacrimal system. In addition, balloon dacryocystoplasty shows better results in incomplete obstruction than in complete obstruction than complete obstruction of the nasolacrimal system.

  12. Coolability of ballooned VVER bundles with pellet relocation

    Energy Technology Data Exchange (ETDEWEB)

    Hozer, Z.; Nagy, I.; Windberg, P.; Vimi, A. [AEKI, 49, Budapest, H-1525 (Hungary)


    During a LOCA incident the high pressure in the fuel rods can lead to clad ballooning and the debris of fuel pellets can fill the enlarged volume. The evaluation of the role of these two effects on the coolability of VVER type fuel bundles was the main objective of the experimental series. The tests were carried out in the modified configuration of the CODEX facility. 19-rod electrically heated VVER type bundle was used. The test section was heated up to 600 deg. C in steam atmosphere and the bundle was quenched from the bottom by cold water. Three series of tests were performed: 1. Reference bundle with fuel rods without ballooning, with uniform power profile. 2. Bundle with 86% blockage rate and with uniform power profile. The blockage rate was reached by superimposing hollow sleeves on all 19 fuel rods. 3. Bundle with 86% blockage rate and with local power peak in the ballooned area. The local power peak was produced by the local reduction the cross section of the internal heater bar inside of the fuel rods. In all three bundle configurations three different cooling water flow-rates were applied. The experimental results confirmed that a VVER bundle with even 86% blockage rate remains coolable after a LOCA event. The ballooned section creates some obstacles for the cooling water during reflood of the bundle, but this effect causes only a short delay in the cooling down of the hot fuel rods. Earlier tests on the coolability of ballooned bundles were performed only with Western type bundles with square fuel lattice. The present test series was the first confirmation of the coolability of VVER type bundles with triangular lattice. The accumulation of fuel pellet debris in the ballooned volume results in a local power peak, which leads to further slowing down of quench front. The first tests indicated that the effect of local power peak was less significant on the delay of cooling down than the effect of ballooning. (authors)

  13. The University of Alberta High Altitude Balloon Program (United States)

    Johnson, W.; Buttenschoen, A.; Farr, Q.; Hodgson, C.; Mann, I. R.; Mazzino, L.; Rae, J.; University of Alberta High Altitude Balloon Team


    The University of Alberta High Altitude Balloon (UA-HAB) program is a one and half year program sponsored by the Canadian Space Agency (CSA) that offers hands on experience for undergraduate and graduate students in the design, build, test and flight of an experimental payload on a high altitude balloon platform. Utilising low cost weather balloon platforms, and through utilisation of the CSA David Florida Laboratory for thermal-vacuum tests , in advance of the final flight of the payload on a NASA high altitude balloon platform. Collectively the program provided unique opportunities for students to experience mission phases which parallel those of a space satellite mission. The program has facilitated several weather balloon missions, which additionally provide educational opportunities for university students and staff, as well as outreach opportunities among junior and senior high school students. Weather balloon missions provide a cheap and quick alternative to suborbital missions; they can be used to test components for more expensive missions, as well as to host student based projects from different disciplines such as Earth and Atmospheric Sciences (EAS), Physics, and Engineering. In addition to extensive skills development, the program aims to promote recruitment of graduate and undergraduate students into careers in space science and engineering. Results from the UA-HAB program and the flight of the UA-HAB shielded Gieger counter payload for cosmic ray and space radiation studies will be presented. Lessons learned from developing and maintaining a weather balloon program will also be discussed. This project is undertaken in partnership with the High Altitude Student Platform, organized by Louisiana State University and the Louisiana Space Consortium (LaSpace), and sponsored by NASA, with the financial support of the Canadian Space Agency.

  14. Development of a super-pressure balloon with a diamond-shaped net --- result of a ground inflation test of a 2,000 cubic-meter balloon --- (United States)

    Saito, Yoshitaka; Nakashino, Kyoichi; Akita, Daisuke; Matsushima, Kiyoho; Shimadu, Shigeyuki; Goto, Ken; Hashimoto, Hiroyuki; Matsuo, Takuma


    A light super-pressure balloon has been developed using a method to cover a balloon with a diamond-shaped net of high-tensile fibers. The goal is to fly a payload of 900 kg to the altitude of 37 km with a 300,000 m^{3} balloon. Beginning from a demonstration test of the net-balloon with a 10 m^{3} balloon in 2010, we have been polished the net-balloon through ground inflation tests and flight tests, including a flight test of a 3,000 m ^{3} balloon in the tandem balloon configuration with a 15,000 m^{3} zero-pressure balloon in 2012, and a flight test of a 10 m^{3} balloon in the tandem balloon configuration with a 2 kg rubber balloon in 2013, as reported in the last COSPAR. In 2014, we developed a 5,000 m^{3} balloon and performed a ground inflation test to find that the balloon burst from a lip panel for termination with a differential pressure of 425 Pa. It was due to a stress concentration at the edge of a thick tape attached along the termination mechanism. In 2015, we modified the balloon by adding tapes on the lip panel to avoid the stress concentration, and also shorten the net length to leave some margin of the film and performed a ground inflation test again to find the balloon showed asymmetrical deployment and burst from the edge of the net with a differential pressure of 348 Pa. We consider it is due to the margin of the film along the circumferential direction, and proposed a gore shape which circumference length is kept as determined by the pumpkin shape of the balloon but setting meridian length longer than that. We developed a 10 m^{3} balloon with the gore design to find that the balloon deployed symmetrically and showed the burst pressure of 10,000 Pa. In 2016, we are going to develop a 2,000 m^{3} balloon with the gore design and perform its ground inflation test. In this paper, we are going to report its result with the sequence of the development.

  15. Fenestrated endovascular aortic repair for juxtarenal abdominal aortic aneurysm

    Institute of Scientific and Technical Information of China (English)

    GUO Wei; ZHANG Hong-peng; LIU Xiao-ping; JIA Xin; XIONG Jiang; MA Xiao-hui


    Background Endovascular stent-graft with fenestration can improve proximal sealing in patients with juxtarenal abdominal aortic aneurysm (JAAA).The purpose of this study was to describe our primary experience and evaluate the safety and efficacy of fenestrated device for JAAA in high-risk patients.Methods Between March 2011 and May 2012,nine male patients (mean age,(79.6±8.6) years) with asymptomatic JAAAs underwent elective deployment of the Zenith fenestrated stent-grafts at a single institution.All patients were treated in the hybrid operating room under general anesthesia.Follow-up computed tomography angiography (CTA) was routinely performed before discharge,at 3,6,and 12 months and annually thereafter.Results Procedural success was achieved in all cases.Total sixteen small fenestrations,two large fenestrations and eight scallops were used.Intra-operative complications occurred in four patients,which included one proximal type Ⅰ endoleak,two type Ⅱ endoleaks,and one renal artery dissection.The mean hospital stay was (8.9±1.4) days,mean blood loss was (360.5±46.8) ml,and mean iodinated contrast volume was (230.6±58.3) ml.The mean follow-up time was (7.6±4.2) months.The visceral graft patency was 100% until now.One patient had an increase of serum creatinine of more than 30%,but did not require dialysis.No patients died,no stent fractured,and migration were diagnosed during the follow-up.Conclusions The early results of fenestrated device for high-risk patients with complex JAAAs are satisfactory.However,long-term fenestrated graft durability and branch vessel patency remain to be determined.

