Significant adhesion reduction and time saving in pediatric heart surgery with 4DryField PH: A retrospective, controlled study.

Adhesions formation after surgery for congenital heart defects can complicate follow-up procedures due to bleeding from detached adhesion bands, injury to cardiac structures or large vessels, all of which do prolong operation times. The problem is enhanced by the fact that detached adhesions are predilection sites for new adhesions setting off a downward spiral. 4DryField® PH gel barrier has demonstrated high efficacy in reducing postoperative adhesions in general surgical and gynecological studies.

Gas phase Elemental abundances in Molecular cloudS (GEMS) II. On the quest for the sulphur reservoir in molecular clouds: the HS case.

Context: Sulphur is one of the most abundant elements in the Universe. Surprisingly, sulphuretted molecules are not as abundant as expected in the interstellar medium and the identity of the main sulphur reservoir is still an open question.

Aims: Our goal is to investigate the HS chemistry in dark clouds, as this stable molecule is a potential sulphur reservoir.

Multipass millimeter/submillimeter spectrometer to probe dissociative reaction dynamics.

We present here the instrument design and first experimental results from a multipass millimeter/submillimeter spectrometer designed to probe dissociative reaction dynamics. This work focuses on benchmarking the instrument performance through detection of the CH3O and H2CO products from methanol dissociation induced by a high-voltage plasma discharge. Multiple rotational lines from CH3O and H2CO were observed when this plasma discharge was applied to a sample of methanol vapor seeded in an argon supersonic expansion.

Evaluation of coumarin derivatives as anti-fungal agents against soil-borne fungal pathogens.

Development of new and safer pesticides that are target-specific is backed by a strong Federal, public and commercial mandate. In order to generate a new generation of pesticides that are more ecologically friendly and safe, natural products are being evaluated for pesticidal activities. Many plant-derived chemicals have proven pesticidal properties, including compounds like sesamol (3,4-Methylenedioxyphenol), a lipid from sesame oil and coumarins (1,2-Benzopyrone) found in a variety of plants such as clover, sweet woodruff and grasses.

Reduction in blood product usage associated with routine use of mini bypass systems in extracorporeal circulation.

Objective: The objective of this study is to investigate the hypothesis that a reduced prime extracorporeal circulation (ECC) system and ensuing reduction in patient hemodilution can affect blood product use.

Methods: We performed a prospective, randomized study from a group of 60 consecutive coronary artery bypass graft (CABG) patients, comparing blood product usage and postoperative bleeding in 30 mini bypass systems (n = 30) to 30 conventional systems (n = 30). The patient demographics in terms of patient weight, height, age, preoperative hemoglobin, preoperative hematocrit, BSA, ejection fraction, and NYHA were not statistically significant.

Influence of a tilting prosthetic mitral valve orientation on the left ventricular flow - an experimental in vivo magnetic resonance imaging study.

Objective: Orientation-related monoleaflet mechanical valve flow and velocity studies in the downstream are limited in mitral valve replacement studies.

Methods: In five sheep, ventricular blood flow was visualized prior to the implantation of a Medtronic Hall tilting valve model. In six sheep, the implant orientation was either anatomical (disc aligned with the anterior leaflet) or anti-anatomical.

Clinical advantages of using mini-bypass systems in terms of blood product use, postoperative bleeding and air entrainment: an in vivo clinical perspective.

Objective: In an effort to minimize the effect of extracorporeal circulation (ECC), mini-bypass is gaining clinical acceptance in routine coronary artery bypass grafting (CABG). These small circuits target combine the clinical advantages of reduced prime, 100% bio-coating and suction blood separation. We demonstrate that the use of mini-bypass in routine CABG reduces homologous blood product use and postoperative bleeding.

Hemolysis, high-intensity transient signals (HITS) and hemodynamic results after aortic valve replacement with the Medtronic Hall Easy-Fit heart valve prosthesis.

Background And Aim Of The Study: Previous studies have shown a correlation between type, orientation and valve size of mechanical heart valve prostheses and the incidence of high-intensity transient signals (HITS). The study aim was to investigate the presence of HITS and hemolysis and the impact of valve size and hemodynamic parameters following aortic valve replacement (AVR) using the new Medtronic Hall Easy-Fit prosthesis.