  16. Successful treatment by transcatheter aortic valve implantation of severe aortic regurgitation in a patient with ascending aorta prosthesis. (United States)

    Rossi, Marco Luciano; Bocchi, Roberto; Barbaro, Cristina; Pagnotta, Paolo; Mennuni, Marco; Zavalloni, Dennis; Gasparini, Gabriele; Presbitero, Patrizia


    Severe aortic regurgitation (AR), when intervention is required, is managed by surgical aortic valve replacement (SAVR). Recently, transcatheter aortic valve replacement (TAVR) for severe aortic stenosis (AS) has shown non-inferiority to SAVR and superiority to medical management. TAVR could be a valid "off label" option to treat severe AR for patients unsuitable for SAVR due to their high surgical risk. Among aortic pathologies leading to severe AR, those involving the aortic root are considered as high risk procedures and thus prohibit TAVR. For these reasons TAVR is not an option for severe AR due to concomitant aortic root dilatation and degeneration. We report a successful case of TAVR for severe AR due to dilatation of degenerated tract of aortic root.

  17. Challenging Friesian horse diseases : aortic rupture and megaesophagus

    NARCIS (Netherlands)

    Ploeg, M.


    Aortic rupture is quite rare in Warmblood horses and is best known as an acute and fatal rupture of the aortic root in older breeding stallions. It has now become clear that aortic rupture, which is diagnosed around an age of 4 years, is more frequent in the Friesian breed than in others. The high p

  18. The risk for type B aortic dissection in Marfan syndrome

    NARCIS (Netherlands)

    den Hartog, Alexander W.; Franken, Romy; Zwinderman, Aeilko H.; Timmermans, Janneke; Scholte, Arthur J.; van den Berg, Maarten P.; de Waard, Vivian; Pals, Gerard; Mulder, Barbara J. M.; Groenink, Maarten


    BACKGROUND: Aortic dissections involving the descending aorta are a major clinical problem in patients with Marfan syndrome. OBJECTIVES: The purpose of this study was to identify clinical parameters associated with type B aortic dissection and to develop a risk model to predict type B aortic dissect

  19. Outcome of pregnancy in patients after repair of aortic coarctation

    NARCIS (Netherlands)

    Vriend, JWJ; Drenthen, W; Pieper, PG; Roos-Hesselink, JW; Zwinderman, AH; van Veldhuisen, DJ; Mulder, BJM


    Aims Nowadays, most women born with aortic coarctation reach childbearing age. However, data on outcome of pregnancy in women after repair of aortic coarctation are scarce. The aim of this study was to report on maternal and neonatal outcome of pregnancy in women after aortic coarctation repair. Met

  20. Transcatheter Aortic Valve Implantation: Insights into Clinical Complications

    NARCIS (Netherlands)

    R.M.A. van der Boon (Robert)


    markdownabstract__Abstract__ Transcatheter Aortic Valve Implantation (TAVI) has emerged as a viable and safe treatment for patients with severe aortic stenosis (AS) who are considered ineligible or at prohibitive risk for Surgical Aortic Valve Replacement (SAVR)1–4. The aim of the present thesis wa

  1. Study of Coronary Artery Disease in Single Aortic Valvular Disease

    Institute of Scientific and Technical Information of China (English)

    张斌; 杨伟民; 占亚平


    Objectives To analyze the results of coronary angiographies (GAG) in patients with single aortic valvular heart disease; To study the relationship between aortic valve diseases and coronary artery disease (CAD). Methods 105 patients with single aortic valvular heart disease before surgery underwent angiography. The data of clinical characteristics and angiographies were analyzed. Results 51 patients had symptoms of angina pectoris among 105 patients with single aortic valvular heart disease. Seven of them were confirmed coronary artery disease by angiographies. Although the incidence of angina in aortic valve stenosis group was significantly higher than that in aortic valve regurgitation, the probability of combination of CAD in aortic valve stenosis group was similar to the later. However, the probability of combination of CAD in degenerative aortic valve group was significantly higher than the groups of rheumatic, congenitally bicuspid aortic valves, and other causes (p <0.01).Conclusions Angina pectoris is not sensitive for diagnosis of CAD in single aortic valve heart disease.The probability of combination of CAD in degenerative aortic valve disease is higher than that in aortic valve disease with other causes. Coronary angiography is strongly suggested for these patients.

  2. Mitral Valve Aneurysm: A Rare Complication of Aortic Valve Endocarditis

    Directory of Open Access Journals (Sweden)

    A Moaref


    Full Text Available A 20-year-old intravenous drug abuser man, refered to our hospital with dyspnea and orthopnea. Tranesophagealechocardiography revealed severe aortic regurgitation, healed vegetation of aortic valve and an aneurysm of theanterior leaflet of the mitral valve. The patient was discharged after aortic valve replacement and mitral valverepair.

  3. Detection of pump degradation

    Energy Technology Data Exchange (ETDEWEB)

    Greene, R.H.; Casada, D.A.; Ayers, C.W. [and others


    This Phase II Nuclear Plant Aging Research study examines the methods of detecting pump degradation that are currently employed in domestic and overseas nuclear facilities. This report evaluates the criteria mandated by required pump testing at U.S. nuclear power plants and compares them to those features characteristic of state-of-the-art diagnostic programs and practices currently implemented by other major industries. Since the working condition of the pump driver is crucial to pump operability, a brief review of new applications of motor diagnostics is provided that highlights recent developments in this technology. The routine collection and analysis of spectral data is superior to all other technologies in its ability to accurately detect numerous types and causes of pump degradation. Existing ASME Code testing criteria do not require the evaluation of pump vibration spectra but instead overall vibration amplitude. The mechanical information discernible from vibration amplitude analysis is limited, and several cases of pump failure were not detected in their early stages by vibration monitoring. Since spectral analysis can provide a wealth of pertinent information concerning the mechanical condition of rotating machinery, its incorporation into ASME testing criteria could merit a relaxation in the monthly-to-quarterly testing schedules that seek to verify and assure pump operability. Pump drivers are not included in the current battery of testing. Operational problems thought to be caused by pump degradation were found to be the result of motor degradation. Recent advances in nonintrusive monitoring techniques have made motor diagnostics a viable technology for assessing motor operability. Motor current/power analysis can detect rotor bar degradation and ascertain ranges of hydraulically unstable operation for a particular pump and motor set. The concept of using motor current or power fluctuations as an indicator of pump hydraulic load stability is presented.