Methods: A total of 150 patients (120 males, 30 females; mean age 62 +/- 8 years; range: 32-78 years) underwent AVR (n = 94; 63% concomitant procedures) with the Easy-Fit valve in its optimal orientation.

Comparison of conventional extracorporeal circulation and minimal extracorporeal circulation with respect to microbubbles and microembolic signals.

The intention of minimal extracorporeal circulation (MECC) is to reduce priming volume and minimize contact of blood with polymers and air in a closed system. In contrast to conventional extracorporeal circulation (ECC), a venous reservoir is missing. Thus, air trapping is limited and avoidance of bubble embolism is a major concern.

Use of a dynamic bubble trap in the arterial line reduces microbubbles during cardiopulmonary bypass and microembolic signals in the middle cerebral artery.

Neurological complications remain an important cause of morbidity and mortality of patients following cardiopulmonary bypass (CPB). Microemboli, as well as cerebral hypoperfusion, are the main postulated mechanisms. This study demonstrates that the insertion of a dynamic bubble trap (DBT) into the curcuit reduces microbubbles in the arterial line and microembolic signals (MES) in the middle cerebral arteries (MCAs).

Neuropsychological deficits after mechanical aortic valve replacement.

Background And Aim Of The Study: Studies using transcranial Doppler monitoring have identified high-intensity transient signals (HITS) after mechanical valve replacement. Although cognitive dysfunction in relation to HITS was reported in some studies, the current data basis is inconsistent. The study aim was to investigate the long-term effects of HITS on cognitive function.

Influence of bileaflet prosthetic mitral valve orientation on left ventricular flow--an experimental in vivo magnetic resonance imaging study.

Objective: Orientation-related bileaflet mechanical valve flow and velocity studies in the downstream area are limited in mitral valve replacement studies.

Methods: In five sheep, ventricular blood flow was visualized prior to the implantation of a mitral Edwards Mira Bileaflet Mechanical Valve Model 9600. The implant orientation was either anatomic, with a 45 degrees rotation, or anti-anatomic, with a 90 degrees rotation.

The dynamic bubble trap reduces microbubbles in extracorporeal circulation and high intensity transient signals in the middle cerebral artery: a case report.

Microemboli during extracorporeal circulation (ECC) might be a reason for postoperative neuropsychological dysfunction. This case report shows that reduction of microbubbles in the arterial line, as well as high intensity transient signals (HITS) in the middle cerebral artery (MCA), could be accomplished by use of a dynamic bubble trap (DBT) during routine coronary artery bypass graft (CABG) surgery in a 63-year-old male. The DBT was placed after the arterial filter, an ultrasound Doppler device was used for detection of microemboli before and after the DBT.

Impact of high intensity transient signals on the choice of mechanical aortic valve substitutes.

Objective: High intensity transient signals (HITS) observed during extracorporeal circulation and following mechanical valve replacement are suspected of causing cognitive dysfunction (deterioration of episodic and working memory). This study evaluates the role played by valve design (bileaflet versus tilting disc) and other parameters in the incidence of HITS.

Methods: Thirty patients were selected for the study as follows: 18 males, 58-78 years of age; ten St.

[Turbulence and high intensity transient signals (HITS) as a parameter for optimum orientation of mechanical heart valves].

Background: In previous studies, the impact of valve orientation on the hemodynamic performance of mechanical aortic valves has been demonstrated. This study investigates Turbulence (RNS values) and High Intensity Transient Signals (HITS) as a new and objective parameter for hemodynamics in various orientations of Medtronic Hall (MH) and St. Jude Medical (SJM) aortic valves.

[Turbulence and high intensity transient signals (HITS) as a parameter for optimum orientation of mechanical heart valves].

Background: In previous studies, the impact of valve orientation on the hemodynamic performance of mechanical aortic valves has been demonstrated. This study investigates Turbulence (RNS values) and High Intensity Transient Signals (HITS) as a new and objective parameter for hemodynamics in various orientations of Medtronic Hall (MH) and St. Jude Medical (SJM) aortic valves.

High-intensity transient signals (HITS) as a parameter for optimum orientation of mechanical aortic valves.