  4. Heritable retinoblastoma and accelerated aortic valve disease (United States)

    Abeyratne, L R; Kingston, J E; Onadim, Z; Dubrey, S W


    Heritable retinoblastoma is associated with a germline mutation in the tumour suppressor gene RBI. The Rb protein (pRb) arises from the RB1 gene, which was the first demonstrated cancer susceptibility gene in humans. 1 Second primary malignancies are recognised complications of retinoblastoma. Furthermore, pRb is implicated in valve remodelling in calcific aortic valve disease. 2 3 We report a family with hereditary retinoblastoma and associated secondary primary malignancies. There are two interesting aspects to this family. The first is the concept of ‘cancer susceptibility genes’; the RBI gene being the first reported in humans. A further feature of note is that two family members also have bicuspid aortic valves. We discuss a potential association between the gene defect responsible for retinoblastoma (with its associated propensity for further malignancies) and accelerated deterioration of the bicuspid aortic valve in the proband carrying this gene defect. PMID:23595191

  5. A Hemodynamic Predict of an Intra-Aorta Pump Application in Vitro Using Numerical Analysis (United States)

    Gao, Bin; Chen, Ningning; Chang, Yu

    The Intra-Aorta Pump is a novel LVAD assisting the native heart without percutaneous drive-lines. The Intra-Aorta Pump is emplaced between the radix aortae and the aortic arch to draw-off the blood from the left ventricle to the aorta. To predict the change of pressure drop and blood flow along with the change of pump speed, a nonlinear model has been made based on the structure and speed of the Intra-Aorta Pump. To do this, a nonlinear electric circuit for the Intra-Aorta Pump has been developed. The model includes two speed dependent current sources and flow dependent resistant to simulate the relationship between the pressure drop of the Intra-Aorta Pump and the flow through the pump along with the change of pump speed. The pressure drop and blood flow is derived by solving differential equations with variable coefficients. The parameters of the model are determined by experiment, and the results of the experiment show that these parameters change along with the change of the pump speed distinctness. The accuracy of the model is tested experimentally on a test loop. The comparison of the prediction data derived from the model with the experimental data shows that the error is lest than 15%. The experimental results showed that the model can predict the change of pressure drop and blood flow accurately.

  6. Champagne Heat Pump (United States)

    Jones, Jack A.


    The term champagne heat pump denotes a developmental heat pump that exploits a cycle of absorption and desorption of carbon dioxide in an alcohol or other organic liquid. Whereas most heat pumps in common use in the United States are energized by mechanical compression, the champagne heat pump is energized by heating. The concept of heat pumps based on other absorption cycles energized by heat has been understood for years, but some of these heat pumps are outlawed in many areas because of the potential hazards posed by leakage of working fluids. For example, in the case of the water/ammonia cycle, there are potential hazards of toxicity and flammability. The organic-liquid/carbon dioxide absorption/desorption cycle of the champagne heat pump is similar to the water/ammonia cycle, but carbon dioxide is nontoxic and environmentally benign, and one can choose an alcohol or other organic liquid that is also relatively nontoxic and environmentally benign. Two candidate nonalcohol organic liquids are isobutyl acetate and amyl acetate. Although alcohols and many other organic liquids are flammable, they present little or no flammability hazard in the champagne heat pump because only the nonflammable carbon dioxide component of the refrigerant mixture is circulated to the evaporator and condenser heat exchangers, which are the only components of the heat pump in direct contact with air in habitable spaces.

  7. Detection of pump degradation

    Energy Technology Data Exchange (ETDEWEB)

    Casada, D. [Oak Ridge National Lab., TN (United States)


    There are a variety of stressors that can affect the operation of centrifugal pumps. Although these general stressors are active in essentially all centrifugal pumps, the stressor level and the extent of wear and degradation can vary greatly. Parameters that affect the extent of stressor activity are manifold. In order to assure the long-term operational readiness of a pump, it is important to both understand the nature and magnitude of the specific degradation mechanisms and to monitor the performance of the pump. The most commonly applied method of monitoring the condition of not only pumps, but rotating machinery in general, is vibration analysis. Periodic or continuous special vibration analysis is a cornerstone of most pump monitoring programs. In the nuclear industry, non-spectral vibration monitoring of safety-related pumps is performed in accordance with the ASME code. Pump head and flow rate are also monitored, per code requirements. Although vibration analysis has dominated the condition monitoring field for many years, there are other measures that have been historically used to help understand pump condition; advances in historically applied technologies and developing technologies offer improved monitoring capabilities. The capabilities of several technologies (including vibration analysis, dynamic pressure analysis, and motor power analysis) to detect the presence and magnitude of both stressors and resultant degradation are discussed.

  8. Optically pumped atoms

    CERN Document Server

    Happer, William; Walker, Thad


    Covering the most important knowledge on optical pumping of atoms, this ready reference is backed by numerous examples of modelling computation for optical pumped systems. The authors show for the first time that modern scientific computing software makes it practical to analyze the full, multilevel system of optically pumped atoms. To make the discussion less abstract, the authors have illustrated key points with sections of MATLAB codes. To make most effective use of contemporary mathematical software, it is especially useful to analyze optical pumping situations in the Liouville spa

  9. Complexity Analysis of Balloon Drawing for Rooted Trees

    CERN Document Server

    Lin, Chun-Cheng; Poon, Sheung-Hung; Fan, Jia-Hao


    In a balloon drawing of a tree, all the children under the same parent are placed on the circumference of the circle centered at their parent, and the radius of the circle centered at each node along any path from the root reflects the number of descendants associated with the node. Among various styles of tree drawings reported in the literature, the balloon drawing enjoys a desirable feature of displaying tree structures in a rather balanced fashion. For each internal node in a balloon drawing, the ray from the node to each of its children divides the wedge accommodating the subtree rooted at the child into two sub-wedges. Depending on whether the two sub-wedge angles are required to be identical or not, a balloon drawing can further be divided into two types: even sub-wedge and uneven sub-wedge types. In the most general case, for any internal node in the tree there are two dimensions of freedom that affect the quality of a balloon drawing: (1) altering the order in which the children of the node appear in...

  10. Time-dependent strains and stresses in a pumpkin balloon (United States)

    Gerngross, T.; Xu, Y.; Pellegrino, S.