Background: In previous studies [1,2], the impact of valve orientation on the hemodynamic performance of mechanical aortic valves has been demonstrated. This study investigates Turbulence (RNS values) and High Intensity Transient Signals (HITS) as a new and objective parameter for hemodynamics in different orientations of Medtronic Hall (MH) and St. Jude Medical (SJM) aortic valves.

Tilting disc versus bileaflet aortic valve substitutes: intraoperative and postoperative hemodynamic performance in humans.

Background And Aim Of The Study: Due to an asymmetrical/eccentric flow profile at the level of the aortic valve, there is an optimal orientation for each aortic valve design. This study evaluates intraoperative flow dynamics (turbulence and pressure gradient) and follow up results (pressure gradient and left ventricular mass regression) for Medtronic Hall tilting disc (MH) and St. Jude Medical bileaflet (SJM) valves, with both valves in their optimum orientation as defined in previous animal experiments.

Downstream turbulence and high intensity transient signals (HITS) following aortic valve replacement with Medtronic Hall or St. Jude Medical valve substitutes.

Objective: High intensity transient signals (HITS) representing microembolization to the brain have been found to contribute to cognitive impairment and psychoneurological dysfunction in patients carrying a mechanical aortic valve. It is unknown, whether HITS represent gaseous or solid emboli. This animal study evaluates the impact of valve orientation on HITS for two different mechanical valves with both valves implanted in their best and worst orientation, which has been defined in previous studies with respect to downstream turbulence.

Orientation of tilting disc and bileaflet aortic valve substitutes for optimal hemodynamics.

Procedures for implantation of mechanical aortic valves have to consider eccentric flow in the aortic root. We describe how to optimize orientation of tilting disc (Medtronic Hall) and bileaflet (St. Jude Medical) valves.

[Increased acceptance of the International Normalized Ratio (INR) as a monitoring parameter of oral anticoagulation therapy in Germany. GELIA Study Group].

In 1994 the German Cardiac Society recommended the International Normalized Ratio (INR) instead of "Quick's test" for the long-term management of oral anticoagulation therapy. Parallel cardiac surgical centers in Germany and Switzerland started patient recruitment for the GELIA study (German Experience with Low Intensity Anticoagulation). By the end of 1996, 862 consecutive patients with mechanical heart valve replacement had been enrolled.

Medtronic Hall versus St. Jude Medical mechanical aortic valve: downstream turbulences with respect to rotation in pigs.

Background And Aims Of The Study: Turbulences downstream of mechanical aortic valves are known to contribute to most valve-related complications such as thrombosis, embolization or damage to blood components. In vitro studies have demonstrated the impact of the orientation of prostheses on transvalvular energy loss. This study evaluates the influence of valve orientation on turbulences in the supravalvular aorta in pigs.

Hydrodynamic function of tilting disc prostheses and bileaflet valves in double valve replacement.

Objective: To determine the energy loss attributable to prosthetic valve size and design in double valve replacement, energy consumption of mitral valves (size #25 to #29), of two different designs (Bjork Shiley tilting disc and Carbomedics bileaflet valves), in combination with a small (#21) and large sized (#27) aortic prosthesis, were analyzed in a flow simulator.

Methods: A pulsatile flow simulator was used to reproduce physiological ventricular dynamics and to match the input and output impedances of the human left ventricle. Hydrodynamic performance was determined as stroke work, closing work and leak work for each combination of valves at low flow (5 liters per minute) and high flow (9 liters per minute) conditions.

Hydrodynamic performance of Carbomedics valves in double valve replacement.

Most patients undergoing double valve replacements have reduced myocardial capacity. However, little is known about the influence of valve sizes on myocardial energy consumption in double valve replacement. This study was designed to supply hydrodynamic data for the proper selection of sizes in double valve replacement.

Malperfusion of the thoracoabdominal vasculature in aortic dissection.

Ischemic damage to vital organs supplied by the thoracoabdominal aorta greatly increases the overall risk of aortic dissection. Of 320 patients operated upon for aortic dissection since 1985, 33 (10.3%) underwent operations directed at the relief of malperfusion (15/158 acute type A; 9/18 acute type B; 4/78 chronic type A; 5/66 chronic type B).