    This paper presents a study of pumpkin-shaped superpressure balloons consisting of gores made from a thin polymeric film attached to high stiffness meridional tendons This type of design is being used for the NASA ULDB balloons The gore film shows considerable time-dependent stress relaxation whereas the behaviour of the tendons is essentially time-independent Upon inflation and pressurization the instantaneous i e linear-elastic strain and stress distributions in the film show significantly higher values in the meridional direction However over time and due to the biaxial visco-elastic stress relaxation of the the gore material the em hoop strains increase and the em meridional stresses decrease whereas the em remaining strain and stress components remain substantially unchanged These results are important for a correct assessment of the structural integrity of a pumpkin balloon in a long-duration mission both in terms of the material performance and the overall stability of the shape of the balloon An experimental investigation of the time dependence of the biaxial strain distribution in the film of a 4 m diameter 48 gore pumpkin balloon is presented The inflated shape of selected gores has been measured using photogrammetry and the time variation in strain components at some particular points of these gores has been measured under constant pressure and temperature The results show good correlation with a numerical study using the ABAQUS finite-element package that includes a widely used model of

  11. Ballooning osteolysis in 71 failed total ankle arthroplasties. (United States)

    Singh, Gurpal; Reichard, Theresa; Hameister, Rita; Awiszus, Friedemann; Schenk, Katja; Feuerstein, Bernd; Roessner, Albert; Lohmann, Christoph


    Background and purpose - Aseptic loosening is a major cause of failure in total ankle arthroplasty (TAA). In contrast to other total joint replacements, large periarticular cysts (ballooning osteolysis) have frequently been observed in this context. We investigated periprosthetic tissue responses in failed TAA, and performed an element analysis of retrieved tissues in failed TAA. Patients and methods - The study cohort consisted of 71 patients undergoing revision surgery for failed TAA, all with hydroxyapatite-coated implants. In addition, 5 patients undergoing primary TAA served as a control group. Radiologically, patients were classified into those with ballooning osteolysis and those without, according to defined criteria. Histomorphometric, immunohistochemical, and elemental analysis of tissues was performed. Von Kossa staining and digital microscopy was performed on all tissue samples. Results - Patients without ballooning osteolysis showed a generally higher expression of lymphocytes, and CD3+, CD11c+, CD20+, and CD68+ cells in a perivascular distribution, compared to diffuse expression. The odds of having ballooning osteolysis was 300 times higher in patients with calcium content >0.5 mg/g in periprosthetic tissue than in patients with calcium content ≤0.5 mg/g (p < 0.001). Interpretation - There have been very few studies investigating the pathomechanisms of failed TAA and the cause-effect nature of ballooning osteolysis in this context. Our data suggest that the hydroxyapatite coating of the implant may be a contributory factor.

  12. Restenosis following balloon dilation of benign esophageal stenosis

    Institute of Scientific and Technical Information of China (English)

    Ying-Sheng Cheng; Ming-Hua Li; Ren-Jie Yang; Hui-Zhen Zhang; Zai-Xian Ding; Qi-Xin Zhuang; Zhi-Ming Jiang; Ke-Zhong Shang


    AIM: To elucidate the mechanism of restenosis following balloon dilation of benign esophageal stenosis.METHODS: A total of 49 rats with esophageal stenosis were induced in 70 rats using 5 ml of 50 % sodium hydroxide solution and the double-balloon method, and an esophageal restenosis (RS) model was developed by esophageal stenosis using dilation of a percutaneous transluminal coronary angioplasty (PTCA) balloon catheter. These 49 rats were divided into two groups: rats with benign esophageal stricture caused by chemical burn only (control group, n=21) and rats with their esophageal stricture treated with balloon catheter dilation (experimental group, n=28). Imaging analysis and immunohistochemistry were used for both quantitative and qualitative analyses of esophageal stenosis and RS formation in the rats, respectively.RESULTS: Cross-sectional areas and perimeters of the esophageal mucosa layer, muscle layer, and the entire esophageal layers increased significantly in the experimental group compared with the control group. Proliferating cell nuclear antigen (PCNA) was expressed on the 5th day after dilation, and was still present at 1 month. Fibronectin (FN)was expressed on the 1st day after dilation, and was still present at 1 month.CONCLUSION: Expression of PCNA and FN plays an important role in RS after balloon dilation of benign esophageal stenosis.

  13. Stratospheric balloons from Esrange - current and future capabilities (United States)

    Norberg, O.

    Stratospheric balloon operations have been carried out at the Swedish Space Corporation's rocket, balloon and satellite operations base Esrange since 1974; approximately 550 stratospheric balloons have been launched during this period. The facility, located in northern Sweden at 68 degrees north, is fully equipped with a large launch pad, payload and flight train preparation hangars, telemetry stations, recovery helicopters, and supporting infrastructure. Many of the scientific balloons launched are CNES missions. This paper will present the possibilities for scientific and technical balloon missions at high latitudes and with a vast landing area in northern Sweden, Finland, and Russia. The proximity to the Arctic polar vortex makes Esrange an ideal base for studies of for example the ozone destruction process in the Arctic. A new option proposed by the Swedish Space Corporation and NASA is to perform week-long missions from the south of Sweden to western Canada. A newly developed line-of-sight telemetry system, E-LINK, for high bit-rates (> 2 Mbps both downlink and uplink) and based on the Ethernet communication standard is also described.

  14. Anesthesia Approach in Endovascular Aortic Reconstruction

    Directory of Open Access Journals (Sweden)

    Ayşin Alagöl


    Full Text Available Introduction: We have analyzed our initial results of our anesthesia techniques in our new-onset endovascular aortic reconstruction cases.Patients and Methods: The perioperative data of 15 elective and emergent endovascular aortic reconstruction cases that were operated in 2010-2011 were collected in a database. The choice of anesthesia was made by the risk factors, surgical team’s preferences, type and location of the aortic pathology and by the predicted operation duration. The data of local and general anesthesia cases were compared.Results: Thirteen (86.7% cases were male and 2 (13.3% female. Eleven patients were in ASA Class III. The demographic parameters, ASA classifications, concurrent diseases were similar in both groups. Thirteen (86.7% cases had infrarenal abdominal aortic aneurysm and 2 (13.3% had Type III aortic dissection. The diastolic arterial pressures were lower in general anesthesia group in 20th and 40th minutes’ measurements just like the mean arterial pressure measurements at the 40th, 100th minutes and during the deployment of the graft. Postoperative mortality occurred in 3 (20.0% patients and they all had general anesthesia and they were operated on emergency basis. Postoperative morbidity occurred in four patients that had general anesthesia (acute renal failure, multi-organ failure and pneumonia. The other patient had atrial fibrillation on the 1st postoperative day and was converted to sinus rhythm with amiodarone infusion.Conclusion: Edovascular aortic reconstruction procedures can safely be performed with both general and local anesthesia less invasively compared to open surgery. General anesthesia may be preferred for the better hemodynamic control.

  15. Resonance wave pumping: wave mass transport pumping (United States)

    Carmigniani, Remi; Violeau, Damien; Gharib, Morteza


    It has been previously reported that pinching at intrinsic resonance frequencies a valveless pump (or Liebau pump) results in a strong pulsating flow. A free-surface version of the Liebau pump is presented. The experiment consists of a closed tank with a submerged plate separating the water into a free-surface and a recirculation section connected through two openings at each end of the tank. A paddle is placed at an off-centre position at the free-surface and controlled in a heaving motion with different frequencies and amplitudes. Near certain frequencies identified as resonance frequencies through a linear potential theory analysis, the system behaves like a pump. Particle Image Velocimetry (PIV) is performed in the near free surface region and compared with simulations using Volume of Fluid (VOF) method. The mean eulerian mass flux field (ρ) is extracted. It is observed that the flow is located in the vicinity of the surface layer suggesting Stokes Drift (or Wave Mass Transport) is the source of the pumping. A model is developped to extend the linear potential theory to the second order to take into account these observations. The authors would like to acknowledge the Gordon and Betty Moore Foundation for their generous support.

  16. Aortic valve replacement in octogenarians

    Directory of Open Access Journals (Sweden)

    Dark John H


    Full Text Available Abstract Background and Aims As our population ages and life expectancy increases the number of people aged over 80 and more referred for cardiac surgery is growing. This study sought to identify the outcome of aortic valve replacement (AVR in octogenarians. Methods 68 patients aged 80 years or more underwent AVR at the Freeman Hospital, between April 2001 and April 2004. A retrospective review of the notes and outcomes from the patients' GP and the NHS strategic tracking service was performed. 54% (37 underwent isolated AVR whilst 46% (31 underwent combined AVR and CABG. Results Follow up was 100% complete. The mean age was 83.1 ± s.d. 2.9 years, a mean gradient of 83 ± s.d. 31 mmHg and mean AVA of 0.56 cm2. The mean additive EuroSCORE was 8.6 ± s.d. 1.2, the logistic EuroSCORE mean 12.0 ± s.d. 5.9. In hospital 30 day mortality was 13 %. Survival was 80% at 1 year and 78% at 2 years. Median follow up was for 712 days. Stepwise logistic regression identified chronic obstructive airways disease as an independent predictor of mortality (p Conclusion Our study demonstrates that the operative mortality for AVR in the over eighties is good, whilst the mid to long term outcome is excellent There is a very low attrition rate with those undergoing the procedure living as long than their age matched population. This study confirms AVR is a safe, acceptable treatment for octogenarians with excellent mid term outcomes.

  17. Idiopathic thoracic aortic aneurysm at pediatric age. (United States)

    Marín-Manzano, E; González-de-Olano, D; Haurie-Girelli, J; Herráiz-Sarachaga, J I; Bermúdez-Cañete, R; Tamariz-Martel, A; Cuesta-Gimeno, C; Pérez-de-León, J


    A 6-year-old-boy presented with epigastric pain and vomiting over 1 year. Chest X-ray and esophagogastric transit showed a mediastinal mass. A chest computerized tomography angiogram demonstrated a descending thoracic aortic aneurysm. Analytical determinations carried out were all negative. The aneurysm was surgically repaired using a Dacron patch. The anatomopathological study described atherosclerotic lesions with calcifications, compatible with an atherosclerotic aneurysm wall. Aneurysms are uncommon in the pediatric population. Usually, no pathogenesis can be determined, and thus, such cases are grouped as idiopathic. Direct repair with or without patch is a therapeutic alternative in pediatric aneurysms and can allow the growth of the aortic circumference.

  18. Infective endocarditis following transcatheter aortic valve replacement-

    DEFF Research Database (Denmark)

    Loh, Poay Huan; Bundgaard, Henning; S�ndergaard, Lars


    Transcatheter aortic valve replacement (TAVR) can improve the symptoms and prognosis of patients with severe aortic stenosis who, due to a high expected operative risk, would not have otherwise been treated surgically. If these patients develop prosthetic valve endocarditis, their presentations may...... be atypical causing a delay in the diagnosis and treatment. The management is also complicated by their comorbidities, and surgical treatment may not be feasible leading to a significant morbidity and mortality. We describe a case of an 85-year-old man with TAVI prosthetic valve endocarditis successfully...

  19. Supravalvular aortic stenosis with sudden cardiac death

    Directory of Open Access Journals (Sweden)

    Pradeep Vaideeswar


    Full Text Available Sudden cardiac death (SCD most commonly results from previously undiagnosed congenital, acquired, or hereditary cardiac diseases. Congenital aortic valvular, subvalvular, and supravalvular disease with left ventricular outflow tract obstruction is an important preventable cause of sudden death. This report documents sudden death presumably due to acute myocardial ischemia in a young male with an undiagnosed supravalvular aortic stenosis (SVAS due to a rare association of isolation of coronary sinuses of Valsalva. Congenital supravalvular pulmonary stenosis and mitral valvular dysplasia were also present.

  20. Demanding pump power; Krevende pumpekraft

    Energy Technology Data Exchange (ETDEWEB)

    Lie, Oeyvind


    The potential for pump power in Norway is huge, but it is difficult to exploit it. Norway has some pumping plants, but these are built for seasonal pumping (pumping up to the magazine in the summer, and production in the winter). Pump power plants for short periods do not exist in Norway. (AG)

  1. Pump element for a tube pump

    DEFF Research Database (Denmark)


    relative to the rod element so as to allow for a fluid flow in the tube through the first valve member, along the rod element, and through the second valve member. The tube comprises an at least partly flexible tube portion between the valve members such that a repeated deformation of the flexible tube...... portion acts to alternately close and open the valve members thereby generating a fluid flow through the tube. The invention further relates to a pump element comprising at least two non-return valve members connected by a rod element, and for insertion in an at least partly flexible tube in such tube...... pump as mentioned above, thereby acting to generate a fluid flow through the tube upon repeated deformation of the tube between the two valve members. The pump element may comprise a connecting part for coupling to another tube and may comprise a sealing part establishing a fluid tight connection...

  2. Diffuse Supravalvular Aortic Stenosis: Surgical Repair in Adulthood

    Directory of Open Access Journals (Sweden)

    Giovanni Ferlan


    Full Text Available We present the case of a 54-year-old woman in which a diffuse congenital supravalvular aortic stenosis (SVAS was associated with a severe aortic valve incompetence and heavy calcification of the aortic annulus. Repair consisted in resection of the ascending aorta, patch augmentation of the hypoplastic aortic root and annulus, placement of a 20 mm Dacron tubular graft (Vascutek, Renfrewshire, UK and aortic valve replacement with a mechanical prosthesis (Sorin, Turin, Italy. Follow-up echocardiography demonstrated normal prosthetic valve function and a postoperative three-dimensional computed tomographic scan showed a normal shape of the reconstructed ascending aorta.

  3. Infected abdominal aortic aneurysm due to Morganella morganii: CT findings. (United States)

    Kwon, Oh Young; Lee, Jong Seok; Choi, Han Sung; Hong, Hoon Pyo; Ko, Young Gwan


    An infected aortic aneurysm, or mycotic aneurysm, is a rare arterial dilatation due to destruction of the infected vessel wall. Common pathogens resulting in an infected aortic aneurysm are Salmonella and Clostridium species, as well as Staphylococcus aureus; Morganella morganii, on the other hand, is very rare. An infected abdominal aortic aneurysm has tendencies to grow rapidly and to rupture. The mortality rate is high in patients undergoing emergent surgical intervention. We report the case of a 65-year-old man who presented with an infected abdominal aortic aneurysm caused by M. morganii. A high index of suspicion and imaging tests are necessary in order to diagnose an infected aortic aneurysm.

  4. Treatment of infrarenal abdominal aortic dissection concomitant with an aneurysm

    Institute of Scientific and Technical Information of China (English)

    WANG Li-xin; ZHU Ting; FU Wei-guo; WANG Yu-qi; XI Xun; GUO Da-qiao; CHEN Bin; JIANG Jun-hao; YANG Ju; SHI Zhen-yu


    @@ Aortic dissection occurs when layers of the aortic walls are separated by the blood flow through an intimal tear. Dissection of the aorta most frequently originates in the ascending aorta (70%), followed by the descending aorta (22%), the aortic arch (7%) and the abdominal aorta (1/%).1 The dissection limited to the abdominal aorta is rare.2 An isolated abdominal aortic dissection (IAAD) concomitant with an abdominal aortic aneurysm (AAA) is uncommon. We present here one patient with IAAD and AAA treated by endovascular therapy.

  5. Ideal ballooning modes, shear flow and the stable continuum (United States)

    Taylor, J. B.


    There is a well-established theory of ballooning modes in a toroidal plasma. The cornerstone of this is a local eigenvalue λ on each magnetic surface—which also depends on the ballooning phase angle k. In stationary plasmas, λ(k) is required only near its maximum, but in rotating plasmas its average over k is required. Unfortunately in many cases λ(k) does not exist for some range of k, because the spectrum there contains only a stable continuum. This limits the application of the theory, and raises the important question of whether this ‘stable interval’ gives rise to significant damping. This question is re-examined using a new, simplified, model—which leads to the conclusion that there is no appreciable damping at small shear flow. In particular, therefore, a small shear flow should not affect ballooning mode stability boundaries.

  6. Ideal MHD Ballooning modes, shear flow and the stable continuum

    CERN Document Server

    Taylor, J B


    There is a well established theory of Ballooning modes in a toroidal plasma. The cornerstone of this is a local eigenvalue lambda on each magnetic surface - which also depends on the ballooning phase angle k. In stationary plasmas lambda(k) is required only near its maximum, but in rotating plasmas its average over k is required. Unfortunately in many case lambda(k) does not exist for some range of k, because the spectrum there contains only a stable continuum. This limits the application of the theory, and raises the important question of whether this "stable interval" gives rise to significant damping. This question is re-examined using a new, simplified, model - which leads to the conclusion that there is no appreciable damping at small shear flow. In particular, therefore, a small shear flow should not affect Ballooning mode stability boundaries.

  7. Tokamak resistive magnetohydrodynamic ballooning instability in the negative shear regime

    Institute of Scientific and Technical Information of China (English)

    Shi Bing-Ren; Lin Jian-Long; Li Ji-Quan


    Improved confinement of tokamak plasma with central negative shear is checked against the resistive ballooning mode. In the negative shear regime, the plasma is always unstable for purely growing resistive ballooning mode. For a simplest tokamak equilibrium model, the s-α model, characteristics of this kind of instability are fully clarified by numerically solving the high n resistive magnetohydrodynamic ballooning eigen-equation. Dependences of the growth rate on the resistivity, the absolute shear value, the pressure gradient are scanned in detail. It is found that the growth rate is a monotonically increasing function of a while it is not sensitive to the changes of the shear s, the initial phase θ0 and the resistivity parameter εR.

  8. Iridium: Global OTH data communications for high altitude scientific ballooning (United States)

    Denney, A.

    While the scientific community is no stranger to embracing commercially available technologies, the growth and availability of truly affordable cutting edge technologies is opening the door to an entirely new means of global communications. For many years high altitude ballooning has provided science an alternative to costly satellite based experimental platforms. As with any project, evolution becomes an integral part of development. Specifically in the NSBF ballooning program, where flight durations have evolved from the earlier days of hours to several weeks and plans are underway to provide missions up to 100 days. Addressing increased flight durations, the harsh operational environment, along with cumbersome and outdated systems used on existing systems, such as the balloon vehicles Support Instrumentation Package (SIP) and ground-based systems, a new Over-The-Horizon (OTH) communications medium is sought. Current OTH equipment planning to be phased-out include: HF commanding systems, ARGOS PTT telemetry downlinks and INMARSAT data terminals. Other aspects up for review in addition to the SIP to utilize this communications medium include pathfinder balloon platforms - thereby, adding commanding abilities and increased data rates, plus providing a package for ultra-small experiments to ride aloft. Existing communication systems employed by the National Scientific Balloon Facility ballooning program have been limited not only by increased cost, slow data rates and "special government use only" services such as TDRSS (Tracking and Data Relay Satellite System), but have had to make special provisions to geographical flight location. Development of the Support Instrumentation Packages whether LDB (Long Duration Balloon), ULDB (Ultra Long Duration Balloon) or conventional ballooning have been plagued by non-standard systems configurations requiring additional support equipment for different regions and missions along with a myriad of backup for redundancy. Several

  9. Aortic root and proximal aortic arch replacement (performed by a left-handed surgeon). (United States)

    Carrel, Thierry


    We present our standard technique of composite graft replacement performed by a left-handed surgeon. This procedure is performed with a 30-day mortality comparable to that of elective isolated aortic valve replacement.

  10. To sail the skies of Mars - Scientific ballooning on the red planet (United States)

    Gaidos, Eric J.; Burke, James D.


    Balloons represent a novel approach to exploring the surface of Mars. One promising aerostat system incorporates a solar-powered balloon as a means of generating diurnally varying lift and so can 'hop' across the surface, obtaining detailed information at a large number of sites. Two important areas of research and testing are underway on solar balloon technology and balloon payload design. The solar balloon concept has been demonstrated on earth, but more work is needed on a 'flyable' version for Mars. Particular attention must be paid to radiation heat transfer and aerodynamic effects. A special 'snake' payload concept has been demonstrated that allows for balloon system traverses of the surface and provides a usable instrument platform. A balloon system of this type could obtain unique surface imaging and physical and chemical data. The flight of the balloon also provides in situ atmospheric boundary-layer and circulation measurements.

  11. Balloon vetebroplasty with calcium phosphate cement augmentation for direct restoration of traumatic thoracolumbar vertebral fractures

    NARCIS (Netherlands)

    Verlaan, JJ; van Helden, WH; Oner, FC; Verbout, AJ; Dhert, WJA


    Study Design. A human cadaveric model was used to evaluate balloon vertebroplasty in traumatic vertebral fractures. Objectives. To assess the feasibility and safety of balloon vertebroplasty followed by calcium phosphate cement augmentation to prevent recurrent kyphosis. Summary of Background Data.

  12. Matrix metalloproteinase inhibition reduces adventitial thickening and collagen accumulation following balloon dilation

    NARCIS (Netherlands)

    Sierevogel, MJ; Velema, E; van der Meer, FJ; Nijhuis, MO; de Kleijn, DPV; Borst, C; Pasterkamp, G


    Objective: Constrictive arterial remodeling following balloon angioplasty has been related to adventitial collagen accumulation and subsequent thickening and can be prevented by matrix ructalloprotemase (MMP) inhibition. Following balloon dilation, we examined the effect of MMP inhibition on colla-e

  13. Congenital quadricuspid aortic valve: analysis of 11 surgical cases

    Institute of Scientific and Technical Information of China (English)

    TANG Yang-feng; XU Ji-bin; HAN Lin; LU Fang-lin; LANG Xi-long; SONG Zhi-gang; XU Zhi-yun


    Background Congenital quadricuspid aortic valve is rarely seen during aortic valve replacement (AVR).The diagnosis and treatment of the disease were reported in 11 cases.Methods Eleven patients (nine men and two women,mean age 33.4 years) with quadricuspid aortic valve were retrospectively evaluated.Medical records,echocardiograms and surgical treatment were reviewed.Results In accordance with the Hurwitz and Roberts classification,the patients were classified as type A (n=2),type B (n=7),type F (n=1) and type G (n=1).Three patients were associated with other heart diseases,including infective endocarditis and mitral prolaps,left superior vena cava,aortic aneurysm.All had aortic regurgitation (AR) except two with aortic stenosis (AS),detected by color-flow Doppler echocardiography.The congenital quadricuspid aortic valve deformity in seven patients was diagnosed by echocardiography.All patients underwent successful aortic valve replacement.Conclusion Quadricuspid aortic valve is a rare cause of aortic insufficiency,while echocardiography plays an important role in diagnosing the disease.Aortic valve replacement is the major therapy for the disease.

  14. Experimental study on aortic remodeling in sinoaortic denervated rats

    Institute of Scientific and Technical Information of China (English)

    MIAO Chao-yu; TAO Xia; GUAN Yun-feng; YANG You-cai; CHU Zheng-xu; SU Ding-feng


    Objective: To study the aortic remodeling produced by chronic sinoaortic denervation (SAD) and its time course, and to study the role of humoral factor in the SAD-induced aortic remodeling. Methods: In rats with chronic SAD or sham operation, the aortic structure was measured by computer-assisted image analysis, the aortic function by isolated artery preparation, and angiotensin Ⅱ concentration by radioimmunoassay. Results and Conclusion: The aortic structural remodeling developed progressively at 4, 8, 16 and 32 weeks after SAD. Aortic structural remodeling after SAD expressed mainly as aortic hypertrophy due to SMC growth and collagen accumulation. The aortic contraction elicited by norepinephrine (NE) was progressively increased 8, 16 and 32 weeks after SAD. The aortic relaxation elicited by acetylcholine (ACh) was depressed 8, 16 and 32 weeks after SAD. In addition, in 32-week SAD rats the NE-induced contraction was not increased by endothelial denudation. These indicated that the increased contraction and depressed relaxation after SAD were related to the change of endothelium and/or the change of interaction between endothelium and SMC. In 10-week SAD rats, plasma angiotensin Ⅱ concentration remained unchanged, whereas aortic angiotensin Ⅱ concentration was significantly increased, suggesting that activation of tissue renin-angiotensin system may be involved in SAD-induced aortic remodeling.

  15. Evolution of NASA Scientific Ballooning and Particle Astrophysics Research (United States)

    Jones, William Vernon


    Particle astrophysics research has a history in ballooning that spans over 100 years, ever since Victor Hess discovered cosmic rays on a manned balloon in 1912. The NASA Particle Astrophysics Program currently covers the origin, acceleration and transport of Galactic cosmic rays, plus the Nature of Dark Matter and Ultrahigh Energy Neutrinos. Progress in each of these topics has come from sophisticated instrumentation flown on Long Duration Balloon (LDB) flights around Antarctica for more than two decades. Super Pressure Balloons (SPB) and International Space Station (ISS) platforms are emerging opportunities that promise major steps forward for these and other objectives. NASA has continued development and qualification flights leading to SPB flights capable of supporting 1000 kg science instruments to 33 km for upwards of hundred day missions, with plans for increasing the altitude to 38 km. This goal is even more important now, in view of the Astro2010 Decadal Study recommendation that NASA should support Ultra-Long Duration Balloon (ULDB) flight development for studies of particle astrophysics, cosmology and indirect detection of dark matter. The mid-latitude test flight of an 18.8 MCF SPB launched from Wanaka, NZ in 2015 achieved 32 days of nearly constant altitude exposure, and an identical SPB launched from Wanaka in 2016 with a science payload flew for 46 days. Scientific ballooning as a vital infrastructure component for cosmic ray and general astrophysics investigations, including training for young scientists, graduate and undergraduate students, leading up to the 2020 Decadal Study and beyond, will be presented and discussed.

  16. Near Space Lab-Rat Experimentation using Stratospheric Balloon (United States)

    Buduru, Suneel Kumar; Reddy Vizapur, Anmi; Rao Tanneeru, Venkateswara; Trivedi, Dharmesh; Devarajan, Anand; Pandit Manikrao Kulkarni, MR..; Ojha, Devendra; Korra, Sakram; Neerudu, Nagendra; Seng, Lim; Godi, Stalin Peter


    First ever balloon borne lab-rat experiment up to near space stratospheric altitude levels carried out at TIFR Balloon Facility, Hydeabad using zero pressure balloons for the purpose of validating the life support system. A series of two balloon experiments conducted under joint collaboration with IN.Genius, Singapore in the year 2015. In these experiments, three lab-rats sent to stratosphere in a pressurized capsule designed to reach an altitude of 30 km by keeping constant pressure, temperature and maintained at a precise rate of oxygen supply inside the capsule. The first experiment conducted on 1 ^{st} February, 2015 with a total suspended weight of 225 kg. During the balloon ascent stage at 18 km altitude, sensors inside the capsule reported drastic drop in internal pressure while oxygen and temperatures maintained at correct levels resulted in premature fligt termination at 20.1 km. All the three lab-rats recovered without life due to the collapse of their lungs caused by the depressurization inside the capsule. The second experiment conducted on 14th March, 2015 using a newly developed capsule with rectification of depressurization fault by using improved sealing gaskets and hermitically sealed connectors for sending lab-rats again to stratosphere comprising a total suspended load of 122.3 kg. The balloon flight was terminated after reaching 29.5 km in 110 minutes and succesfully recovered all the three lab-rats alive. This paper focuses on lessons learnt of the development of the life support system as an integral pressurized vessel, flight control instrumentation, flight simulation tests using thermo-vaccum chamber with pre-flight operations.

  17. Paclitaxel-coated balloons - Survey of preclinical data. (United States)

    Schnorr, B; Kelsch, B; Cremers, B; Clever, Y P; Speck, U; Scheller, B


    Restenosis following interventions in the coronary or peripheral arteries develops over weeks to months. In coronary arteries the restenosis rate has been markedly reduced since the advent of drug-eluting stents. Non-stent-based methods for local drug delivery enable restenosis inhibition without the need for stent implantation, does not permanently change the structure of the vessel, are repeatable, and seems to be applicable where drug-eluting stents provide insufficient protection. Preclinical data indicate that short exposure of the vessel wall to a lipophilic inhibitor of cell proliferation is sufficient for preventing restenosis. Initial evidence to this effect emerged from an investigation of paclitaxel embedded in a matrix that enhances the solubility and release of the agent from the balloon coating as well as its transfer to the vessel wall. Further corroborating data from preclinical and clinical studies demonstrating a reduction in late lumen loss and lower restenosis rates led to the market introduction of a variety of paclitaxel-coated angioplasty balloons. The effectiveness of restenosis inhibition is not determined by the active agent alone. Other factors that are crucial for the effectiveness and safety of drug-coated angioplasty balloons are the formulation containing the agent and the coating technique. In this review we first outline the development of paclitaxel-coated balloons to then provide an overview of the preclinical results obtained with different paclitaxel-coated balloons and finally compare these with the outcome in patients. The article concludes with a short outlook on initial results with a zotarolimus-coated angioplasty balloon.

  18. Second-generation endometrial ablation technologies: the hot liquid balloons. (United States)

    Vilos, George A; Edris, Fawaz


    Hysteroscopic endometrial ablation (HEA) was introduced in the 1980s to treat menorrhagia. Its use required additional training, surgical expertise and specialized equipment to minimize emergent complications such as uterine perforations, thermal injuries and excessive fluid absorption. To overcome these difficulties and concerns, thermal balloon endometrial ablation (TBEA) was introduced in the 1990s. Four hot liquid balloons have been introduced into clinical practice. All systems consist of a catheter (4-10mm diameter), a silicone balloon and a control unit. Liquids used to inflate the balloons include internally heated dextrose in water (ThermaChoice, 87 degrees C), and externally heated glycine (Cavaterm, 78 degrees C), saline (Menotreat, 85 degrees ) and glycerine (Thermablate, 173 degrees C). All balloons require pressurization from 160 to 240 mmHg for treatment cycles of 2 to 10 minutes. Prior to TBEA, preoperative endometrial thinning, including suction curettage, is optional. Several RCTs and cohort studies indicate that the advantages of TBEA include portability, ease of use and short learning curve. In addition, small diameter catheters requiring minimal cervical dilatation (5-7 mm) and short duration of treatment cycles (2-8 min) allow treatment under minimal analgesia/anesthesia requirements in a clinic setting. Following TBEA serious adverse events, including thermal injuries to viscera have been experienced. To minimize such injuries some surgeons advocate the use of routine post-dilatation hysteroscopy and/or ultrasonography to confirm correct intrauterine placement of the balloon prior to initiating the treatment cycle. After 10 years of clinical practice, TBEA is thought to be the preferred first-line surgical treatment of menorrhagia in appropriately selected candidates. Economic modeling also suggested that TBEA may be more cost-effective than HEA.

  19. Balloon-Borne Infrasound Detection of Energetic Bolide Events (United States)

    Young, Eliot F.; Ballard, Courtney; Klein, Viliam; Bowman, Daniel; Boslough, Mark


    Infrasound is usually defined as sound waves below 20 Hz, the nominal limit of human hearing. Infrasound waves propagate over vast distances through the Earth's atmosphere: the CTBTO (Comprehensive Nuclear-Test-Ban Treaty Organization) has 48 installed infrasound-sensing stations around the world to detect nuclear detonations and other disturbances. In February 2013, several CTBTO infrasound stations detected infrasound signals from a large bolide that exploded over Chelyabinsk, Russia. Some stations recorded signals that had circumnavigated the Earth, over a day after the original event. The goal of this project is to improve upon the sensitivity of the CTBTO network by putting microphones on small, long-duration super-pressure balloons, with the overarching goal of studying the small end of the NEO population by using the Earth's atmosphere as a witness plate.A balloon-borne infrasound sensor is expected to have two advantages over ground-based stations: a lack of wind noise and a concentration of infrasound energy in the "stratospheric duct" between roughly 5 - 50 km altitude. To test these advantages, we have built a small balloon payload with five calibrated microphones. We plan to fly this payload on a NASA high-altitude balloon from Ft Sumner, NM in August 2016. We have arranged for three large explosions to take place in Socorro, NM while the balloon is aloft to assess the sensitivity of balloon-borne vs. ground-based infrasound sensors. We will report on the results from this test flight and the prospects for detecting/characterizing small bolides in the stratosphere.

  20. Factors influencing long-term survival after aortic valve replacement.

    Directory of Open Access Journals (Sweden)



    Full Text Available In the aortic stenosis group, the left ventricular (LV muscle mass index was a good parameter for predicting the prognosis. Associated mitral valve disease had no influence on long term survival after aortic valve replacement. In the aortic insufficiency group, associated mitral valve disease had a marked influence on the results of aortic valve replacement. In general, the aortic insufficiency group had less clinical improvement postoperatively than the aortic stenosis group. In the annuloaortic ectasia group, left ventricular enddiastolic pressure (LVEDP might be the predictor to the prognosis. This group had the worst prognosis, of the three groups. Early operation should be considered for patients who have no, or only mild symptoms of, aortic valve disease.